Chemotherapy embolization is referred to as chemoembolization. It is a procedure that involves a combination of chemotherapy and a process called embolization. Although this treatment is not considered to be the best to cure cancer, it does help in improving the quality of life of the patient. So how does chemoembolization work? The name of the treatment contains the term chemotherapy in it; however it is slightly different than the conventional chemotherapy procedure. In this procedure, the chemotherapy drugs are directly injected into the blood vessel that feeds the malignant tumor. Besides injecting the drugs, substances called embolic agents are transferred to the blood vessels that provide blood to the cancerous tumor. These embolic agents block the blood vessels and as a result the tumor is deprived of blood flow. Chemoembolization is used for patients with liver cancer and could also be used to shrink the tumor in the liver until the patient gets a donor organ. Although this procedure is characterized with liver cancer it could be used for other cancers that have spread to the liver. Metastasis or spread to the liver from breast cancer, sarcomas, colon cancer etc. could be treated with chemoembolization. Depending on the type of tumor, chemotherapy embolization could be used with other cancer treatment options such as radio frequency ablation or radio therapy.

Preparation for Chemotherapy Embolization

Before undergoing this treatment, the doctor will prescribe tests to determine the location of the tumor, the size, type and the severity of it. Some of the tests that could be conducted to determine what is required involve blood tests, liver function tests, biopsy, MRI, spiral CT scan and arteriography. Any regular intakes of medicines should be informed to the doctor. A case of pregnancy should also be informed to the doctor if X-ray needs to be taken along with the other tests as the fetus could be exposed to radiation. Chemotherapy during pregnancy can be harmful for the fetus; if you are expecting a baby, or planning to have one, talk to your doctor about it. Before undergoing the procedure the patient may be asked to stop the intake of aspirin and non-steroidal anti inflammatory drugs for a specific period.

On the day of the procedure the patient may be given antibiotics, sedatives, anti-nausea drugs, intravenous fluids or painkillers. Eating or drinking is not allowed for about 4-8 hours before the procedure if the patient is to be given sedatives during the treatment.

Procedure of Chemotherapy Embolization

In chemoembolization, a catheter which is a thin and long plastic tube, an X-ray equipment and embolic agents are used. The embolic agents used to block the blood vessels are tiny particles made from plastic (made from polyvinyl alcohol) or oil. An IV or intravenous line may also be required during the procedure.

Chemoembolization is performed by an expert in intrerventional radiology and usually takes not more than one and a half hours. First of all, the X-ray images are taken to locate the path of the blood vessels that feed the tumor. Once the path is mapped out, sedative is given to the patient through the IV line. General anesthesia could also be given to the patient. After that a small cut is made in the skin at the location and the catheter is inserted through the cut. This goes through the femoral artery, then the large groin vessel and eventually advances into the liver. Once it reaches the liver, another substance is injected via IV and more X-rays are taken. The embolic agents and the available chemotherapy drugs are then mixed and injected into the area. This process should destroy the tumor. It is confirmed by taking another X-ray after the procedure. The last step is to remove the catheter and stop the bleeding if any and dress the slit made for the procedure.

The patient is kept under observation after the procedure for about 5-6 hours. Abdominal pain could be one of the immediate effects of the procedure that could be noticed during this period. Antibiotics are given to the patient after the procedure and the patient is usually required to stay in the hospital for 1 or 2 days. One week is usually enough to get back to the normal activities however, signs of weakness and low energy levels may be evident for approximately 2 weeks or so.

Normally chemotherapy embolization is a safe procedure; it may cause nausea and vomiting, low grade fever and bruising as minor side effects. Sometimes, patients might experience pain at the location where the catheter was inserted during the procedure. These minor discomforts could be controlled with medication. As mentioned before, this treatment option does not guarantee a complete cure but it does show significant improvement in the liver and liver functions.