What is tumor embolization?

Tumor embolization shrinks a liver tumor by cutting off its blood supply.

You may get medicine to help you relax and to help with pain before the procedure. The doctor will insert a thin, flexible tube into an artery near your groin. Or the tube may be put in your arm. This tube is called a catheter. The doctor will guide it into the artery that supplies blood to the tumor. Then the doctor will send a dye through the catheter into the artery. The dye is called contrast material. It shows up on X-ray pictures. It allows the doctor to check blood flow to the liver and the tumor.

The doctor will send small particles, chemotherapy, or tiny beads through the catheter into the artery. This stops blood flow to the tumor, causing it to slowly shrink. The tiny beads may contain chemotherapy or radiation to help kill the tumor cells.

Bit by bit, the tumor will be replaced with scar tissue in the months after this is done. This should not affect your liver's ability to do its job.

Activity

• Rest when you feel tired. Getting enough sleep will help you recover.
• Try to walk each day. Start by walking a little more than you did the day before. Bit by bit, increase the amount you walk. Walking boosts blood flow and helps prevent pneumonia and constipation. If you feel unsteady, have someone walk with you.
• Try not to walk up stairs for the first couple of days.
• Avoid strenuous activities, such as bicycle riding, jogging, weight lifting, or aerobic exercise, for at least 2 days or until your doctor says it is okay.
• For 2 to 3 days, avoid lifting anything that would make you strain. This may include a child, heavy grocery bags and milk containers, a heavy briefcase or backpack, cat litter or dog food bags, or a vacuum cleaner.
• You may shower 48 hours after the procedure, if your doctor says it is okay. Tape a plastic bag over the puncture site when you shower. Do not take a bath for the first 5 days, or until your doctor tells you it is okay.
• Ask your doctor when you can drive again.
• It may take a month or more to fully get your energy back.

Diet

• You can eat your normal diet. If your stomach is upset, try bland, low-fat foods like plain rice, broiled chicken, toast, and yogurt.
• Drink plenty of fluids (unless your doctor tells you not to).

Medicines

• Your doctor will tell you if and when you can restart your medicines. You will also get instructions about taking any new medicines.
• If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
• Be safe with medicines. Take pain medicines exactly as directed.
  • If the doctor gave you a prescription medicine for pain, take it as prescribed.
  • If you are not taking a prescription pain medicine, ask your doctor if acetaminophen (Tylenol) is safe for you. Also, ask how much you can safely take.
  • Do not take aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), or other nonsteroidal anti-inflammatory drugs (NSAIDs) unless your doctor says it is okay.
• If you think your pain medicine is making you sick to your stomach:
  • Take your medicine after meals (unless your doctor has told you not to).
  • Ask your doctor for a different pain medicine.
• If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.

Care of the puncture site

• Keep a bandage over the puncture site for the first 2 to 3 days, or until your doctor says you can take it off.
• After the doctor says it is okay to take off the bandage, wash the area daily with warm water and pat it dry. Don't use hydrogen peroxide or alcohol, which can slow healing. You may cover the area with a gauze bandage if it weeps or rubs against clothing. Change the bandage every day.
• Keep the area clean and dry.
• Put ice or a cold pack on the area for 10 to 20 minutes at a time to help with soreness or swelling. You can do this two times a day. Put a thin cloth between the ice and your skin.

Procedures can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for your procedure.

Preparing for the procedure

• Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
• Understand exactly what procedure is planned, along with the risks, benefits, and other options.
• If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your procedure. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
• Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your procedure. Your doctor will tell you if you should stop taking any of them before the procedure and how soon to do it.
• Make sure your doctor and the hospital have a copy of your advance directive. If you don’t have one, you may want to prepare one. It lets others know your health care wishes. It’s a good thing to have before any type of surgery or procedure.

You may be able to go home the same day. But in some cases, you might need to stay in the hospital overnight or longer.

You will have a bandage over your skin where the probe or catheter was inserted. This area may be sore for a day or two.

You will have tests in the months after the procedure to see how well the treatment worked.

Tumor embolization is a procedure to shrink a liver tumor by cutting off its blood supply. The doctor put a thin, flexible tube, called a catheter, into an artery near your groin or in your arm. The catheter was guided into the liver artery (the hepatic artery) that supplies blood to the tumor. The doctor sent small particles, chemotherapy, or tiny beads through the catheter into the hepatic artery. This stops blood flow to the tumor, causing it to slowly shrink. The tiny beads may contain chemotherapy or radiation to help kill the tumor cells.

You may go home the same day. Or you might need to stay in the hospital overnight or longer. The area where the catheter was put through your skin into your artery (the puncture site) may be sore for a day or two after the procedure. You will probably have a bruise for at least a week.

You may feel like you have the flu and may feel tired and have a low fever and an upset stomach. You may not feel as hungry as you usually do. This is common. These symptoms usually get better in 1 to 2 weeks.

It may take a month or more to fully get your energy back.

You will have tests in the months after the procedure to check the liver tumor and see how well the treatment worked.

For both procedures, the doctor uses ultrasound, a CT scan, or other imaging to guide the treatment.

Tumor embolization is usually done through an artery. This is called arterial or trans-arterial embolization. A thin tube called a catheter is inserted into a large artery, often one near the groin. Then the doctor moves the catheter into the smaller artery that supplies blood to the tumor. The substance that will block the blood supply is placed in the artery near the tumor. Then the catheter is removed.

Tumor ablation is done using a special needle called a probe. The doctor puts it through the skin and into the tumor. The probe sends heat, cold, or chemicals into the tumor. If the tumor is large, the doctor may repeat the process from a different angle. This is to make sure that all parts of the tumor are treated. After the treatment, the doctor removes the probe.

• Follow the instructions exactly about when to stop eating and drinking. If you don't, your procedure may be canceled. If your doctor told you to take your medicines on the day of the procedure, take them with only a sip of water.
• Take a bath or shower before you come in for your procedure. Do not apply lotions, perfumes, deodorants, or nail polish.
• Remove all jewelry, piercings, and contact lenses.

At the hospital or surgery center

• Bring a picture ID.
• Tell your doctor about any allergies you have.
• You will be kept comfortable and safe by your anesthesia provider. The anesthesia may make you sleep. Or it may just numb the area being worked on.
• The procedure will take about 1 to 3 hours.