Chemoembolization of liver is a procedure in which chemotherapy is directly injected into the arteries that supply blood to the liver tumor. The artery that supplies blood to the tumor is called as hepatic artery. Portal vein is the vein that supplies blood to the normal liver tissue.
Since the medicine is directly injected into the tumor, it can be given in lower doses. This procedure does not affect the body in a way that the chemotherapy affects. Moreover, the hepatic artery is blocked by injecting small particles. Chemotherapy plus the blockage of hepatic artery will make the tumor starve. Hence, this procedure is effective in curing the liver tumor.
People with following tumors should go for this procedure:
- Ocular melanomas
- Colon cancer
- Islet cell tumors
- Carcinoid tumors
People with the above tumors should have some amount of normal liver tissue, which can be decided based on blood tests, CT scan or MRI.
People who are not eligible for surgery should go for this procedure.
- Biopsy of tumor is carried out to determine the type of tumor.
- CT scan or MRI is conducted to know the size and location of tumor, blood flow in portal vein and blockage of bile ducts.
- Chest CT scan is carried out to know if the tumor has spread to the lungs. It also gives information regarding fluid or infection that would delay the procedure.
- Blood tests are carried out to check liver and kidney function.
- Blood counts and tumor markers are also conducted.
The procedure should be carried out when the patient doesn’t show signs of infection, which include cough, fever, burning sensation while urinating and chills. The procedure should be performed when there are no signs of liver failure.
- A nurse will insert an intravenous (IV) line into a vein in your hand to give you medicine so that you won’t sense pain during the procedure.
- The doctor will insert a needle in an artery in the groin.
- A small tube called catheter will be inserted into the artery which will be passed into the liver.
- A contrast material is injected in the IV and various X-rays will be taken to differentiate between the hepatic artery and portal vein.
- Once the doctor has located the hepatic arteries, the doctor will use special X-ray equipment to take some more X-rays of the tumor.
- After having a clear idea about the tumor, the doctor will inject anti-cancer drugs into the hepatic artery.
- Then, small particles are injected to block the hepatic artery.
- Thereafter, catheter will be removed and pressure will be applied on the hepatic artery to stop bleeding.
- The opening is covered with a dressing.
After the procedure
- The patient will be kept under observation for few hours. Blood pressure and other vital signs will be monitored after shifting to a regular room.
- Some people experience pain in the upper right abdomen and nausea. Pain killers will be given to relieve it.
- Pain and nausea will come down after 24-48 hours.
- Patient may experience fever and loss of appetite. These are normal signs of recovery.
- Patient can resume normal activities in one month.
- Blood tests, CT and MRI scan should be performed to know if the tumor has shrunk in size.
- It increases the life expectancy by 50-70%.
In people, for whom surgery was not an option to cure liver tumor because of tumor size, after chemoembolization, surgery can be performed to those people.