General Information |
Scheduling, Insurance and Preparation |
What to Expect
What Chemoembolization of Tumors Is
Chemoembolization is a non-surgical procedure used to treat inoperable liver cancer. It is used to treat primary and secondary liver cancer in patients who cannot have the tumors surgically removed. Secondary liver cancer is cancer that originated elsewhere (such as the colon) and traveled to the liver. Chemoembolization may also be used to shrink tumors prior to surgery.
With chemoembolization, a catheter is inserted through a tiny cut in the groin and passed through the arteries until it reaches the hepatic artery. Then a chemotherapy drug and millions of tiny particles are released into the blood stream. The particles lodge into the smaller blood vessels that feed the tumor. They keep the chemotherapy drugs in the liver longer, giving them more time to kill nearby cancer cells. The particles also prevent oxygen and nutrients from reaching the tumor, further helping to shrink it.
The liver processes and removes the chemotherapy drug over approximately a four week period. The particles will remain in the liver without causing any complications.
Depending on the type of cancer and number of tumors, chemoembolization may be used alone or in conjunction with another treatment, such as surgery or radiation. If there is a tumor in both lobes of the liver, you will need to have two treatments to treat each side separately, with at least one month between the treatments.
Studies have shown that at least 70% of patients experience improvement after this procedure and the benefits generally last for 10-14 months. This minimally-invasive treatment has few side effects. While it won’t cure the cancer, it can shrink tumors, improve the quality of life, and possibly extend life for people with inoperable liver cancer.
There are two blood vessels that feed the liver – the hepatic artery and the portal vein. The hepatic artery usually supplies blood to the tumors. Consequently, chemoembolization is administered through this artery. During chemoembolization, healthy liver tissue will continue to get blood from the portal vein, so very little healthy tissue is damaged by the procedure.
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Chemoembolization vs. Other Non-Surgical Treatments
Not everyone with liver cancer is a candidate for this procedure. If you are a candidate, your doctor may recommend this procedure over other non-surgical treatments for the following reasons:
- Treatment is regional (only affects the liver)
- Milder side effects
- Allows a more potent chemotherapy drug to be used
- Very short recovery
- Treats all tumors fed by the hepatic artery, including undetected tumors
- Can be repeated
- Results have been very promising
Risks Involved in Chemoembolization of Tumors
The risks involved in chemoembolization include the following:
- Damage to a blood vessel
- Bruising, bleeding, or infection at the puncture site
- Allergic reaction to the contrast material used during the procedure
- Radiation exposure; however, it is well below the level that generally causes adverse affects
Serious complications occur in 5% of cases and typically include liver infection or damage.
Serious side effects are also possible in the gastrointestinal tract or lungs if the particles are not correctly placed in the liver. These are uncommon and usually only occur in patients who have unusual or severely damaged blood vessels in the liver.
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Scheduling, Insurance and Preparation
Consultations for chemoembolization are done at
The procedure is performed at the following Radiology Imaging Associates
partner hospitals in the Denver, Colorado area:
To schedule a consultation to discuss chemoembolization, call 720-493-3406.
- Medical Center of Aurora
- Littleton Adventist Hospital
- Porter Adventist Hospital
- Sky Ridge Medical Center
- Swedish Medical Center
Chemoembolization of tumors is usually covered by insurance. Check with your insurance company to be sure. Please bring your insurance card with you to your consultation.
Conditions to Let Us Know About
When you have your consultation for chemoembolization, let the radiologist or nurse know if any of the following circumstances apply to you:
- Previous reaction to iodine/CT or X-ray contrast
- Previous reaction to anesthesia
- Coagulation disorder or taking blood thinning medication
- Diabetes or kidney disease
- Currently pregnant or nursing
If you are a candidate for chemoembolization, you will be given detailed preparation guidelines. Following are some of the basic guidelines; however, you may receive additional or differing guidelines based on your specific situation. Please contact us at 720-493-3406 if you have any questions.
- Stop taking blood-thinning medications 3-5 days before the procedure
(contact your doctor first to ensure it’s safe).
- Do not eat or drink anything but clear liquids for 8 hours before the procedure;
do not drink anything for 4 hours before the procedure.
- Prepare for an overnight stay in the hospital.
- Arrange for someone to drive you home from the procedure.
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What to Expect
Before the Procedure
Before scheduling the procedure, an interventional radiologist must determine if you are a good candidate for chemoembolization. You or your doctor will need to supply your medical records and prior test results so your eligibility can be determined.
If you appear to be a candidate, you will undergo additional exams including a blood test and a CT scan. These exams will help the interventional radiologist confirm your eligibility for chemoembolization and determine an appropriate chemotherapy drug dose for your liver.
During the Procedure
Here is generally what will happen during chemoembolization of tumors:
- You will change into a gown.
- A technologist will answer your questions then start an intravenous (IV) line in your arm. You will receive antibiotics and other medication through the IV to prevent infection and protect your kidneys during the procedure.
- The technologist will set up various devices so your heart rate and blood pressure can be monitored throughout the procedure.
- You will receive intravenous conscious sedation to help you relax and eliminate discomfort. You will remain awake for the procedure.
- The site of the groin incision will be cleansed.
- A fluoroscope will be moved into position above your abdomen.
- The groin incision will be made and the catheter will be inserted into the femoral artery.
- While watching the fluoroscope images, the interventional radiologist will carefully guide the catheter to the hepatic artery in the liver.
- The interventional radiologist will deploy the chemotherapy drug and particles through the catheter and into the hepatic artery. This procedure is generally painless; however, some patients experience pain when the particles are released. Let the radiologist known immediately if you feel any pain.
- After the entire dose has been deposited, the catheter will be withdrawn.
- The incision will be cleaned and taped.
The procedure usually takes 2-3 hours. Patients generally spend one night in the hospital for observation and pain and nausea management; however, some may need to stay longer.
After the Procedure
Most patients experience side effects after chemoembolization. These include:
- Loss of appetite
- Fatigue for 1-4 weeks
You will receive prescriptions for medication to control pain and nausea and an antibiotic to prevent infection. If your fever suddenly becomes higher or the intensity of your pain increases, contact us at 720-493-3406 and your oncologist.
The chemotherapy drug rarely causes hair loss, decreases in white blood cells and platelets, or anemia.
You will have a blood test within two weeks of the last procedure to determine how effective the treatment was. You will also have a CT or MRI scan 2 weeks after the procedure. You will continue to have a CT scan or MRI every three months to check tumor shrinkage and look for new tumors. Alternatively, you may be followed with PET scan/CT as well.
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