What Patients And Families Should Know

By Author: Sandeep Sharma
Total Articles: 3
Comment this article

A diagnosis of liver cancer is overwhelming, and the treatment choices can be confusing. Surgery or transplant is not possible for every patient, particularly when the liver is already scarred by cirrhosis. Transarterial chemoembolization (TACE) is a well-established, minimally invasive treatment that delivers chemotherapy directly to the tumour while cutting off its blood supply.

Understanding Liver Cancer
The most common primary liver cancer is hepatocellular carcinoma (HCC), which usually develops in people with chronic liver disease from hepatitis B, hepatitis C, alcohol, or fatty liver disease. The liver can also be affected by cancers that spread from other organs (metastases).
Warning signs include:
Unexplained weight loss and loss of appetite
Pain or fullness in the upper right abdomen
Jaundice
Abdominal swelling from fluid
Fatigue and weakness
A rising tumour marker such as AFP, or a new lesion on surveillance scans
Many early cancers cause no symptoms, which is why regular ultrasound screening of people with cirrhosis matters.

How the Liver's Blood ...
... Supply Helps Treatment
Normal liver tissue gets most of its blood from the portal vein, while liver tumours depend largely on the hepatic artery. This difference makes TACE possible: the artery feeding the tumour can be targeted while healthy liver tissue is relatively spared.

What Is TACE?
An interventional radiologist passes a thin catheter, usually through the groin or wrist, into the hepatic artery under X-ray guidance. After mapping the blood vessels supplying the tumour, a mixture of chemotherapy and embolic particles is delivered directly into the tumour's arteries. The chemotherapy attacks cancer cells, while the embolic material blocks the tumour's blood supply, starving it of oxygen.
Variants include conventional TACE using an oily carrier, drug-eluting bead TACE (DEB-TACE), and bland embolization without chemotherapy.

Who Is a Candidate?
Patients with intermediate-stage HCC and multiple tumours
Tumours too large for ablation
Patients awaiting liver transplant to control tumour growth ("bridging")
Selected patients to shrink a tumour so that surgery or ablation becomes possible ("downstaging")
Some patients with liver metastases from certain cancers

Who May Not Be Suitable?
Severely impaired liver function
Complete blockage of the main portal vein
Severe kidney failure
Advanced cancer spread outside the liver in some situations
Uncontrolled infection or bleeding disorders
Liver function tests, scans, and a multidisciplinary discussion guide the decision.

The Procedure
TACE is usually done under local anaesthesia with sedation and takes one to two hours. Patients typically stay in hospital one to two nights for monitoring and symptom control.

What to Expect Afterwards: Post-Embolization Syndrome
Many patients experience:
Pain in the upper right abdomen
Fever
Nausea or vomiting
Fatigue
This usually peaks in the first two to three days and improves with medication and rest. Report persistent high fever, severe pain, or yellowing of the eyes promptly.

Follow-Up and Results
A scan, usually CT or MRI, is done about four to six weeks later to see how the tumour has responded. If cancer remains or new tumours appear, TACE can be repeated, sometimes in planned sessions. Many patients achieve tumour control and improved survival, though results depend on tumour burden and liver function.

Possible Risks
Worsening liver function, especially in advanced cirrhosis
Infection or liver abscess
Gallbladder inflammation
Damage to nearby organs from stray particles
Kidney strain from contrast dye
Bleeding or groin complications
Careful selection and super-selective technique reduce these risks.
Combining TACE With Other Treatments
Ablation for tumours that remain after TACE
Systemic therapy such as targeted drugs or immunotherapy
Radiotherapy in selected cases
Liver transplant or surgery after downstaging
Supporting Your Liver
Take medicines for hepatitis as prescribed
Avoid alcohol completely
Eat a balanced, protein-adequate diet
Stay active as tolerated
Avoid herbal remedies without medical advice
Keep all follow-up and surveillance appointments

Caring Support for Families
Caregivers play a big part. Help with medicines, appointments, and nutrition, and learn warning signs of complications. Don't hesitate to ask the team questions.

Frequently Asked Questions
Is TACE a cure?
TACE is mainly used to control tumours and prolong life, and in some cases bridges patients to transplant or ablation. A complete cure is possible for some small tumours, though not typical for larger or multiple ones.

Will I lose my hair?
The chemotherapy is delivered locally in small doses, so hair loss and severe whole-body side effects are uncommon.

How many sessions will I need?
It varies. Some patients need one, others several sessions at intervals, based on scan results.

Can I eat normally?
Yes, once nausea settles. A light, nutritious diet is best in the first days afterwards.

When can I return to normal life?
Many people return to light activities within a week, though tiredness may last longer.

Preparing for TACE
Your team will review blood tests including liver function, clotting, and kidney function, along with CT or MRI scans. Tell them about all medicines, especially blood thinners and diabetes drugs. You will be asked to fast beforehand, and you may be given anti-nausea medication and fluids. Ask questions, and bring a family member for support.

Key Points to Remember
TACE delivers chemotherapy directly to the liver tumour and blocks its blood supply
It suits intermediate-stage liver cancer and selected other situations
Post-embolization symptoms are common but temporary
Follow-up scans decide whether further treatment is needed
Good liver health and surveillance remain vital

Nutrition During Treatment
Protein-rich, small, frequent meals help maintain strength. Limit salt if you have fluid in the abdomen, avoid raw or undercooked food that could cause infection, and ask your dietitian about supplements.

Liver Cancer Care at IRFacilities
Dr. Sandeep Sharma and the IRFacilities team evaluate each patient's tumour, liver function, and overall health, and plan treatment together with oncologists and hepatologists.
Been diagnosed with a liver tumour? Book a consultation at IRFacilities.

We IRFACILITIES provides top-notch neurointerventional radiology services, led by Dr. Sandeep Sharma.agnose and treat nerve system quirks with advanced tools and a real focus on the patient. We're experts in minor operations to fix blood vessel issues, spine procedures, and tumor embolization. Turn to IRFACILITIES for supreme know-how and kind concern. Reach out and discover more about how we can guide you toward health. For more info: https://www.irfacilities.com/profile.php