Transarterial Radioembolisation (TARE) for Hepatocellular Cancer (HCC): How we use the tool to extend curative options in HCC
Introduction
Hepatocellular carcinoma (HCC) is the most common type of liver cancer that arises in the context of chronic liver diseases, such as hepatitis or cirrhosis. Most of the patients with HCC present late. When traditional treatments are unsuitable, an advanced technique called Transarterial Radioembolisation (TARE) offers hope – as a bridge to curative treatments and sometimes as an effective palliation.
This blog will explain TARE in simple terms, helping you understand how it works, its benefits, and what to expect during the procedure.
What is Transarterial Radioembolisation (TARE)?
Transarterial Radioembolisation, often referred to as TARE or radioembolization, is a minimally invasive treatment for liver cancer. It combines radiotherapy and embolization to target and destroy cancer cells within the liver.
How Does TARE Work?
- Material: TARE involves a beta emitter treatment through Yttrium 90 loaded microspheres. We use imported material specifically created for each patient and use patient specific data to create the best solution for each patient
- Targeted Approach: TARE involves the injection of the radioactive material into the arteries supplying blood to the liver tumor.
- Radiation Delivery: These beads emit radiation directly into the tumor, minimizing damage to surrounding healthy tissue.
- Embolization: In TARE, there is no need to block the blood supply to the tumour and it also does not damage the liver artery so that surgery or liver transplantation can be done at a later date.
The Procedure - Preparation: Before the procedure, patients undergo various tests, including imaging scans, to determine the size and location of the tumor. We specifically check for alternative blood flow to tumour and shunting of blood flow to lungs before the procedure. Preparation takes 1 week for testing and preparation of the material.
- Catheter Insertion: During TARE, a small catheter (a thin tube) is inserted through the groin vessels and guided to the liver artery.
- Bead Injection: Once in place, the radioactive beads are injected through the catheter into the liver tumor’s blood supply.
- Post-Procedure Monitoring: After the procedure, patients are monitored for a few hours and usually can go home the next day.
Benefits of TARE
- Minimally Invasive: TARE is less invasive than traditional surgery, leading to a shorter recovery time and fewer complications.
- Targeted Treatment: By delivering radiation directly to the tumor, TARE spares healthy liver tissue, reducing side effects.
- Effectiveness: TARE provides the most effective bridging treatment in patients who go for curative liver transplantation. TARE can shrink tumors, relieve symptoms, and improve the quality of life for patients with advanced liver cancer.
Who Can Benefit from TARE?
TARE is typically recommended for patients with large or multiple liver cancers or those with high tumour marker levels that cannot be surgically removed or treated effectively with other methods. We use it mainly for treatment of cancer when the patient is waiting for liver transplantation.
It is useful for patients whose cancer has not spread beyond the liver.
What to Expect During Recovery
- Hospital Stay: Most patients can leave the hospital within 48 hours after the procedure.
- Side Effects: Common side effects include fatigue, nausea, and mild pain at the catheter insertion site. These usually resolve within a few days.
- Follow-Up: Regular follow-up appointments are essential to monitor the effectiveness of the treatment and manage any side effects.
Conclusion
Transarterial Radioembolisation (TARE) is a promising treatment for hepatocellular carcinoma, offering targeted therapy with fewer side effects and a quicker recovery compared to traditional treatments. By understanding how TARE works and what to expect, patients and their families can make informed decisions about their treatment options.