Chemoembolization

Embolization is the process of injecting a foreign substance into the tumor to stop the blood flow. The lack of blood deprives the tumor of needed oxygen and nutrients and eventually causes cells to die. The tumor blood supply is stopped with small pieces of material that have been saturated with chemotherapy drugs. Once the blood flow has stopped, the tumor is soaked in a very high concentration of drugs for a prolonged period of time. Thus, the tumor cells die very quickly. Below is a sketch that demonstrates the mechanism of chemoembolization.

A variety of materials may be used in the embolization process. Most embolization materials only cause temporary blockage of blood flow to the tumor cells, though in some cases materials will be used that can cause permanent blockage.

Chemoembolization is most beneficial to patients whose disease is limited to the liver. Some success has been demonstrated with patients whose cancer has spread to other areas. Patients with kidney disease, blood coagulation problems, or known allergies to contrast agents are not good candidates for this procedure.

The chemoembolization procedure takes place in a hospital setting. The actual procedure depends on the embolizing agent being used. Such issues as drug administration, anesthetic requirements, length of time of procedure, and potential side effects differ with each agent.

Chemoembolization is considered to be a relatively safe and effective method of treating unresectable liver tumors. The overall risk of the procedure is related to your general underlying health. People with jaundice, severe cirrhosis or kidney failure have an increased chance of complications.

Under x-ray guidance a small catheter is inserted into the femoral artery (located in the groin) and advanced into the liver artery. The embolic material and drugs are then injected through the catheter into the liver tumor. The procedure usually lasts 2 - 3 hours.

The majority of patients experience some side effects which may include abdominal pain, nausea, vomiting or fever. Various drugs can be administered that will control these symptoms and keep you comfortable. The symptoms will stop after 3 - 5 days. Studies show that patients with hepatocellular cancer undergoing this procedure may experience tumor shrinkage as well as an increased survival rate. The effectiveness of this therapy for patients with metastatic colon cancer is currently undergoing active investigation.

Below is an example of a patient with a large liver tumor (depicted as the dark area) who underwent chemoembolization.

Five months later the tumor was necrotic (depicted as a round and homogenous mass) and the remainder of the liver had grown or hypertrophied. This patient subsequently underwent a liver resection.

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