Let's learn about TACE treatment, which treats the cancer itself? (Transarterial Chemoembolization)

It is difficult to put into words the fear and shock you feel when you or someone you love is diagnosed with cancer. But thanks to the advancements in medicine today, there are many effective treatments that target only cancer cells and minimize damage to the body. One such treatment, especially for liver cancer, is TACE. Let's talk about this in simple terms today.

Simply put, what is TACE treatment?

The full name of TACE is Transarterial Chemoembolization . Although the name is a bit complicated, what happens in this is very simple. Think of a cancer as a place where bad guys are hiding. They need food and water (i.e. blood) to live. In this treatment, you find the main blood vessel that supplies blood to the cancer, and inject some anti-cancer drugs ( chemo ) directly into the cancer through that vessel. Then, the blood vessel is blocked with a small particle.

Simply put, this does two things at once:

1. The medicine that kills cancer cells is delivered directly to the tumor .

2. When the tumor stops receiving blood, it loses the oxygen and nutrients it needs, and the tumor becomes weak and begins to die, as if "caught in a coma."

Is this different from regular chemotherapy?

Yes, this is very different from the chemotherapy we usually know. Let's see what the main differences are.

Who is this TACE treatment suitable for?

This treatment is mainly used for people with liver cancer (hepatocellular carcinoma) , especially those with tumors that are too large to be removed surgically.

Also, this treatment is used for several types of cancer that have spread to the liver (metastasized) from other places.

• Breast cancer
• Colon cancer
• Neuroendocrine tumors (cancers related to the nervous system)
• Sarcoma (` Sarcoma `)
• Ocular melanoma

Will this harm the liver?

This is a reasonable fear for many people. But surprisingly, there are two main blood supply routes to our liver.

1. Hepatic artery: This artery supplies a small amount of blood to the liver. However, cancerous tumors in the liver receive almost all of their blood supply from this artery.

2. Portal vein: This is where the liver receives the majority of its blood supply.

In TACE treatment, only the hepatic artery that supplies blood to the cancer is blocked. Since the healthy parts of the liver continue to receive blood from the portal vein, there is no significant damage to the liver's function.

Are there people who should not have TACE treatment?

Yes, this treatment is not suitable for everyone. Your doctor will examine you and decide whether this is suitable for you. It is generally not suitable for people with the following conditions:

• If the bile ducts are blocked
• If you have blood clotting disorders
• If you have kidney disease
• If the cancer has spread to multiple organs in the body
• If you have other serious liver conditions (hepatic encephalopathy, portal vein thrombosis)
• If you have severe allergies to specific dyes used in the treatment

Okay, now let's see how this TACE treatment works.

This treatment is performed by an Interventional Radiologist . That is, a doctor who uses special X-ray-like machines to look at the body and insert small tubes (catheters) into it.

What do you do before treatment?

Your doctor will perform several tests to plan your treatment.

• A CT scan or MRI scan
• Blood tests to check kidney function and blood clotting

Also, before treatment, you may be given antibiotics to prevent infection, medications to reduce nausea, and medications to protect your kidneys from substances released when cancer cells die.

What happens during treatment?

This is not a major operation. Here's what happens:

1. Small children are given general anesthesia . This means they are completely asleep. Adults are only given sedation, which makes them a little sleepy .

2. The doctor will make a very small cut into a blood vessel near your groin or wrist.

3. A thin tube called a catheter is inserted through that incision.

4. Then, while looking at a special X-ray-like machine (`fluoroscopy`), the tube is carefully advanced to the vein that supplies blood to the liver cancer tumor.

5. Next, a special dye is passed through the tube. The cancer and the surrounding blood vessels are then clearly visible.

6. Once the exact location is found, the doctor injects a mixture of chemotherapy drugs and small particles (embolic agents) that block the blood vessel into the vein.

7. When the procedure is finished, the catheter is removed and a bandage is applied to the small incision. Since there is no large incision, there is no need for stitches.

What are the benefits and risks of this treatment?

Like any medical treatment, TACE has both benefits and risks.

What happens after treatment? How long does it take to recover?

After treatment, many people experience fever, nausea, vomiting, and pain. This is called postembolization syndrome . This is common. You will need to stay in the hospital for a day or two until these symptoms subside.

You need to rest a little after you go home.

• Take the medicine your doctor gives you for pain and nausea.
• There may be a slight fever for about a week.
• You may feel tired and have a loss of appetite for several weeks.

All of this gradually subsides. Most people recover completely within a few weeks and live a good quality of life. However, you will need to continue to be tested to see if new tumors develop.

If you have these symptoms, see a doctor immediately!

If you experience any of the following symptoms after you go home after treatment, call your doctor immediately or go to the hospital where you received treatment.

• If you cannot control vomiting and nausea despite taking medication.
• If you have difficulty concentrating, feel confused, or have difficulty walking.
• If you have a fever that won't go away and your body is cold and sweaty.
• If the eyes or skin turn yellow (jaundice) - this may be a sign of liver damage.

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