Embolisation treatments for secondary cancer in the liver

In embolisation, substances are injected into the liver to try to block the blood flow to the cancer cells. This can shrink the cancer or stop it from growing, as its supply of oxygen and food is reduced.

In secondary liver cancer, embolisation can be given in combination with chemotherapy (chemoembolisation), or using radiation (radioembolisation).

In chemoembolisation, a chemotherapy drug is injected into the liver. It is mixed with an oily liquid that creates blood clots in the vessels that carry blood to the tumour. This stops oxygen and nutrients getting to the tumour. The chemotherapy stays in the tumour in high concentrations, which can kill some of the cells and shrink the tumour.

Radioembolisation, also called selective internal radiotherapy (SIRT), uses tiny radioactive beads (microspheres) to treat secondary cancer in the liver. The radiation given off by the SIRT beads damages the cancer cells and stops them growing. It also damages the blood vessels to the tumour so that it can’t get the nutrients it needs.

Chemoembolisation and radioembolisation may cause side effects. Your doctor can prescribe medicines to control these.

What are embolisation treatments?

Embolisation is when substances are injected into the liver to try to block the blood flow to the cancer cells. This reduces the supply of oxygen and food to the cancer, which can make it shrink or stop it from growing.

In secondary liver cancer, embolisation can be given in combination with chemotherapy (chemoembolisation), or using radiation (radioembolisation).


Chemoembolisation

What is chemoembolisation?

In chemoembolisation a chemotherapy drug is injected directly into the liver. The drug is mixed with an oily liquid. The oily liquid creates blood clots in the blood vessels that carry blood to the tumour. This stops oxygen and nutrients getting to the tumour.

The chemotherapy stays in the tumour in high concentrations, which can kill some of the cells and shrink the tumour. In some hospitals the chemotherapy drug is loaded into special beads, which keep the drug in the tumour and cut off the blood supply at the same time.

Chemoembolisation is sometimes called TACE (trans-arterial chemoembolisation) or CT-ACE (computerised tomography guided arterial chemoembolisation).

How it is given

You may need to stay in hospital overnight and possibly for a day or two. Before treatment the nurse or doctor will usually give you a mild sedative to help you to relax. They then inject some local anaesthetic into the skin at the top of your leg (your groin) to numb the area. After this the doctor makes a tiny cut in the skin.

While using x-ray pictures, the doctor places a thin plastic tube (catheter) into a blood vessel in the groin. This is passed upwards until the tip is in the artery that takes blood to the liver (hepatic artery). A chemotherapy drug mixed with the oily liquid is then injected into the liver and the catheter is removed.

Side effects

Chemoembolisation can cause side effects, such as:

You will be given anti-sickness drugs and painkillers to take until the side effects settle down. This is usually within 1–2 weeks. Serious complications are rare, but occasionally it can damage the liver.


Radioembolisation

What is radioembolisation?

This treatment uses tiny radioactive beads (microspheres) to treat secondary cancer in the liver.

Radioembolisation is also known as selective internal radiotherapy (SIRT). It is only available in some hospitals so you may have to travel for this treatment if it is suitable for you.

Before having the treatment, a test called an angiogram is done. A fine tube (catheter) is put into a blood vessel in your groin area and passed into a blood vessel taking blood to the liver (hepatic artery). This shows where the SIRT beads would travel through the bloodstream and allows the doctor to close off any blood vessels that would take the SIRT beads to other parts of the body.

How it is given

When you have the treatment you will have another angiogram and the SIRT beads will be injected into the catheter. They get stuck in the small blood vessels around the tumour.

The radiation given off by the SIRT beads damages the cancer cells and stops them growing. It also damages the blood vessels to the tumour so that it can’t get the nutrients it needs.

You may need to stay in hospital overnight after your treatment.

The amount of radiation given off by the beads is small and lasts for about 10–14 days. You will be told about any safety precautions you need to take during this time. You should drink plenty of fluids. The beads remain in the liver permanently and are harmless.

Depending on how effective it is, the treatment can sometimes be repeated.

Side effects

Side effects include having a high temperature and abdominal pain straight after the injection. These can last for a few days.

Other side effects include feeling sick (nausea), being sick (vomiting), and diarrhoea. Your doctor will prescribe medicines to control these.

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Chemotherapy

Chemotherapy uses drugs to treat many different types of cancer. It is most commonly given as an injection into a vein or as tablets or capsules.

Surgery

Surgery involves removing all or part of the cancer with an operation. It is an important treatment for many cancers.

Hormonal therapies

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Radiotherapy

Radiotherapy is the use of high-energy rays, usually x-rays and similar rays (such as electrons) to treat cancer.

Life after cancer treatment

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