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Cancer Treatment-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.

Chemoembolization is most beneficial to patients whose disease is predominately limited to the liver, whether the tumor began in the liver or spread to the liver (metastasized) from another organ.

Your doctor may recommend Chemoembolization to treat cancers such as Hepatoma or hepatocellular carcinoma (primary liver cancer) or Metastasis (spread) to the liver from:

  • Colon cancer
  • Breast cancer
  • Carcinoid tumors and other neuroendocrine tumors
  • Islet cell tumors of the pancreas
  • Sarcomas
  • Other vascular primary tumors in the body

Several days before the procedure, you will have an office consultation with the interventional radiologist who will be performing your procedure. Prior to your procedure, your blood may be tested to determine how well your liver and kidneys are functioning and whether your blood clots normally. You will receive specific instructions on how to prepare, including any changes that need to be made to your regular medication schedule. If you are going to be given a sedative during the procedure, you may be asked not to eat or drink anything for four to eight hours before your exam. If so, you may want to have a relative or friend accompany you and drive you home afterward. You may have to stay overnight at the hospital for one or more days. You will be given a gown to wear during the procedure.

In this procedure, x-ray equipment, a catheter and embolic agents are used. A catheter is a long, thin plastic tube, about as thick as a strand of spaghetti. Various materials called embolic agents are used to occlude or block off blood vessels, but the most common are oil or plastic particles made from polyvinyl alcohol (PVA). Other equipment that may be used during the procedure includes an intravenous line (IV) and equipment that monitors your heart rate and blood pressure.

Chemoembolization attacks the cancer in two ways. First, it delivers a very high concentration of chemotherapy, or anti-cancer drugs, directly into the tumor, without exposing the entire body to the effects of those drugs. Second, the procedure cuts off blood supply to the tumor, trapping the anti-cancer drugs at the site and depriving the tumor of the oxygen and nutrients it needs to grow. The liver is unique because it has two blood supplies-an artery (the hepatic artery) and a large vein (the portal vein). The normal liver receives about 75 percent of its blood supply through the portal vein and only 25 percent through the hepatic artery. But when a tumor grows in the liver, it receives almost all of its blood supply from the hepatic artery.

Chemotherapy drugs injected into the hepatic artery reach the tumor very directly, sparing most of the healthy liver tissue. Then, when the artery is blocked, the blood is no longer supplied to the tumor, while the liver continues to be supplied by blood from the portal vein. This also permits a higher concentration of the anti-cancer drugs to be in contact with the tumor for a longer period of time.

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