Medical Oncologist
CION Cancer Clinics
Is TACE painful? What you feel and how pain is controlled | CION Cancer Clinics
TACE itself is usually not very painful: you are sedated and the skin where the tube goes in is numbed. Most discomfort comes afterwards, as an ache under the right ribs with fever and nausea for a few days, and it can be treated. This page explains what you will feel at each stage, how the team controls pain, and which kinds of pain mean going to hospital today. At CION Cancer Clinics, a multidisciplinary tumour board weighs your liver function and your scans before recommending any treatment.
NG
Medically reviewed by Dr. Naresh GunduConsultant Medical Oncologist · MBBS, DNB (Internal Medicine), DM (Medical Oncology, AIIMS) · last reviewed October 2026, next review due October 2027
17+specialists on panel
15,000+patients treated
35+centres across Telangana & AP
4.8★ / 800+Google rating
The short answer
Does TACE hurt while it is being done?
The procedure itself is usually not very painful. You are awake but sedated, and the only needle you feel is the local anaesthetic at the top of the leg or the wrist. Most of the discomfort comes later, in the hours after the tumour's blood supply has been blocked.
Where the pain actually comes from
TACE (transarterial chemoembolisation) means a thin tube is passed through an artery into the liver, and chemotherapy plus tiny particles are released straight into the tumour's feeding vessels. When the tumour loses its blood supply, it swells and the tissue around it becomes inflamed. That is what aches, usually under the right ribs, sometimes up into the right shoulder.
Who this page is for
This page is for people with hepatocellular carcinoma (HCC, cancer that started in the liver) who have been offered TACE, and their families. If the cancer spread to the liver from the bowel or another organ, read TACE for liver metastases as well, because the plan can differ. For the full procedure, see TACE explained.
Pain after TACE is expected and treatable. It is not a sign the procedure went wrong.Stage by stage
What will I feel before, during and after TACE?
Discomfort comes in phases, and each one is handled differently.
The needle
A brief sting as local anaesthetic numbs the skin over the artery. After that, the tube moving inside the artery is not felt, because the inside of a blood vessel does not sense it.
During the injection
Some people feel a warm flush when contrast dye goes in, or a dull ache under the ribs as the particles are released. The team can give more pain relief through the drip straight away if you tell them.
Tell the team if you feel
- Pain under the ribs that builds
- Nausea or a wish to vomit
- Pain in the right shoulder
The first night
This is usually the hardest part. The ache is often strongest on the first evening and through the next day, along with fever and nausea. Doctors call this cluster post-embolisation syndrome.
The following days
Pain usually settles over the next several days. Tiredness and a poor appetite often last longer than the pain itself.
Not sure whether this applies to you?
Ask an oncologistHow it is managed
How is pain controlled around a TACE?
Before the procedure
The team checks your liver blood tests and kidney function and asks about any painkillers you already take. Some common painkillers are unsafe with a damaged liver, so do not start your own at home.
Sedation and local anaesthetic
Most people are given medicine to relax them through the drip, plus a numbing injection where the tube enters. Some hospitals use a general anaesthetic. Your team will tell you which applies.
Medicines given on the table
Anti-sickness medicine and pain relief are often given before the particles go in, so the ache is caught early rather than chased later.
On the ward
Most people stay in hospital overnight or a little longer. Nurses ask about pain regularly. Strong pain relief through the drip is used if tablets are not enough.
At home
You go home with tablets for pain and nausea and clear advice on which ones are safe for your liver. Take them on schedule for the first few days rather than waiting for the pain to peak.
!
When pain after TACE is not ordinary
Go to hospital today if the pain becomes severe and keeps getting worse despite your tablets, if you have a high fever with shivering, if your skin or eyes turn yellow, if you become confused or very drowsy, or if you vomit blood or pass black stools. These can mean infection, bleeding or strain on the liver. Tell the doctor you had TACE and when.
Leave a number, we will call you
One field. No form to fill in, and no charge for the call.
On your discharge notes
What do the words on the TACE notes mean?
- TACE
- Transarterial chemoembolisation. Chemotherapy and blocking particles delivered through an artery straight into the tumour.
- Post-embolisation syndrome
- The expected pain, fever and nausea after the tumour's blood supply is blocked. It is a reaction, not usually an infection.
- Femoral or radial access
- Where the tube went in: the artery at the top of the leg (femoral) or at the wrist (radial). It decides how long you lie flat afterwards.
- Sedation
- Medicine that makes you drowsy and relaxed. You may remember little of the procedure.
- Liver function tests
- Blood tests, including bilirubin (the yellow pigment) and albumin (a protein the liver makes), checked to see how the liver handled the treatment.
Commonly believed
What do families often believe about TACE pain?
"More pain means the treatment worked better."
How much it hurts does not reliably tell you how well the tumour responded. Response is judged on a scan taken some weeks later, not by how the first night felt.
"He should be brave and not ask for painkillers."
Untreated pain makes it harder to eat, walk and sleep, which slows recovery. Asking for relief early is the sensible thing to do, and nurses expect to be asked.
"Any painkiller from the chemist will do."
Some common painkillers can harm a liver with cirrhosis or upset the kidneys after contrast dye. Use only what the treating team has advised, and ask before adding anything, including herbal liver tonics.
"If the first TACE was bad, the next one will be worse."
Not necessarily. Later sessions often target smaller areas, and the team can adjust pain relief based on how the first one went. Tell them what was hardest.
Being straight with you
What can this page not tell you?
It cannot predict how much pain you personally will have. That depends on the size of the tumour, how much of the liver is treated, how healthy the rest of the liver is, and how your body reacts. Some people barely need tablets. Others need strong relief through the drip for a night or two.
Who this does not apply to
If you have been offered TARE (radioembolisation, using radioactive beads), ablation (destroying the tumour with heat through a needle) or surgery, the pain pattern is different. Read the page for that treatment instead. If TACE has not yet been decided, start with who is suitable for TACE.
Who can answer your question
The interventional radiologist who performs the TACE, and your oncologist, can tell you what to expect for your tumour. At CION, the tumour board reviews the scans and the plan, and CION coordinates TACE through NABH-accredited partner hospitals. Your team will tell you where the procedure takes place and who to call afterwards.
Write your questions down before the procedure day. Pain relief at home is the one families most often forget to ask about.Questions we are asked
Common questions about pain and TACE
Will I be awake during TACE?
Usually yes, but sedated and comfortable. You are given medicine through the drip that makes you relaxed and drowsy, and the skin where the tube goes in is numbed. Some hospitals use a general anaesthetic instead. Ask your team which approach they use, so you know what to expect on the day.
How long does the pain last after TACE?
For most people it is worst on the first evening and the next day, then eases over several days. Tiredness and poor appetite often linger a little longer. Pain that keeps getting worse instead of better is not expected and needs a doctor the same day, so call your team rather than waiting.
Why does my right shoulder hurt after TACE?
The liver sits under the diaphragm, and irritation there is often felt in the right shoulder through shared nerves. It is a common, expected ache after TACE. If it comes with breathlessness, chest pain or a high fever, contact your team or go to hospital today.
Which painkillers are safe at home?
Only the ones your treating team prescribes. Some everyday painkillers bought over the counter can harm a liver with cirrhosis or strain the kidneys. Paracetamol may be allowed, but at a limit your doctor sets for your liver. Read more about painkillers and a damaged liver.
Is fever after TACE a sign of infection?
A mild fever in the first few days is common and part of post-embolisation syndrome. A high fever with shivering, a fever that starts later, or one that keeps rising can mean an infection or an abscess in the liver. That needs to be checked in hospital the same day.
Does the groin or wrist hurt afterwards?
There may be mild soreness and a small bruise where the tube went in. A swelling that grows quickly, bleeding that does not stop with firm pressure, or a cold, pale leg or hand needs urgent attention. Press firmly on the spot and call for help straight away.
Is TACE more painful than ablation or surgery?
They are different kinds of discomfort. Surgery has a wound and a longer recovery. Ablation can cause a sharp, short ache near the needle site. TACE usually causes a deeper ache with fever and nausea for a few days. The choice between them depends on the tumour and the liver, not on pain alone.
What should I ask before my first TACE?
Ask whether you will be sedated, how long you will stay in hospital, which pain and nausea medicines you go home with, and who to call at night. Our page of questions before your first TACE has a fuller list you can print.
Your Specialists
Meet CION's liver cancer specialists. Bring your scan reports and liver blood tests.
Our medical and surgical oncologists plan liver cancer care together, weighing the tumour and how well your liver works before choosing surgery, a liver-directed procedure or medicines.
Medical Oncologist
Dr. C. Raghavendra Reddy
MBBS(Gold Medal), DNB(General Medicine), DM(Medical Oncology)(Gold Medal)
Medical Oncologist
Dr. Bharati Devi Gorantla
MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
Medical Oncologist
Dr. Owais Mohammed
MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)
Medical Oncologist
Medical Oncologist
Surgical Oncologist
Dr. Muralidhar Muddusetty
MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
Surgical Oncologist
Want a specific doctor for your case? Mention them when booking.
Book Free ConsultationBook an appointment with our specialist
Share your name and number — we'll call you back within 30 minutes to schedule your consultation.
Sources
- American Cancer Society — Embolization Therapy for Liver Cancer
- Cancer Research UK — Treatment for liver cancer
- NHS — Treatment for liver cancer
- Macmillan Cancer Support — Liver cancer (hepatocellular carcinoma HCC)
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Talk to us
Worried about how a TACE will feel?
Tell us what you have been told about the procedure and what worries you most. We will explain what to expect and help you plan pain relief with your team. One helpline serves every CION centre.