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Tumour Embolization for Liver Cancer: Before Your Procedure

The digestive system

What is tumour embolization?

Tumour embolization shrinks a liver tumour by cutting off its blood supply. Procedures commonly done in Alberta include chemoembolization and radioembolization.

Before the procedure, you may get medicine to help you relax and to help with pain. The doctor will insert a thin, flexible tube into an artery in your groin or arm. This tube is called a catheter. The doctor will guide it into the artery that supplies blood to the tumour. Then the doctor will inject a dye through the catheter into the artery. The dye shows up on X-ray pictures. It allows the doctor to check blood flow to the liver and the tumour.

The doctor will send small particles (like grains of sand) through the tube into the artery. This mixture blocks the artery and stops blood from getting to the tumour. This causes the tumour to slowly shrink. The mixture may contain chemotherapy or radiation. It helps kill the tumour cells. You may need to stay in the hospital overnight.

Bit by bit, the tumour 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.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or Health Link at 811 if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

How do you prepare for the procedure?

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

  • Do not eat or drink for 6 to 8 hours before the procedure.
  • Be sure you have someone to take you home. Some medicines you'll get during the procedure 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 aspirin or some other blood thinner, ask your doctor if you should stop taking it before your procedure. Make sure that you understand exactly what your doctor wants you to do. These medicines increase the risk of bleeding.
  • Tell your doctor all the medicines and natural health products 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 care plan. 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 asked to have blood tests done before the procedure.

What happens on the day of the procedure?

  • Follow the instructions exactly about when to stop eating and drinking. If you don't, your procedure may be cancelled. 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 jewellery, piercings, and contact lenses.

At the hospital

  • Bring a picture ID and your Alberta Personal Health Care card.
  • Tell your doctor about any allergies you have.
  • You will be kept comfortable and safe by your healthcare team. You may get medicine that relaxes you or puts you in a light sleep. The area being worked on will be numb.
  • The procedure will take about 1 to 3 hours.
  • After the procedure, pressure will be applied to the area where the catheter was put in your blood vessel. Then the area may be covered with a bandage or a compression device. This will prevent bleeding.
  • Nurses will check your heart rate and blood pressure. The nurse will also check the catheter site for bleeding.
  • If the catheter was put in your groin, you will need to lie still and keep your leg straight for several hours.
  • If the catheter was put in your arm, you may be able to sit up and get out of bed right away. But you will need to keep your arm still for at least 1 hour. Check with your healthcare team before getting up.
  • You may have a bruise or a small lump where the catheter was put in your blood vessel. This is normal and will go away.
  • You may also have post-embolization syndrome (PES). This is a common side effect following this procedure. Symptoms can include:
    • Pain and cramping.
    • Low-grade fever.
    • Nausea, vomiting, or both.
    • Feeling unwell.
  • Symptoms typically start within a few days of the embolization and may last anywhere from 2 to 3 days or up to 2 weeks. These symptoms will go away by themselves.
  • Your doctor may prescribe medicine to manage your symptoms, such as pain or anti-nausea medicine. If you are not taking prescription medicine, ask your doctor if you can take an over-the-counter medicine such as Tylenol or Gravol.

When should you call your doctor?

  • You have questions or concerns.
  • You don't understand how to prepare for your procedure.
  • You become ill before the procedure (such as fever, flu, or a cold).
  • You need to reschedule or have changed your mind about having the procedure.

For more information on embolization for liver cancer, watch this My Health Alberta video: Cirrhosis - Embolization for liver cancer

For more information on liver cancer, go to www.CirrhosisCare.ca

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