Chemoembolization is one of the newest treatments with minimal side effects. This method has seen significant advances in Turkey due to the efficiency of its doctors and equipment. It is also known as targeted chemotherapy with embolization.
What is chemoembolization?
Chemoembolization (also known as Transarterial Chemoembolization or TACE) is a modern therapeutic method that combines chemotherapy and embolization to alleviate tumor symptoms and reduce tumor size by killing cancer cells, similar to Radioembolization (Interventional Radiation Therapy). The key difference is that instead of small particles loaded with radioactive isotopes, we inject chemicals that directly target and kill cancer cells. This chemotherapy method is commonly used in the treatment of liver cancers (Hepatocellular cancer, HCC), whether they are primary or metastatic.
Chemoembolization is a minimally invasive procedure performed by a radiologist and is almost identical to angiography in terms of mechanism.
Embolization is done by injecting an embolic material that blocks the blood vessels feeding the tumor, preventing the spread of the chemotherapy effect to other areas. Chemoembolization can be used alone or combined with other treatments such as radiation therapy, with studies showing improved survival in patients with hepatocellular carcinoma when radiation therapy is combined with Chemoembolization, chemotherapy, or Radiofrequency Ablation.
What are the advantages of chemoembolization therapy?
It has several advantages over other standard treatment methods, including:
- It prevents blood-borne oxygen from reaching the tumor, which contributes to shrinking the tumor size and killing cancer cells.
- Because the chemotherapy dose will be injected directly into the tumor, a larger dose of the chemotherapy drug can be administered in chemoembolization than the dose used in standard chemotherapy.
- Clotting the arterial blood and cutting off the perfusion of the bypassed cancer in this procedure prevents the spread of the chemotherapy drug to neighboring areas.
- The symptoms in this chemotherapy treatment are significantly less and milder because of what we mentioned earlier.
When do we use transarterial chemoembolization (TACE)?
Doctors often use this method when other methods have failed or patients are too ill to undergo more aggressive treatments (such as surgery).
Chemoembolization is most useful for patients whose disease is mainly confined to the liver, whether the tumor started there or has spread to it (metastatic cancer) from another organ.
Cancers that can be treated with chemoembolization include:
- Hepatocellular carcinoma
- Cholanoma
- Some cancers that can metastasize to the liver (hepatic metastases):
- Colon cancer
- Breast cancer
- Carcinoid tumors and other neuroendocrine tumors
- Pancreatic islet tumors
- Eye melanoma
How do patients prepare for chemoembolization in Turkey?
The operating physician will recommend several tests, including blood tests and liver function tests, and a CT scan or MRI of the liver may be performed before the chemoembolization procedure.
The doctor will prescribe some tranquilizing medications and stop any medication the patient is taking that may interfere with the procedure (including aspirin).
After the test results come back, the doctor must ensure that there is no blockage in the hepatic blood flow (portal vein obstruction), liver cirrhosis, or bile ducts.
The patient will be asked to stop eating or drinking after midnight the night before the chemoembolization treatment. Patients usually stay in the hospital for 1-4 nights after the procedure. The procedure is performed by an interventional radiologist in the interventional radiology department. The patient will have an intravenous line opened, through which intravenous fluids, antibiotics, and sedative medications will be given.
How is chemoembolization (TACE) performed in Turkey?
In Chemoembolization in Turkey, the efforts of the best doctors combine with the best nurses and modern medical devices to provide the most effective chemotherapy combined with local blood clotting, achieving the best results at the lowest possible cost. Bimaristan Medical Center remains your first choice for treatment in Turkey.
X-rays will be taken to map the path of the blood vessels feeding the tumor, and the patient may be given a drug called allopurinol, which helps protect the kidneys from chemotherapy and the byproducts produced by dying tumor cells.
The interventional radiologist will place a small catheter (transcatheter) in an artery in the groin and perform an Arterial Gram Arteriogram to specifically examine the arteries in the liver. Chemoembolization may use local anesthesia. It does not require intubation; however, some patients may require general anesthesia if local anesthesia is not sufficient.
The doctor will make a very small skin incision at the site. Using X-ray guidance, the doctor inserts a thin catheter through the skin into the arterial pathway, either in the groin or wrist, and pushes it into the liver. The contrast material is injected through the catheter and another series of X-ray images are taken. Once the catheter is placed in the arterial branches feeding the tumor, anti-cancer drugs and embolic agents are mixed together and injected.
Additional X-rays will be taken to make sure that the chemotherapy has reached the cancer and the arterial route to the cancer has completely embolized. When the procedure is complete, the doctor will remove the catheter and apply pressure to stop any bleeding. Occasionally, the doctor may use a closure device to close the small opening where the catheter enters, allowing you to heal more quickly, with no visible stitches on the skin.
Your doctor may provide you with medications to help prevent nausea and pain and antibiotics to help prevent infection and sepsis after the procedure.
Chemoembolization is one of the latest minimally invasive cancer treatments available today. If you have questions about how it works or whether it’s right for you, don’t hesitate to reach out.
Your trusted medical family — Bimaristan Center in Turkey — is here to guide you every step of the way.
Complications and side effects of chemoembolization (TACE)
After the procedure, Patients may have varying degrees of pain, fever and nausea, these symptoms may last from a few hours to a few days, and can be easily treated as the operation doctor prescribes medications that help get rid of these symptoms, the patient may also notice slight hair loss, which is rarely observed in anyone else.
Serious complications from chemoembolization are rare.
In less than 3% of procedures, the cancer site treated with chemoembolization may become infected, and an abscess may form.
One case of liver failure due to transarterial chemoembolization (TACE) was reported out of 100 surgeries.
Care after chemoembolization treatment in Turkey
The patient should be able to resume normal daily activities within a week of Chemoembolization treatment in Turkey.
During the first month following chemotherapy combined with arterial treatment, you should routinely check in with your doctor, report any issues, and monitor your progress. You may need a CT scan or MRI scan and blood tests to determine the size and status of the cancer being treated.
The liver is divided into two parts: the right hepatic lobe and the left hepatic lobe. If there is a tumor involving both lobes, it is usually treated in a staged manner; during the first setting, one lobe is treated, and the second lobe is usually treated about a month later. A CT scan or MRI is recommended every three months thereafter to determine how much the cancer has shrunk and to see if new tumors are appearing in the liver. The median time before the second round of treatment (due to a new tumor) is between 10 and 14 months.
Treatment can be repeated many times over many years, as long as it is still technically possible and the patient is healthy enough to tolerate repeated procedures.
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