TACE/TARE

Transarterial Radioembolization

Transarterial Radioembolization (TARE) is a minimally invasive surgery that selectively delivers intrarterial radiation dose to the liver tumor. This procedure helps patients suffering from Liver Malignancy, be it primary tumours like Hepatocellular Carcinoma (HCC) or Cholangiocarcinoma,  which are among the top five most common cancers worldwide.

The diagnosis of HCC is often late. Hence radical therapy does not offer much success. However, TARE shows promising results.

TACE, or transarterial chemoembolisation, is a minimally invasive procedure that combines embolisation with the delivery of chemotherapy to treat cancer. TACE is often used to treat tumours in the liver. 

The procedure involves injecting anti-cancer drugs into the blood vessel feeding a cancerous tumour, then placing synthetic material called an embolic agent inside the blood vessels that supply blood to the tumour. 

TACE effectively kills cancer cells while preserving healthy tissue by trapping chemotherapy in the tumour and blocking blood flow.

WHY IS IT DONE?

Transarterial radioembolisation (TARE) is a treatment method that uses radiation to destroy the tumour in the liver. It treats patients with unresectable HCC and a life expectancy of at least three months.

TARE helps patients with HCC confined to the liver with tumours comprising less than 70% of the liver volume and those unsuitable for surgery or other treatment modalities. 

TARE promises a good treatment effect, particularly in patients with significant vascular involvement. 

Transarterial means "through the artery," and radioembolisation is a term for using tiny beads of radiation-emitting material (tiny beads) to destroy cancer cells in an area of your body.

Transarterial chemoembolisation (TACE) is a minimally invasive surgery where surgeons use a catheter to inject chemotherapy directly into the liver tumour. It primarily helps patients with diseases limited to the liver, whether the tumour began in the liver or spread to the liver (metastasised) from another organ.

TACE treats: 

• Primary liver cancer

• Cholangiocarcinoma or the primary cancer of the bile ducts in the liver)

• Spread to the liver from cancers originating in the colon, breast, carcinoid and other neuroendocrine tumours, islet cell tumours of the pancreas, and other vascular primary tumours in the body.

Visit the best interventional radiology hospital in Delhi to get the best treatment with the help of a team of experts at Manipal Hospitals. 

RISK

• Transarterial radioembolisation (TARE)

The risks associated with TARE include:

• Bleeding

• Fever, chills and other Infusion reactions

• Fluid build-up in the lung

• Gastric ulcer

• Fatigue and nausea 

• Bladder pain

• Skin irritation at the incision site

• Hair loss 

• Transarterial chemoembolisation (TACE)

There are several risks associated with TACE, including:

• Damage to the blood vessel

• Bruising or bleeding at the incision site. 

• Although rare, the embolisation material may lodge in the wrong place, depriving normal tissue of blood supply.

• Patients with diabetes or kidney diseases may experience kidney damage.

• Nausea, hair loss, platelets and white blood cells decrease, and anaemia.

• Infection or liver damage. 

• Pediatric patients risk blood clots because of the small vessel size.

PREPARATION

• Transarterial radioembolisation (TARE)

Transarterial radioembolisation (TARE) is a treatment that uses tiny particles to destroy cancer cells. It is mainly used to treat liver cancer and is sometimes used to treat lung cancer. Preparation for this procedure involves:

• Doctors assess patients' fitness to undergo the treatment.

• Surgeon administers anaesthesia

• Doctors ensure no blockages or other issues with this vessel before treatment begins.

• Doctors study the patient's medical history and conduct a physical examination.

• Patients undergo clinical laboratory tests, imaging, and arteriography/macro aggregated albumin (MAA) lung shunting study.

• Doctors may conduct angiography to assess the treatment.

• Transarterial chemoembolisation (TACE)

Transarterial chemoembolisation is a procedure that removes cancerous tumours from the liver. The procedure is done by injecting tiny particles into the bloodstream and delivering them to the tumour. Preparations for TACE involve:

• Blood tests check kidney function and determine if blood clots normally.

• Patients need to declare all their medications, including supplements. 

• Patients need to inform doctors about any allergies.

• Doctors may recommend fasting.

DURING THE PROCEDURE

• Transarterial radioembolisation (TARE)

• The surgeon inserts an intravenous line (IV) into the arm or hand to administer drugs.

• A catheter through the patient's groin reaches into their blood vessels towards the liver (transarterial approach). 

• Surgeons use the catheter to inject radioactive particles directly into the liver (intra-arterial injection).

• Radioactive particles kill cancer cells by damaging their DNA.

• Transarterial chemoembolisation (TACE)

• X-ray images map the path of the blood vessels feeding the tumour.

• The doctor gives medication to help protect the kidneys from the chemotherapy.

• The doctor provides medications to help prevent nausea and pain and antibiotics to help prevent infection.

• The nursing staff monitors heart rate, blood pressure, oxygen level, and pulse.

• The surgeon inserts a thin catheter using X-ray guidance through the skin into an artery, either in the groin or wrist, and advances it to the liver. 

• Surgeons inject contrast material through the catheter. 

• The surgeon injects mixed anti-cancer drugs and embolic agents. 

• Additional x-rays confirm tumour treatment.

AFTER THE PROCEDURE

• Transarterial radioembolisation (TARE)

• The doctor assesses patients for adverse events attributable to TARE, namely abdominal pain, nausea, vomiting, and fatigue.

• The doctor examines if the disease symptoms exist. 

• The patient should be able to leave the hospital within 48 hours if their pain and nausea have subsided.

• Transarterial chemoembolisation (TACE)

• The pain and nausea will subside within 48 hours after the procedure, and the patient can leave the hospital.

• The doctor prescribes medicines and antibiotics.

• Some fever, fatigue and nausea may remain for two weeks.

• If pain or fever increases, the patient must contact the doctor immediately.

• Some patients may get a breathing apparatus with usage instructions to help inflate lungs and avoid the development of pneumonia.

RESULT

• Transarterial radioembolisation (TARE)

• The doctor recommends lifestyle changes to move to everyday activities gradually.

• The dietician recommends the nutrition plan for the patient.

• The patient may resume everyday activities after two weeks under the doctor's guidance.

• Transarterial chemoembolisation (TACE)

• The patient gradually resumes everyday activities after a week.

• After a month, the doctor conducts a CT scan or MRI to assess the treatment.

• The surgeon may repeat TACE if needed.

WHY MANIPAL HOSPITALS?

At Manipal Hospitals, we believe that every patient deserves the best treatment. Our tumour board discusses each case in depth to determine the most appropriate treatment for each patient based on their unique condition. We ensure that our team comprises experts at all stages of cancer treatment and that they have access to state-of-the-art facilities.

It can be overwhelming when cancer strikes—but we are here every step of the way. Our expert team has access to state-of-the-art facilities and equipment that allow us to provide treatments for every stage of cancer at all ages. 

Manipal Hospitals offer treatments for cancers even at advanced stages. We ensure a comfortable stay for our patients with multi-speciality, nutrition guidance, physiotherapy, and palliative care services for all patients.

FREQUENTLY ASKED QUESTIONS

• What are the limitations of TACE?

Doctors do not recommend TACE if the patient has severe damage to the liver or kidney. Patients also need average blood clotting ability to handle the TACE procedure. 

• When is TARE recommended?

Patients with advanced disease may find that TARE is a good option for treatment, especially considering the less selective nature of the procedure. 

TARE has also demonstrated utility in patients with portal vein thrombosis, a relative contraindication to TACE.

• What is hepatic cancer?

Hepatic cancer, or hepatocellular carcinoma (HCC), is a type of liver cancer that begins in the cells of the liver and can spread to other parts of the body. While it is not common, it is still one of the most deadly cancers.

Some patients have no symptoms at first and find out they have hepatic cancer during a routine blood test or other diagnostic procedure. 

SUMMARY

Transarterial Radioembolization (TARE) and Transarterial chemoembolisation (TACE) are minimally invasive surgeries that block blood vessels to prevent blood flow. TARE helps patients suffering from primary tumours like Hepatocellular Carcinoma (HCC). TACE combines embolisation with the delivery of chemotherapy to treat cancer.

TARE uses tiny beads of radiation-emitting material (tiny beads) to destroy cancer cells in an area of your body. TARE is a minimally invasive procedure combining embolisation with chemotherapy delivery to treat cancer. TACE injects chemotherapy directly into the liver tumour. TARE combines embolisation with the delivery of chemotherapy to treat cancer.

In TARE, Surgeons use the catheter to inject radioactive particles directly into the liver (intra-arterial injection). The Radioactive particles kill cancer cells by damaging their DNA. In TACE, Surgeons use a catheter to inject mixed anti-cancer drugs and embolic agents through the catheter.