Embolisation treatments for primary liver cancer

Embolisation is when substances are injected into blood vessels to block the blood flow to the cancer cells. This reduces the oxygen going to the cancer and can help to shrink it.

For primary liver cancer (HCC), embolisation is usually given along with chemotherapy (chemoembolisation). Less commonly, it is given with radiotherapy (radioembolisation, or SIRT). Doctors don’t use these treatments if the cancer has spread outside the liver.

With chemoembolisation, a doctor injects chemotherapy into the liver through a tube (catheter) in a blood vessel. They then inject a gel or tiny plastic beads to block the blood supply to the tumour.

With radioembolisation (SIRT), they inject radioactive beads into blood vessels close to the tumour. They give it through a catheter in the same way as chemoembolisation. The radiation destroys the blood vessels and stops the blood flow to the tumour.

You usually need a short stay in hospital for these treatments. Side effects may include pain, high temperature, sickness and tiredness. Your doctor or nurse will tell you what to expect. They can prescribe drugs to help control side effects.

What are embolisation treatments?

Embolisation is a way of blocking blood vessels. A doctor injects local anaesthetic around a blood vessel (artery) in the groin or wrist to numb it. They then use x-rays to guide a long plastic tube into the artery, until it reaches the artery that carries blood to the liver. The doctor injects a substance into this artery to block the blood flow. This reduces the supply of oxygen and food to the cancer, which can shrink it or stop it growing.

For primary liver cancer (HCC), embolisation is usually given with chemotherapy. This is called chemoembolisation. You need to be reasonably well to have this treatment. And the part of your liver that is not affected needs to have a good blood supply.

Less commonly, embolisation is given with radiation. This is called radioembolisation or SIRT (selective internal radiation therapy).

These treatments can be used when the cancer cannot be removed with surgery or treated with ablation. They are not used if the cancer has spread outside the liver.

My cancer shrunk slightly with embolisation treatment. It did not cause me many side effects, but it did knock me out a bit for a couple of weeks after treatment.

Karen, Online Community member


Chemoembolisation

In chemoembolisation, a chemotherapy drug is injected directly into the liver. This means the tumour gets a higher concentration of the drugs. After the chemotherapy drug is given, you have an injection into the blood vessels that carry blood to the liver (arteries). This blocks the arteries and cuts off the blood supply to the tumour (embolisation).

Sometimes the chemotherapy drug is loaded into special beads. Chemoembolisation is sometimes called TACE (trans-arterial chemoembolisation) or CT-ACE (computerised tomography-guided arterial chemoembolisation).

The drugs most often used are doxorubicin and cisplatin.

How it is given

You may need to stay in hospital for a couple of nights. Before the treatment, the nurse or doctor will usually give you a mild sedative to help you 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. They put a fine tube called a catheter through the cut and into a blood vessel in your groin (the femoral artery).

The doctor passes the catheter up along the artery until it reaches the blood vessels that take blood to the liver and tumour. You have an x-ray of the blood vessels at the same time. This is called an angiogram. A dye is put into the blood vessel through the catheter. This shows the blood supply on the x-ray so the doctor sees exactly where the catheter is. After this, they slowly inject the chemotherapy into the liver through the catheter. The doctor then injects a gel or tiny plastic beads to block the blood supply to the tumour. The beads may contain a chemotherapy drug.

You can have chemoembolisation several times. It is sometimes given with radiofrequency ablation. Your doctor can explain this treatment to you in more detail, if this would be helpful for you.

Side effects

Chemoembolisation can cause side effects such as sickness, pain, a raised temperature and feeling very tired. You will be given anti-sickness drugs and painkillers until the side effects reduce. This usually takes 1 to 2 weeks.

It is unusual for chemotherapy given in this way to cause side effects outside your liver. Serious complications are rare, but occasionally it can damage the liver.

I had two episodes of TACE and a microwave beam to zap the cancer. It was done under general anaesthetic through a keyhole opening.

Martyn, Online Community member


Radioembolisation

Radioembolisation is sometimes called SIRT (selective internal radiotherapy). Radioembolisation is done less often than chemoembolisation. It is not available in all hospitals.

How it is given

A doctor injects tiny radioactive beads (microspheres) into a blood vessel close to the tumour. The radiation destroys the blood vessels and stops blood flow to the tumours. Without a blood supply, the tumours shrink and may die. The radiation only travels a few millimetres. This means that other parts of the liver are not affected and you are not radioactive. The beads stay in the liver permanently and are harmless.

You have radioembolisation through a fine tube (catheter) put into an artery in your groin. This is done in the same way as chemoembolisation. You have an angiogram about a week before to check the blood flow to the liver. You stay in hospital for 1 to 4 days to have it.

You may be able to have radioembolisation again, depending on how well it works for you.

Side effects

Side effects can last for a few days and include a high temperature and tummy pain straight after the injection. Other side effects include feeling sick and diarrhoea. Your doctor will prescribe drugs to control these until they go away. Rarely, it may damage the liver.

Back to Treating

Making treatment decisions

Your doctors may tell you there are different options for your treatment. Having the right information will help you make the right decision for you.

Surgery

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

Tumour ablation

Tumour ablation is when the tumour is destroyed by applying heat or alcohol directly to it.

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.

Clinical trials

Many people are offered a trial as part of treatment. Find out more to help you decide if a trial is right for you.

Life after cancer treatment

You might be thinking about how to get back to normal following treatment. Find advice, information and support about coping with and after cancer.