Chemoembolization for Liver Cancer: The Procedure

Front view of liver, gallbladder, and blood vessels.

Chemoembolization is a way to treat cancer in the liver. It can be used for cancer that starts in the liver. Or it can be used for cancer that has spread (metastasized) to the liver from other parts of the body. The procedure treats only cancer in the liver. It is done by a specially trained doctor (interventional radiologist).

How does chemoembolization work?

The hepatic artery is a large blood vessel. It sends blood to the liver. To grow, a liver tumor takes most of its blood from this artery. During the procedure, chemotherapy medicines are put into the hepatic artery. The artery is then blocked off from the rest of the body. This makes sure the medicines stay in the liver. And it cuts off blood to the tumor.

The goals of chemoembolization

  • Block the tumor’s blood flow so it gets no oxygen or nutrients.

  • Send high doses of chemotherapy medicines right to the tumor site.

  • Keep chemotherapy medicines in the tumor for long periods of time.

  • Reduce side effects to the rest of the body. This is because the medicines don't leave the liver.

Getting ready for the procedure

  • Follow any directions you are given for not eating or drinking before the procedure.

  • Tell your healthcare provider about all your health conditions.

  • Tell your provider about all the medicines you take. This includes all prescription and over-the-counter medicines. It also includes vitamins, herbs, supplements, and illegal drugs. You may be told to stop taking some medicines before the procedure.

During the procedure

When you arrive for the procedure, an IV (intravenous) line will be put into your arm. This IV will give you fluids and medicine to prepare your body for the procedure. This preparation may take several hours. To begin the procedure:

  • The healthcare provider puts a long, flexible tube (catheter) into an artery in your groin.

  • The provider puts an X-ray dye (contrast medium) through the catheter. This helps the artery and catheter show up better on X-rays. The provider can see the catheter's movement on a video screen.

  • The provider guides the catheter to the hepatic artery in the liver. He or she then moves it to the tumor.

  • The provider injects the chemoembolization medicines through the catheter. He or she then injects a substance that blocks the artery.

  • The catheter is removed. The provider puts pressure on the insertion site for 15 minutes. This is to prevent bleeding.

  • You will lie flat for several hours. During this time, the IV line will give you fluids. You will likely stay in the hospital for a few days after the procedure.

Side effects of chemoembolization

Side effects include tiredness, belly pain, fever, nausea, and loss of appetite. These may last for several days. Medicines can help reduce certain side effects.

Possible risks

  • Blood clot in a blood vessel

  • Infection or bruising where the catheter was inserted

  • Death of normal liver tissue, which may lead to liver failure

  • Damage to the gallbladder or other nearby organs

  • Problems because of the X-ray dye, such as an allergic reaction or kidney damage

  • Damage to an artery

  • Death