Utilized to treat tumors in the liver, chemoembolization is the process of injecting chemotherapy directly into the blood vessels which feed the tumor.
Chemoembolization is a treatment that can be focused on cancerous cells that have spread to the liver but does not expose the rest of the body to the effects of chemotherapy. It is not a cure but does offer relief (palliative) and preserves the quality of life. The technique is minimally invasive and approximately 70% of patients will experience improvement in liver function and survival time.
The referring physician will probably recommend several tests prior to the procedure, such as, liver function blood tests and a CAT scan or an MRI of the liver. These tests insure there is no blockage of the portal vein in the liver; there is no cirrhosis of the liver; and there is no blockage of the bile ducts. Any of these complications may prevent the procedure from being performed.
A radiologist performs this procedure in a hospital under x-ray guidance by inserting a small catheter (tiny tube) through a hollow needle into the femoral artery, located in the groin. It is then threaded up through the aorta and into the artery in the liver that feeds the tumor. During chemoemolization, three chemotherapy drugs are injected directly into this artery and it is then "embolized" or blocked off with a mixture of oil and tiny particles. Since the drugs are injected directly into the tumor, the dosage is 20-200 times greater than that received with standard treatment via a vein in the arm. Since the tumor is blocked off, the drugs stay in it for a much longer time. Also, with the blood supply blocked, the tumor is deprived of oxygen and nutrients, which serves to hasten its destruction. The liver has two blood supplies, a hepatic artery and a large portal vein so it can still function with one blocked off.
The procedure takes approximately three hours to perform, occurs while the patient is under conscious sedation, and usually involves an overnight stay in the hospital. It is usually performed on a monthly basis with three sessions being the average treatment regimen.
Linda K. Bennington C.N.S., M.S.N., The Gale Group Inc., Gale, Detroit,