Chemoembolization of Tumors

Chemoembolization is a non-surgical procedure used to treat inoperable liver cancer. This innovative procedure delivers chemotherapy directly to the tumor. Studies have shown that at least 70% of patients experience improvement after this procedure and the benefits generally last for 10-14 months.

With chemoembolization, a catheter is inserted through a tiny puncture in the groin and threaded through the arteries until it reaches the hepatic artery. The hepatic artery is one of two blood vessels that feed the liver and the one that usually supplies blood to the tumors. Once the catheter is properly placed in the hepatic artery, 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 adjacent cancer cells. The particles also prevent oxygen and nutrients from reaching the tumor, further contributing to the tumor’s shrinkage. Healthy liver tissue continues to get blood from the portal vein, so very little of it is damaged by the chemoembolization.

Since the entire body is not exposed to the chemotherapy drug as it is with conventional chemotherapy, there is a lesser chance of side effects. Additionally, this targeted approach allows a much more potent chemotherapy drug to be used.

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.

This minimally-invasive treatment has few side effects. It can be used to treat both primary and secondary liver cancer. 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.

Learn more about this procedure by watching an interview with Dr. Charles Nutting, an RIA interventional radiologist specializing in minimally invasive cancer treatment. Dr. Nutting explains the latest options for patients suffering from liver and other cancers. This interview aired May 7 on Colorado & Company on NBC.

This page contains the following information about chemoembolization of tumors:

Reasons for Having Chemoembolization of Tumors

Chemoembolization is used to treat liver cancer in patients who cannot have the tumors surgically removed. It may also be used to shrink tumors prior to surgery.

Not everyone with inoperable 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:

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Risks Involved in Chemoembolization of Tumors

Since a catheter is placed within the blood vessels, there is a risk of damage to a blood vessel, bruising or bleeding at the puncture site, or infection.

You could have an allergic reaction to the contrast material used during the procedure.

Most patients experience side effects after chemoembolization. These include pain, nausea, vomiting, and fever. The chemotherapy drug may also cause hair loss, decreases in white blood cells and platelets, and anemia; however, these are usually mild.

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.

Most patients remain in the hospital for 23 hours and are discharged the next day.

Conditions to Let Our Doctor Know About

In advance of your exam, let your Invision Sally Jobe radiologist or technologist know if any of the following circumstances apply to you:

Insurance Coverage for Chemoembolization of Tumors

Chemoembolization is usually covered by insurance. Check with your insurance carrier to be sure.

Procedure Locations

Consultations for chemoembolization of tumors are done at the RIA at Alton Way.

The procedure is done at the following Invision Sally Jobe partner hospitals in the Denver, Colorado area:

Please note:

Invision Sally Jobe is partially owned by Radiology Imaging Associates (RIA); consequently, your radiologist’s lab coat and your bill, if you receive one, may say RIA rather than Invision Sally Jobe.

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Scheduling Chemoembolization of Tumors

To schedule a consultation to discuss chemoembolization of tumors, call 720-493-3406.

Preparing for Chemoembolization of Tumors

Following are the preparation guidelines for chemoembolization. Please contact us at 720-493-3406 if you have any questions.

What to Expect During Your Procedure

Before scheduling the procedure, an Invision Sally Jobe radiologist must determine if you are a good candidate for chemoembolization. You will need to supply Invision Sally Jobe with numerous medical records and 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 radiologist confirm your eligibility for chemoembolization and determine an appropriate chemotherapy drug dose for your liver.

When you come in for the procedure, you will be asked to change into a gown. A nurse or technologist will 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.

Before beginning the procedure, the technologist will set up various devices so your heart rate and blood pressure can be monitored throughout the procedure. You will remain awake for the procedure, but you will be given conscious sedation through the IV to help you relax.

The site of the groin incision will be cleansed. A fluoroscope will be moved into position above your abdomen. The radiologist will then make the incision and insert the catheter. While watching the fluoroscope images, he or she will carefully guide the catheter to the hepatic artery in the liver.

After the catheter is properly placed near the tumor, the radiologist will deploy the chemotherapy drug and particles through the catheter and into the hepatic artery. After the entire dose has been deposited, the catheter will be withdrawn and the incision cleaned and taped.

This procedure is generally painless; however, some patients experience pain when the particles are deployed. Let the radiologist known immediately if you feel any pain.

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.

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Recovering from Your Procedure

Most patients return to their normal activities within a week. All patients will experience fatigue for 1-4 weeks following the therapeutic injection. Many patients may also experience a low-grade fever, loss of appetite, nausea, vomiting, or pain for up to a week. 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 your physician.

Follow-Up for This Procedure

You will have a CT or MRI scan and a blood test within two weeks of the last procedure to determine how effective the treatment was. You will continue to have a CT or MRI scan every three months to check tumor shrinkage and look for new tumors.

Additional Information

The information on this page was taken in part from some of the following web sites. Visit these sites for additional information on chemoembolization of tumors.

Sources

Chemoembolization of tumors is performed in a hospital using a fluoroscope to take real-time x-rays of the body during the procedure. Chemotherapy drugs and tiny particles are deployed through a catheter directly at the site of the tumor