Transarterial Chemoembolization (TACE) in Thailand 2023: Compare Price & Reviews

What you need to know about:

Transarterial Chemoembolization (TACE)

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Average Cost:

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Recovery Period:

1 day or more

Permanence:

Depends on patient condition

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Time it takes:

within 2 hours

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General Anesthesia

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Overview of

Transarterial Chemoembolization (TACE)

in Thailand

Transarterial Chemoembolization ( TACE) is a minimally invasive palliative treatment for liver cancer patients who are not qualified for surgery. It is a non-surgical procedure that involves the administration of a chemotherapeutic agent to an artery through a process called embolization. By injecting an embolic agent into the blood vessels directly connected to the tumor, the chemotherapeutic agent is contained and blood flow is interrupted.

Goals of

Transarterial Chemoembolization (TACE)

TACE aims to control the growth of tumors with lesser side effects than traditional chemotherapy treatment. Being a palliative procedure, the main goal of TACE is to alleviate symptoms and extend patient survival. While it helps shrink the size of tumors, it cannot treat cancer. Following treatment, some cancer cells may still survive and regrow. For this reason, repeated sessions may be necessary to destroy the remaining cancer cells. These sessions may be scheduled in regular 6-8 week intervals and are also helpful in controlling cancer cells while waiting on a liver transplant.

Price of

Transarterial Chemoembolization (TACE)

Average Cost

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Price Range

$500 to $1,500

Pros and cons of

Transarterial Chemoembolization (TACE)

Pros

In the majority of cases, TACE is found effective in shrinking tumors and inhibiting their growth. This benefit can last from 10-14 months and can be repeated if necessary.
Because it can shrink tumors, TACE provides hope and opportunity for surgery for those previously deemed inoperable.
Side-effects experienced after surgery are less than that of traditional chemotherapy treatment.
Because TACE helps in preventing the growth of tumors, it improves the overall quality of life of a patient by preserving liver function.

Cons

Since TACE requires a needle insertion, it poses a risk of infection on the puncture site. Although it rarely occurs, this problem is often treated with a short course of antibiotics therapy.
Due to catheter insertion into the blood vessels, there are also risks of bleeding and bruising on the puncture site as well as damage to the blood vessels.
During embolization, there is also a risk of having the embolizing agent lodge in other areas and cause impairment in blood supply to the surrounding tissues.
Part of the process of TACE requires angiography, which makes use of an IV contrast. This poses a risk for patients developing an allergic reaction to the contrast material.
Other side-effects of chemotherapy may also occur such as nausea, hair loss, and anemia. However, due to its ability to trap chemotherapeutic agents within the tumor, TACE helps ensure that these symptoms are mild and manageable.

How it works:

Transarterial Chemoembolization (TACE)

Before TACE, monitors are set in place to check the patient's blood pressure and heart rate throughout the procedure. A local or general anesthesia is then administered to relax or put you to sleep. A catheter is inserted into a blood vessel on the groin, which is moved upwards until it reaches the hepatic artery.

To find the arteries feeding the tumor, the surgeon performs an angiogram, which involves administering a radio-opaque dye through the catheter. Once located, a chemotherapeutic agent is injected into these arteries to block blood flow to the tumor.

The most common material used for TACE is a gelatin sponge. This is carefully soaked in a chemotherapeutic agent and an oily substance called Lipiodol before being injected into the bloodstream. The sponge keeps chemotherapy drugs confined within the tumor while the oil keeps it in place for a longer period.

In cases wherein only one lobe of the liver is affected, a minimal amount of chemotherapeutic agent is also applied to the unaffected lobe. This is to prevent cancer cells from spreading and growing in the unaffected areas.

After TACE, the catheter is carefully pulled out and ice packs are applied to the incision site to manage the swelling and prevent further bleeding.

Preparation before

Transarterial Chemoembolization (TACE)

Pre - treatment

During the pre-treatment consultation, the surgeon will discuss the risks and benefits, side effects, and possible complications so that realistic expectations can be mutually set. He will also explain how the procedure is done, and determine how much chemotherapy agent will be utilized during the treatment. This consultation is also a good avenue for the patient to raise any concerns he/she may have about TACE.

The patient will need to undergo a 2DEcho and ECG ( echocardiogram) which are both diagnostic procedures used to evaluate heart health and function.

In addition to this, there are plenty of other tests and instructions needed before treatment.

Complete blood work before treatment is extremely important to test for the speed of blood clotting and to gauge how well the kidneys and liver work.
CT scans of the chest and abdomen are to be completed within 2 months before TACE.
A thorough health history is also needed for proper evaluation prior to treatment. The attending physician should be informed of any significant health information such as medications taken, previous surgeries or treatment, and allergies to specific medications or anesthesia.
The doctor will also advise the patient to avoid taking Aspirin, blood thinners ( including garlic and other supplements), and non-steroidal anti-inflammatory drugs.
Pregnant women need to inform their physicians about the pregnancy before treatment.
Because of the effects of the anesthesia, the patient may need to arrange for someone to stay with them before and a few days after the procedure.

Recovery after

Transarterial Chemoembolization (TACE)

Post - treatment

Close observation and monitoring are done for the first 8 hours after treatment. During this period, the catheter insertion site will be closely observed for bleeding and inflammation.
Vital signs will be monitored at regular intervals including blood pressure, heart rate, respiration, and temperature.
Some patients experience mild side effects associated with chemotherapy treatment like nausea, fever, and pain. These are usually resolved with pain medications and rest.
An IV infusion will be required for the first few hours post-treatment
It is recommended that patients stay in the hospital for 24 hrs after treatment to facilitate close observation.
Patients are sent home with after-care instructions and prescriptions for home medications.
Regular activities may be resumed as tolerated, and some pain and fever may still be present after a week or two since patients' recovery phases may differ from one another.
Follow-up consultations and subsequent imaging tests may need to be done to check on how the tumor progresses over time.

Risks & side effects

The side effects of Transarterial Chemoembolization are generally mild and minimal. Symptoms that may occur post-treatment may differ from one person to another and are largely dependent on the patient's health condition, tumor size, and overall liver function.

Most of the side effects experienced after treatment can be associated with the post-embolization syndrome. Other symptoms are determined by the patient's liver function, tumor size, and overall health condition. Some of these are as follows:

Bruising, swelling, and some hematoma on the puncture site.
Reduced liver function
Nausea and vomiting and a slight fever is considered normal reaction for the first 2 weeks after the procedure and usually resolves on their own.
Although rare, some forms of infection may arise from the puncture site.
Because of catheter insertion, injuries to the blood vessels may occur, causing bleeding, bruising, and inflammation on the insertion site.
There is also a small risk of having an embolizing agent getting into normal tissue and causing an obstruction in blood supply.

FAQs:

Transarterial Chemoembolization (TACE)

What are the recommendations for travel after undergoing this procedure?

Patients may be allowed to go home and have a short commute from the hospital 24 hours after treatment. Staying somewhere close to the hospital is strongly suggested. A companion should also be available to assist the patient with travel during the recovery phase.

What kind of patients is eligible for this procedure?

Patients undergoing palliative treatment
Patients with multiple tumors
Patients with large and growing tumors
Patients who are not medically qualified to undergo surgery due to extremely poor liver function
Patients who need to shrink their tumors before surgery

What kind of patients are not eligible for this procedure?

TACE is not recommended for patients who suffer from severe liver or kidney dysfunction.
Patients who have had prior surgery involving blockage of the bile ducts.
Patients suffering from blood clotting disorders
Patients with more than 50% of cancerous liver involvement
Patients suffering from portal vein thrombosis
Patients with a poor medical history
Those who have known allergies to contrasts.

What type of Chemotherapy drugs are used during the procedure?

Since there are no specific standards of chemotherapy usage for TACE, these may be used alone or combined with another: