Chemoembolization is a technique used to treat cancer in the body and is used most often to target malignant (cancerous) liver tumors. Performed by an interventional radiologist, chemoembolization is the introduction of high levels of chemotherapy drugs directly into a tumor with the goal of shrinking or killing the tumor without damaging surrounding healthy tissue. Chemoembolization attacks a tumor on two levels: first the physician places chemotherapy medication in the tumor, then cut off its life-giving blood supply with an additional medication that stops blood flow from the hepatic artery to the tumor.
The hepatic artery is one of two sources of blood supply to the liver and provides about 25% of the organ’s blood supply when functioning normally. Livers with a tumor usually get a very small or no blood supply from the hepatic artery so cutting off blood flow from it will not damage the liver’s main source of blood.
This approach is especially helpful for patients who may not be a candidate for other surgical approaches or may be combined with other cancer treatments like radiation, systemic chemotherapy or ablation techniques.
What Tumors Can Be Treated With Chemoembolization?
Chemoembolization can be used to treat tumors in their original location and cancer metastasis to the liver from other areas of the body. It has shown some success in the treatment of tumors in other areas of the body.
Cancers that have spread to the liver from:
- Hepatocellular carcinoma
- Breast cancer
- Colon cancer
- Ocular melanoma
- Neuroendocrine or carcinoid tumors
Prior to the procedure, patients are scheduled for consultation with the radiologist performing the chemoembolization. Patients should make sure to provide the physician with a list of all medications they are taking including blood thinners like aspirin, blood thinners or non-steroidal anti-inflammatory drugs (NSAIDS) like ibuprofen or Aleve®. Patients should expect preoperative X-rays or blood work to assess kidney function and clotting factors.
Patients should inform the radiologist of any drug allergies including allergies to “X-ray dye”, contrast media, general or local anesthesia.
On the day of the procedure, patients may be treated in the operating room or in an interventional radiology suite. Patients are provided light sedation or may be completely asleep depending on the case.
To reach the tumor, the radiologist will make a small incision in the bend of the leg at the groin. A thin, flexible tube is inserted and moved up through the femoral artery and the tube is monitored on a television screen. Once the tip of the tube reaches the liver, contrast dye is placed in the patient’s IV and additional X-rays may be taken. The tube is moved to the edge of the arteries that are feeding the tumor and a mixture of chemotherapy drugs and drugs to stop blood flow to the tumor are mixed and run up through the tube. Additional X-rays may be taken to make sure the entire tumor has been exposed to the drugs. The process usually takes about an hour and a half to complete.
After the procedure, the tube is slowly removed and a dressing is placed on the groin. Stitches are not needed. Patients will spend six to eight hours in recovery.