Perlmutter Cancer Center doctors may use embolization—a technique that delivers either chemotherapy or radiation therapy directly to liver or bile duct tumors—to destroy cancer cells. It can also be used to treat people with cancer that has spread to the liver from other organs, such as the colon. The treatment blocks blood flow to tumors, helping to kill cancer cells, and increase the effectiveness of chemotherapy or radiation therapy. A portal vein embolization can be used to help improve liver function after surgery, if necessary.
Embolization with chemotherapy is known as chemoembolization, and embolization with radiation therapy is called radioembolization.
Either technique may be used in people with both small and large liver tumors and multiple tumors. An interventional radiologist, a doctor who uses minimally invasive techniques with the guidance of imaging tests, usually performs embolization procedures.
Chemoembolization delivers chemotherapy drugs to tumors such as doxorubicin for liver cancer cell, or irinotecan for colon cancer that has spread to the liver. The procedure also distributes substances that block blood flow to the tumor, which helps chemotherapy destroy cancer cells.
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Chemoembolization offers several advantages over systemic chemotherapy, in which drugs are used to destroy cancer cells throughout the body. It allows the chemotherapy drug to stay in contact with the tumor for up to several weeks, increasing the medication’s effectiveness. With chemoembolization, the concentration of the drug can be up to 200 times that of systemic chemotherapy.
This therapy is delivered only to the tumor and does not travel throughout the bloodstream, as does systemic chemotherapy. This allows healthy tissue to be spared from treatment, reducing the occurrence of side effects. For this reason, doctors can give a higher-than-usual dose of chemotherapy.
Blocking blood flow to the tumor helps to hold the chemotherapy in place. It may also deprive the tumor of the oxygen and nutrients it needs to live and grow.
For tumors larger than 3 centimeters in diameter, chemoembolization followed by thermal ablation can increase the effectiveness of each treatment approach. This combined therapy can also help to destroy any remaining cancer cells, reducing the chance of recurrence.
Radioembolization is similar to chemoembolization. In this procedure, radioactive particles are delivered through tubing called a catheter into the artery or arteries feeding the liver tumor.
These radioactive particles lodge in very small arteries within the tumor and help destroy cancer cells. The particles also block blood flow through the arteries to the cancer, depriving it of the oxygen and vital nutrients that support its growth.
Delivering radioactive particles directly to the tumor avoids exposing healthy tissue to the treatment. The level of radiation gradually declines and is usually gone in about two weeks.
Doctors recommend that people who receive this treatment take some precautions afterward, including limiting their physical proximity to other people, especially children, for several days.
Prior to and following the procedure, your doctor also prescribes a medication that prevents ulcer formation in the stomach and the upper portion of the small intestine.
What to Expect During Embolization
A physician starts chemoembolization or radioembolization therapy by inserting a catheter into an artery in the groin and advancing it into the artery supplying the liver. He or she then injects a contrast agent, which highlights the vessels and tumors on X-ray images of the liver.
During chemoembolization, the doctor moves the catheter directly into the artery feeding the tumor and injects doxorubicin and small beads or particles that block blood flow. For radioembolization, he or she injects radioactive particles. Afterward, the doctor withdraws the catheter from the body and applies pressure to the entry site to prevent bleeding.
Embolization is typically an outpatient procedure, although you may need to stay overnight in the hospital so your doctor can manage any pain or nausea you may experience.
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