Guidelines for Liver Cancer Treatment with Transarterial Chemotherapy

TACE stands for Trans Arterial Chemo Embolization, which refers to another treatment method for liver cancer in patients who cannot undergo surgery. This treatment involves delivering targeted chemotherapy through the artery that directly supplies the liver tumor, then blocking that artery to prevent blood flow to the tumor.

TACE Procedure

The treatment must be performed in an angiography room by injecting local anesthesia in the groin area and inserting a catheter into the hepatic artery. The doctor can observe the catheter moving through the blood vessels on the X-ray monitor. When the catheter reaches the desired location, a contrast agent is injected to visualize the pathology and blood vessel characteristics. Then, chemotherapy mixed with the contrast agent is injected into the tumor, and the artery is embolized until no blood flows to the cancerous tumor.

Benefits of TACE for Liver Cancer Patients

1. The tumor is directly destroyed by chemotherapy and from the lack of blood supply.
2. The small amount of chemotherapy used reduces side effects on other parts of the body.

Are there any side effects or complications?

Common side effects include bruising at the puncture site, which usually occurs in the first few days and gradually resolves on its own. Post-embolization syndrome may occur, characterized by nausea, loss of appetite, and low-grade fever, affecting about 40% of patients, usually within the first 2-3 days and resolving within 1-2 weeks. Other possible complications include ascites (4-20%), cholecystitis (1-11%), or liver abscess (2-5%).

Preparation Before the Procedure

1. Patients must have blood tests to check liver function, blood clotting, platelets, kidney function, and tumor marker (AFP).
2. Patients undergo lesion assessment with CT scan, ultrasound, or MRI, and may have had a biopsy previously.
3. Fasting from food and water for at least 6 hours before the procedure.
4. Patients will be prepared by cleaning and shaving the groin area where the catheter will be inserted.
5. Patients will receive intravenous fluids on the day of the procedure.

During the Procedure

1. Patients will have their vital signs monitored periodically during and after the procedure.
2. Other medications may be given according to the treatment plan.
3. Some mild abdominal pain or discomfort may occur during the procedure, which is not severe. Patients can inform the doctor or staff in the procedure room if they experience this.

Post-Treatment Care

1. Patients will have their vital signs monitored periodically after the procedure until stable.
2. Observe the toes for pain, swelling, coldness, discoloration, or absent pulse and report to medical staff immediately.
3. If the procedure was done via the femoral artery, patients must lie flat on the bed, avoid bending the treated leg, and refrain from sitting or walking for at least 8 hours.
4. Monitor for bleeding at the puncture site and report immediately if found.
5. After 2 hours post-procedure, if there is no nausea or vomiting, patients may eat.

Home Care After Treatment

1. Exercise is allowed but should not be excessive.
2. Eat a balanced diet with all five food groups and easily digestible foods.
3. Avoid high-fat foods and alcohol.
4. Maintain a positive mindset and avoid stress.
5. Get adequate rest and sleep.