Chemoembolization

Chemoembolization is a procedure that combines two things: chemotherapy and embolization. It delivers drugs that kill cancer cells (chemotherapy) through a blood vessel directly to a tumor. At the same time, another substance is put into the blood vessel to create a blockage (embolization). This keeps blood from "feeding" the tumor and traps the chemotherapy in place.

Chemoembolization is most often used to treat liver cancer. It is well-suited to the liver because the liver has 2 large blood vessels that supply it with blood. One blood vessel can be used to deliver chemotherapy and then blocked. The other blood vessel can still get blood to the liver.

For most people, chemoembolization helps slow the growth of the tumor or stop it from growing. If the tumor continues to grow or returns after treatment, the procedure can be done again.

LET YOUR CAREGIVER KNOW ABOUT:

  • Allergies to food or medicine.

  • Medicines taken, including vitamins, herbs, eyedrops, over-the-counter medicines, and creams.

  • Use of steroids (by mouth or creams).

  • Previous problems with anesthetics or numbing medicines.

  • History of bleeding problems or blood clots.

  • Previous surgery.

  • Other health problems, including diabetes and kidney problems.

  • Possibility of pregnancy, if this applies.

RISKS AND COMPLICATIONS

  • Infection or numbness near the surgical cut (incision).

  • Swelling or bruising.

  • Slow healing.

  • Blood clots.

  • Damage to the blood vessel.

  • Damage to healthy cells close to the chemoembolization site.

  • Allergic reaction to the contrast dye used in the procedure.

  • Side effects from the chemotherapy. These could include nausea, hair loss, and a decrease in red blood cells (anemia).

  • Damage to the liver. This is rare.

BEFORE THE PROCEDURE

  • Your caregiver may want you to have blood tests. These tests can help tell how well your kidneys and liver are working. They can also show how well your blood clots.

  • Two weeks before your procedure, stop using aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs) for pain relief. This includes prescription drugs and over-the-counter drugs such as ibuprofen and naproxen. Also stop taking vitamin E.

  • If you take blood thinners, ask your caregiver when you should stop taking them.

  • Do not eat or drink for about 8 hours before your procedure.

  • You might be asked to shower or wash with an antibacterial soap before the procedure.

  • Make arrangements for someone to drive you home. Depending on the procedure, you may be able to go home the same day. However, most people stay overnight in the hospital after this procedure. Ask your caregiver what to expect.

PROCEDURE

Chemoembolization usually takes about 90 minutes. The procedure may vary depending on which organ or area of the body is being treated. If the liver is the target, here is what you can expect:

  • An intravenous (IV) needle will be inserted in your arm. Medicine will be able to flow directly into your body through this needle.

  • You may be given medicine that numbs the chemoembolization insertion site (local anesthetic).

  • You may be given medicine that makes you sleep (general anesthetic).

  • A needle will be inserted into the femoral artery in the groin.

  • A thin, flexible tube (catheter) will be inserted into the needle and guided to a blood vessel that enters the liver.

  • A dye will be injected through your IV. Then, X-rays will be taken. This helps to visualize the exact location of the blood vessels that lead into your liver.

  • The chemotherapy drugs and the substance used for embolization will be injected into the blood vessel.

  • More X-rays will be taken to make sure the procedure has closed the blood vessel.

  • The catheter will be removed. Pressure will be put on the incision to stop any bleeding, and a bandage (dressing) will be applied.

AFTER THE PROCEDURE

  • You will stay in a recovery area until the anesthesia has worn off. Your blood pressure and pulse will be checked.

  • Pain and nausea are common right after chemoembolization. You can be given medicine to control this. Be sure to tell your caregiver how you are feeling.

  • You will need to remain lying down for 6 to 8 hours. This often means an overnight stay in the hospital. Sometimes people stay longer.