Transarterial Chemoembolization (TACE)

Transarterial Chemoembolization (TACE) is a minimally invasive procedure used primarily to treat liver cancer. It combines chemotherapy and embolization to target tumours directly while minimizing damage to healthy tissue.

When Do I Need the Procedure

• Primary Liver Cancer: Often used for hepatocellular carcinoma (HCC) when surgery isn’t an option.
• Metastatic Liver Cancer: Treats cancers that have spread to the liver from other parts of the body.
• Bridge to Transplant: Helps control tumour growth while waiting for a liver transplant.

What Do I Expect

During Transarterial Chemoembolization (TACE), you can expect the following:

1. Preparation: Before the procedure, you’ll undergo a pre-assessment, including blood tests and imaging scans. You may need to fast for several hours and stop certain medications. You’ll also receive antibiotics and possibly a sedative.
2. Procedure:

• A trained interventional radiologist will perform the procedure in a specialized radiology suite.
• You’ll be given a local anaesthetic to numb the area where the catheter will be inserted (usually the groin).
• Using imaging guidance, the radiologist will insert the catheter into the artery supplying the tumour and deliver chemotherapy drugs along with embolic agents to block the tumour’s blood supply.
• Embolic agents (e.g., tiny beads or gels) are used to block the blood supply to the tumour, trapping the chemotherapy in place and starving the tumour of oxygen and nutrients.

3. Duration: The procedure typically takes 1–2 hours, depending on the complexity.
4. Post-Procedure: Afterward, you’ll be monitored for a few hours to ensure there are no immediate complications. You may experience mild discomfort or fatigue.

After the procedure

Patients may experience some common side effects, including nausea, pain in the abdomen or right shoulder, fatigue, and fever. Here are some key aftercare recommendations:

1. Managing Nausea & Vomiting: Anti-nausea medications may be prescribed. Drinking fluids like water, diluted juice, or sports drinks can help prevent dehydration.
2. Pain Management: Pain in the catheter entry siteis common. Prescription pain medication may be necessary.
3. Monitoring Fever: A mild fever is expected, but if it exceeds 38°C, medical attention may be needed.

Safety of the Procedure

Transarterial Chemoembolization (TACE) is generally considered a safe and minimally invasive procedure for treating liver cancer and other cancers that have spread to the liver. It delivers chemotherapy drugs directly to the tumour while blocking its blood supply, minimizing systemic side effects.

Benefits

• Targeted Treatment: Chemotherapy is concentrated at the tumour site, reducing exposure to the rest of the body.
• Minimally Invasive: Performed under imaging guidance, it avoids the need for open surgery.
• Preserves Liver Function: The procedure does not significantly affect the liver’s overall blood supply.
• Can shrink tumours, making surgery or other treatments possible.

Risks

While complications are rare, they can include:

• Pain or Discomfort: Temporary soreness or mild pain at the catheter insertion site.
• Infection: A rare possibility at the puncture site.
• Allergic Reaction: Some patients may react to the contrast dye used during the procedure.
• Possible side effects include fever, nausea, or post-embolization syndrome (pain and fatigue).
• Not suitable for patients with severe liver dysfunction or certain other conditions.

Cost of the Procedure

• Transarterial Chemoembolization (TACE) is a hospital procedure, it is covered under most hospitalization plans.
• The procedure is also Medisave deductible. Most of the companies’ health benefits and private health insurances cover the cost of the procedure, which may extend to the private hospitals.
• The fee benchmarks on the procedure done in different hospitals can be found in the website of Ministry of Health Singapore.
• Before the endoscopic procedure, a detailed financial counselling will be done to help the patients understand the cost breakdown in the preferred hospital.
• Patients should also check with their insurance provider on the updated policy regulations before the procedure.