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Chemoembolization is a palliative treatment for liver cancer. This can be a cancer originating in the liver or a cancer that has spread ("metastasized") to the liver from other areas in the body. During chemoembolization, chemotherapy drugs are injected directly into the artery that supplies blood to the tumor in the liver. The artery is then blocked off ("embolized") with a mixture of oils and tiny particles. This procedure accomplishes four things:

 

1. The tumor becomes deprived of oxygen and nutrients once the blood supply is blocked.
2. Because these drugs are injected directly at the tumor site, this dosage is 20 to 200 times greater than achieved with standard chemotherapy injected into a vein in the arm.
3. Because the artery is blocked, no blood washes through the tumor. As a result, the drugs stay in the tumor for a much longer time - as long as a month.
4. There is a decrease in side effects because the drugs are trapped in the liver instead of circulating throughout the body.

 

The liver is unique in having two blood supplies - an artery (the hepatic artery) and a large vein (the portal vein). The normal liver gets about 75% of its blood from the portal vein and only 25% of its blood from the hepatic artery. When a tumor grows in the liver, it receives almost all of its blood supply from the hepatic artery. Therefore, chemotherapy drugs injected into the hepatic artery at the liver reach the tumor very directly, sparing most of the healthy liver tissue. Then, when the artery is blocked, nearly all of the blood is taken away from the tumor, while the liver continues to be supplied by blood from the portal vein.

 

Remember, chemoembolization only treats tumors in the liver and will have little or effect on any other cancer in the body. For example, the following liver cancers may be treated by chemoembolization:

 

Hepatoma (primary liver cancer) Matastasis (spread) to the liver from: Colon cancer Carcinoid Ocular melanoma Sarcomas  A primary tumor in another part of the body

The radiologist may recommend that you have several tests, including liver function blood tests, and a CT scan or an MRI of your liver prior to the chemoembolization procedure. The radiologist will check these test results to make sure you do not have: 

The evening before the exam you may not eat or drink anything. You will be instructed which medications you may take in the morning, and when to arrive at the hospital. After registering at the hospital, you will be sent to the Special Procedures Area (SPA), where you will have an intravenous (IV) line placed in your arm, and a tube (Foley) will be placed into your bladder. Fluids, antibiotics and anti-nausea medication will be given prior to your procedure. You will then be sent to the Interventional Angiography Suite in the Department of Radiology. Here you will meet with your doctor (Interventional Radiologist) and nurses/technologists trained in this procedure. You will be given sedation for relaxation and pain, but you will be conscious during the procedure.

First, the radiologist will place a small catheter (a small tube) in an artery in your groin and perform an arteriogram which will specifically look at the arteries in your liver. After these arteries are identified, the catheter is directed into the branch of the artery supplying blood to the tumor, and the chemoembolization mixture is injected. Once this is completed, you are sent to your hospital room where you will lie flat in bed for six hours. More IV fluids are given to you overnight. Most patients are discharged from the hospital the following day.

 

Following the procedure you may have varying degrees of pain, fever and nausea. These symptoms may last a few hours to a few days, and are easily treated by various medications. You may also notice slight hair loss, rarely perceived by anyone other than yourself.

Serious complications from chemoembolization are rare. In less than 3% of the procedures, the liver tumor is destroyed by the procedure and may become infected and abscessed. There has been one fatality in 100 procedures due to liver failure.

 

Remember this is a treatment, not a cure. Approximately 70% of the patients will see improvement in the liver and depending on the type of liver cancer, it may improve your survival.

For additional information or to schedule a chemoembolization procedure, please contact our clinical coordinator at 873-3724.

Here is a PDF for more information.

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