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Potential side effects of transarterial chemoembolization for liver cancer

Post-embolization syndrome

Abnormal liver function tests

Inflammation of the gallbladder

Problems at the catheter site

Lung problems

Ascites

Liver abscess

Tumour lysis syndrome

Rare side effects

 

Side effects can occur with any type of treatment for liver cancer, but not everyone has them or experiences them in the same way. Side effects of transarterial chemoembolization (TACE) will depend mainly on the:

  • number of tumours being treated
  • person’s overall health
  • amount of cirrhosis present in the liver

 

TACE kills cancer cells, but healthy cells in the treatment area can also be damaged. Steps are taken to protect healthy cells as much as possible.

 

Side effects can happen any time during TACE. Some may happen during, immediately after, or a few days or weeks after TACE. Most side effects go away after TACE is finished.

Post-embolization syndrome

Post-embolization syndrome is a group of symptoms that include:

 

Most people will have post-embolization syndrome after TACE because the chemotherapy drugs irritate the liver tissues and cause inflammation. Post-embolization syndrome may last up to 2 weeks and is treated with medications to control fever and nausea.

 

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Abnormal liver function tests

The results of liver function tests will be abnormally high immediately after TACE because the procedure causes changes to the liver tissues. Liver function returns to normal within a week after TACE is done. Long term abnormal liver function tests are rare and may be a sign of liver failure.

 

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Inflammation of the gallbladder

TACE may cause inflammation of the gallbladder (cholecystitis) in a small number of people. If the intrahepatic bile ducts are in the area of the tumour being treated by TACE, they can be damaged or become blocked. This damage or blockage can cause bile to back up into the gallbladder, which leads to inflammation. Symptoms of cholecystitis include pain in the upper-right abdomen, fever, light-coloured stool (feces), nausea and vomiting. The person may need surgery to remove the gallbladder.

 

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Problems at the catheter site

During TACE, a thin tube (catheter) is threaded through the artery in the inner thigh, up into the liver. Some people may have the following side effects at the catheter incision site:

  • pain
  • bruising
  • bleeding
  • collection of blood in the area (hematoma)
  • infection

 

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Lung problems

Some people may have lung problems after TACE. The types of lung problems are:

  • abnormal buildup of fluid in the space between the lungs and the walls of the chest (pleural effusion)
  • lung infection (pneumonia)
  • blood clots in the lung (pulmonary embolism)

 

Stopping smoking before TACE helps prevent lung infections. Frequent deep breathing and coughing, and turning in bed, help to reduce the chance of lung problems after treatment. You may be given a special device to help you take deep breaths.

 

Report shortness of breath, chest pain, fever and cough to your doctor or the healthcare team.

 

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Ascites

 A small number of people may develop ascites after TACE. Ascites is a buildup of fluid in the abdomen (peritoneal cavity). It occurs when the body produces fluids faster than it can remove them. The blood flow through the liver is changed during TACE, lowering the amount of fluid that the liver can remove from the body.

 

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Liver abscess

After TACE, pus may collect in the area where the tumour was destroyed. Antibiotics may be prescribed after TACE is completed to help prevent a liver abscess from forming.

 

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Tumour lysis syndrome

Tumour lysis syndrome is a very rare side effect that can occur because of a rapid breakdown of cancer cells after TACE. The large number of tumour cells that are destroyed by the chemotherapy drugs release toxic substances into the blood when they die. It is more likely to occur in people who are having large or multiple tumours treated.

 

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Rare side effects

The following are side effects that may very rarely occur after TACE:

  • kidney problems
  • liver failure
  • stroke
  • inflammation of the pancreas (pancreatitis)
  • ulcers in the stomach or small intestine – caused by a backup of the chemotherapy drugs through the bile ducts

 

People who experience these side effects will be given treatments based on their individual situation.

 

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References

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