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What Is Chemoembolization?

Chemoembolization is a combination of local delivery of chemotherapy and a procedure called embolization to treat cancer, most often of the liver. In chemoembolization, anti-cancer drugs are injected directly into the blood vessel feeding a cancerous tumor. In addition, synthetic material called an embolic agent is placed inside the blood vessels that supply blood to the tumor, in effect trapping the chemotherapy in the tumor.

Hepatic Chemoembolization

The liver is unique in that it has two sources of blood supply: the hepatic artery and the portal vein. Most of the healthy liver receives blood flow through the portal vein, while most tumors receive blood flow through the hepatic artery. Therefore, chemotherapy injected into the hepatic artery reaches the tumor(s) directly and spares the healthy liver tissue.

Chemoembolization May Be Contraindicated If You Have:

Severe liver or kidney damage
Blockage of the portal vein
Blockage of the bile ducts
Greater than 50% of your normal liver has been replaced by tumor(s)

During the procedure, an angiogram will be performed. A small catheter is placed into the artery in your groin. Small amounts of dye are injected into the catheter. X-ray pictures are taken to identify the branches of the artery supplying blood to the tumor(s). Up to three chemotherapy drugs, mixed together, are then injected into that artery. An oil contrast added to the chemotherapy helps to keep the drugs in contact with the tumor(s). Tiny particles are added to the end of the injection to slow the blood flow to the tumor(s).

The Benefits Of Chemoembolization Include:

1. The tumor(s) becomes starved of oxygen and nutrients after the blood supply is compromised.

2. The drugs are delivered directly to the tumor(s) and are much more concentrated than standard chemotherapy.

3. The drugs can affect the tumor(s) for a longer period of time- up to a month.

4. There is a decrease in side effects because the chemotherapy does not circulate throughout the body as standard chemotherapy does.

Following the procedure, you will be treated with intravenous fluids, pain medication and antibiotics overnight in the hospital. You will need to lie flat for several hours to allow the artery in your groin to seal. You may eat following the procedure.

You will be sent home on antibiotics and medication for pain and nausea if needed. Side effects of the procedure include varying degrees of pain, fever and nausea. These symptoms usually last for several days. You may experience a decrease in appetite. It is important to drink plenty of fluids to prevent dehydration.

Serious complications following chemoembolization are rare. In less than 3% of the procedures, the tumor affected by the procedure may become infected. Severe liver damage, though extremely rare, may also occur.

Chemoembolization will not cure liver cancer. The goal of the treatments is to stop the tumor(s) from growing, reduce tumor size, decrease pain, and preserve liver function.

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