Chemoembolization

Chemoembolization is a procedure in which chemotherapy drugs and embolic agents
are delivered directly to a tumor via a long, thin tube called a catheter. Tiny particles in embolic agents block the blood vessels leading to the tumor, which deprives it of blood flow. Embolic agents also increase the concentration and toxicity of the chemotherapy drugs.

Chemoembolization kills cancer tumors but spares healthy tissue, minimizing side effects of conventional chemotherapy, such as hair loss and nausea.

Currently, the procedure is mainly used to treat patients with primary liver cancer or other types of cancer that have spread to the liver.

Chemoembolization can not cure cancer, but it can increase the length of life. Chemoembolization is often used with other interventional cancer therapies, including radiofrequency ablation, cyoablation, chemical ablation and some intravenous chemotherapies.

When is it indicated?
Chemoembolization is indicated in patients who have liver cancer and are candidates for the procedure. Chemoembolization may also be used to shrink liver tumors while the patient awaits a donor again.

A liver biopsy helps determine the type and severity of liver cancer.

Pre-treatment Guidelines
The physician will order tests to determine the location, type and severity of the cancer.
These tests may include:
• Biopsy
• Blood tests
• Computed Tomography (CT) scan
• Spiral CT scan
• MRI
• Liver function tests
• Arteriography
The night before the procedure, the patient is usually required to fast. However, water is often allowed up to 2 hours before the procedure.

Patients may be given one or more of the following drugs the day of the procedure:
• Antibiotics
• Antinausea drugs
• Painkillers
• Sedatives
• Intravenous fluids

Who is eligible?
Eligible patients have primary or secondary liver cancer.
Patients who have severe cirrhosis may be ineligible for chemoembolization.
The following conditions increase the risk of complications from the procedure:
• A blockage in the portal vein in the liver
• Bile duct obstruction
• Poor liver function
• Poor kidney function
• Diabetes mellitus
• A tumor that is greater than 50 percent of the liver volume

If disease outside the liver (such as colon cancer) is the main source of symptoms, other treatments should be considered because chemoembolization only treats the liver.

What to expect?
The physician will locate the tumor using arteriography and choose an insertion point for the catheter, usually above the femoral artery in the groin.

Interventional procedures are generally painless. Because there are no nerve endings inside the arteries, people can not feel the catheters as they move through their body.
Using an imaging technique called fluoroscopy, the physician steers the catheter through the arteries to the tumor, administers chemotherapy and embolic agents and removes the catheter.

Once treatment is complete, pressure is applied on the insertion site for 15 to 30 minutes to prevent bleeding.

Post-treatment Guidelines and Care
The patient’s vital signs are monitored for the first 5 to 6 hours after the procedure. Initially, some patients may experience abdominal pain. Antibiotics and antinausea drugs are administered as needed.

Chemoembolization typically requires a hospital stay of 1 to 2 days.

Patients can usually resume normal activities within 1 week. Chemoembolization patients typically have lower energy levels for 2 to 3 weeks following the procedure.
Patients return for follow-up CT scan, MRI or blood tests. A second treatment, if needed, is usually performed 1 to 2 months after the first.

Possible Complications
In general, chemoembolization is safe and commonly associated with only minor side effects including:
• Low-grade fever
• Nausea
• Pain

These side effects are usually controlled with medication. Other minor complications include hair loss and bruising or bleeding at the insertion site.

Rarely, chemoembolization causes serious complications such as:
• Injury to the liver
• Allergic reaction to the contrast material used in arteriography
• Liver abscess
• Hemorrhage or bleeding

Providing safe, quality patient care is our highest priority. To help ensure quality and safety, we ask that you do not bring young children with you to your appointments, as children are not allowed to accompany you during Imaging procedures. Staff is unable to monitor your child in your absence.

If you have any questions or concerns, please contact your doctor or contact Imaging Services at (320) 255-5619.

Your appointment is on:

Date: ________________ Time: ________________ at the following location:

____ St. Cloud Hospital - please check in at Door A / South Entrance

____ CentraCare Health Plaza - please check in at Woodlands Entrance