What is Tumour Embolization?
Tumour embolization is a minimally invasive surgical procedure in which the blood supply to the tumour is cut off or tumour-killing agents are directly delivered into the tumour to help starve or destroy tumour cells. The procedure is performed under image guidance and involves passing a small, thin tube called a catheter into the patient’s groin and carefully navigating it into the arteries that feed the tumour to block blood flow to the tumour, deprive it of nutrients and oxygen required for its growth and survival, and cause the tumour to eventually die. Tumour embolization is most commonly applied to treat tumours of the liver and kidneys.
Some of the common tumour embolization procedures include:
- Bland embolization: This procedure involves injecting small beads into the tumour vessel to block the blood supply to the tumour.
- Chemoembolization: This procedure works by delivering very small beads filled with chemotherapy agents through a blood vessel right into the tumour.
- Radioembolization: This is a radiation therapy in which very small beads containing radioactive isotopes are injected into the blood vessel to directly treat tumours.
Indications for Tumour Embolization
Tumour embolization is indicated for the treatment of both cancerous as well as non-cancerous tumours. Some of the indications for tumour embolization include:
Noncancerous tumours
- Hepatic adenoma
- Uterine fibroids
- Benign prostatic hyperplasia (BPH)
- Angiomyolipoma (benign tumours of the liver and kidney)
Cancerous tumours
- Renal cell cancer
- Hepatocellular cancer
- Liver metastasis, mostly from pancreas or colon
Preparation for Tumour Embolization
Pre-procedure preparation for tumour embolization will involve the following steps:
- A thorough examination by your doctor is performed to check for any medical issues that need to be addressed prior to the procedure.
- Depending on your medical history, social history, and age, you may need to undergo tests such as blood work and imaging to help detect any abnormalities that could threaten the safety of the procedure.
- You will be asked if you have allergies to medications, anaesthesia, or latex.
- You should inform your doctor of any medications, vitamins, or supplements that you are taking.
- Women should always notify their doctor if they are pregnant or suspect to be pregnant.
- You should refrain from medications or supplements such as blood thinners, aspirin, or anti-inflammatory medicines for some days prior to surgery.
- You should refrain from alcohol or tobacco at least 24 hours prior to surgery.
- You should not consume any solids or liquids at least 8 hours prior to surgery.
- You may be instructed to shower with an antibacterial soap on the morning prior to surgery to reduce the risk of infection.
- Arrange for someone to drive you home as you will not be able to drive yourself after surgery.
- A written consent will be obtained from you after the surgical procedure has been explained in detail.
Procedure for Tumour Embolization
The procedure is performed by an interventional radiologist mostly in an outpatient setting under general or local anaesthesia. Your physician makes a small cut in the groin region to access a blood vessel and meticulously inserts a catheter into the vessel. This is followed by injection of contrast material into the vessel via the catheter to visualize the vessel on imaging to examine the blood supply of the tumour and assess the condition of the vessel. Using image guidance such as fluoroscopy (X-ray video) or ultrasound, your physician guides the catheter to the site of the tumour and places medication or agents such as foam, tiny metal coils or plastic particles to close the blood vessels that feed the tumour. After completion of the procedure, the catheter is withdrawn and the groin site is covered with a bandage.
Post-procedure Care and Recovery from Tumour Embolization
In general, tumour embolization will involve the following post-procedure care instructions:
- You will be transferred to the recovery area to be monitored until you are awake from the anaesthesia.
- Your nurse will monitor your vital signs and observe you for any allergic or anaesthetic reactions as you recover.
- Most individuals are able to walk, eat, and drink within a couple of hours post procedure.
- You will likely be discharged the same day once stable; however, some may require an overnight stay.
- You may experience some pain, swelling, and discomfort in the treatment area. Pain and anti-inflammatory medications and cold packs are recommended as needed.
- Your physician will also provide you with antibiotics to prevent infection.
- Refrain from smoking for a specific period of time as this may hamper proper healing.
- You should be able to resume all your normal activities within a few days; however, you may need to take off work for at least a week to recover and promote healing.
- Refrain from strenuous activities and lifting heavy weights for the first few weeks. Gradual increase in activities over a period of time is recommended.
- A periodic follow-up appointment will be scheduled to monitor your progress.
Benefits of Tumour Embolization
Some of the benefits of tumour embolization include:
- No surgical incision is required, just a small nick on the skin
- Ideal method to treat tumours that cannot be surgically excised or when surgery is deemed risky
- Much less invasive than traditional open surgery
- Minimal complications and discomfort with shorter hospital stay and faster recovery
- High success rate of over 85 per cent
Risks and Complications of Tumour Embolization
Tumour embolization is a relatively safe procedure; however, as with any minimally invasive surgery, some risks and complications may occur, such as:
- Infection
- Bleeding
- Blood clots
- Fever
- Damage to surrounding soft tissue structures
- Post-procedure pain, requiring narcotics for relief
- Allergic/anaesthetic reaction
