Chemo Infusion and Chemoembolization of Liver (cont.)
Tse-Ling Fong, MD
Dr. Fong is the Medical Director of the USC Liver Transplant Program and Associate Professor of Medicine at the USC Keck School of Medicine. He obtained his medical degree from the University of Southern California and completed his residency in Internal Medicine at Los Angeles County-USC Medical Center. He is board certified in Internal Medicine and the subspecialty of Gastroenterology.
In this Article
- Why is the chemotherapy injected into the hepatic artery?
- What are the side effects and benefits of arterial chemotherapy infusion?
- Just how is arterial chemotherapy infusion done?
- What happens to the patient after this procedure is done?
- How does chemoembolization differ from arterial chemotherapy infusion?
- How does chemoembolization compare with arterial chemotherapy infusion?
- What about mixing the chemotherapy with lipiodol?
- What are the benefits of TACE?
- Find a local Oncologist in your town
Just how is arterial chemotherapy infusion done?
An interventional radiologist (one who does therapeutic procedures) usually carries out this procedure. The radiologist must work closely with an oncologist (cancer specialist), who determines the amount of chemotherapy that the patient receives at each session. Some patients may undergo repeat sessions at six- to 12-week intervals. This procedure is done with the help of the visualization of the hepatic arterial circulation via fluoroscopy (type of x-ray) imaging. A catheter (long, narrow tube) is inserted into the femoral artery in the groin and is threaded into the aorta (the main artery of the body). From the aorta, the catheter is advanced into the hepatic artery. Once the branches of the hepatic artery that feed the liver cancer are identified, the chemotherapy is infused. The whole procedure takes one to two hours, and then the catheter is removed.
What happens to the patient after this procedure is done?
The patient generally stays in the hospital overnight for observation. A sandbag is placed over the groin to compress the area where the catheter was inserted into the femoral artery. The nurses periodically check for signs of bleeding from the femoral artery puncture. They also check for the pulse in the foot on the side of the catheter insertion to be sure that the femoral artery is not blocked as a result of the procedure. (Blockage would be signaled by the absence of a pulse.)
Generally, the liver blood test levels rise during the two to three days after the procedure. This worsening of the liver tests is actually due to death of the tumor (and some non-tumor) cells. The patient may experience some post-procedure abdominal pain and low-grade fever. However, severe abdominal pain and vomiting suggest that a more serious complication has developed. Imaging studies of the liver are repeated in six to 12 weeks to assess the change in size of the tumor in response to the treatment.
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