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Local therapy
Liver-directed therapy (TACE & TARE)
Treating liver tumours through their own blood supply, leaving the rest of the liver alone.
Delivered at a partner unit
What it is
A catheter is threaded to the artery feeding the tumour and either chemotherapy with embolic particles (TACE) or radioactive microspheres (TARE) are delivered directly into it. Healthy liver, fed mainly by the portal vein, is largely spared.
These are workhorse treatments in hepatocellular carcinoma and in liver-dominant metastatic disease. They are not curative on their own in most cases; they buy control, and sometimes they bridge a patient to transplant or resection.
When it is used
- Hepatocellular carcinoma not suitable for surgery or ablation
- Liver-dominant metastatic disease
- As a bridge to transplant
- When liver disease is what will determine survival
How the decision is made
- Whether liver disease is the thing that limits you, or whether disease elsewhere makes this beside the point.
- Liver function reserve, this is the constraint that decides who can safely have it.
- TACE or TARE, and how many sessions are realistic before diminishing returns.
Decided here; delivered at an interventional radiology and nuclear medicine partner unit.
Who does what
What we handle, and what happens elsewhere
KPCIRC handles
- Liver reserve and staging review
- A board decision on sequence with systemic therapy
- Transplant-candidacy screening where relevant
- Written response assessment after each cycle
Performed and billed elsewhere
- The catheter procedure
- Radioisotope supply and dosimetry
- Overnight observation
- Post-embolisation syndrome, fever, pain, nausea for a few days, is common and expected. Jaundice, confusion or swelling is not.
Questions to ask your own doctor
Take these with you. They work whether or not you are treated here.
- Is my liver function good enough for this?
- Will this be combined with systemic treatment or replace it?
- How many sessions are we planning?
- Could this make me a transplant or surgery candidate?
Support that goes with it
Where this is used
Cancers this commonly forms part of
Not sure this is the right option for you?
That is exactly what a second opinion is for. Bring what you have, we will tell you what is missing and what the alternatives actually are, in writing.