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CION Cancer Clinics
TACE explained: chemoembolisation of the liver | CION Cancer Clinics
TACE is a liver cancer treatment that delivers chemotherapy straight into the tumour through its own artery and then blocks that artery, starving the tumour of blood. It is most often offered for intermediate hepatocellular carcinoma that is confined to the liver when surgery or ablation is not possible. This page explains how it works, who it suits, who it does not, and what to ask. At CION Cancer Clinics, a multidisciplinary tumour board weighs your liver function and your scans before recommending any treatment.
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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
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On this page
- What is TACE, and why has it been offered to me?
- What does the team look at before recommending TACE?
- What happens during a TACE session?
- What do the words on a TACE plan mean?
- Four things families assume about TACE, and what is true
- Who is TACE not suitable for?
- What this page cannot tell you
- Common questions about TACE
The short answer
What is TACE, and why has it been offered to me?
TACE (transarterial chemoembolisation) is a treatment that sends chemotherapy straight into a liver tumour through its own artery, then blocks that artery. It is most often offered to people with hepatocellular carcinoma (HCC, cancer that started in the liver) that is too large or too spread out inside the liver for surgery or ablation, but has not spread outside it.
Where it fits in liver cancer care
Doctors stage HCC using the BCLC system, which looks at the tumour, how well the liver is working and how well you are. TACE is the usual starting treatment for BCLC stage B, the intermediate stage. That means several tumours, or one large one, inside the liver, with liver function that is still reasonably good. The BCLC stage B page explains that stage in plain words.
What TACE is not
TACE is not a tablet and it is not whole-body chemotherapy. It is a procedure done by an interventional radiologist, a doctor who treats through thin tubes guided by X-ray pictures. Most people go home after a short hospital stay. It is aimed at the liver tumours only.
This page is about cancer that started in the liver. If your cancer began in the bowel or elsewhere and spread to the liver, read TACE for liver metastases instead.Before it is offered
What does the team look at before recommending TACE?
The decision rests on three things together. A good result on one cannot make up for a poor result on another.
The tumour
How many tumours there are, how big, and where they sit. TACE suits disease that is confined to the liver and has a good blood supply, which most HCC does.
The team checks
- No spread outside the liver
- No tumour growing into the main portal vein
- Enough tumour blood supply to target
The liver itself
Most people with HCC also have cirrhosis (scarring of the liver). TACE briefly stresses the healthy liver around the tumour, so the liver must have enough reserve to cope. Your Child-Pugh score, bilirubin and albumin on blood tests answer this.
You, as a whole person
How active you are day to day, your kidney function, and any heart or lung problems. A person who is mostly in bed is usually better served by a gentler plan.
Where the decision is made
At CION, the tumour board reviews your scans and blood results together. Medical, surgical and radiation oncologists agree a plan before anything is booked.
Not sure whether this applies to you?
Ask an oncologistThe procedure
What happens during a TACE session?
Preparation
Blood tests check your liver, kidneys and clotting. You fast for a few hours beforehand. Tell the team about every medicine you take, especially blood thinners and diabetes tablets.
Reaching the liver
Under local anaesthetic and light sedation, a thin tube is passed into an artery at the groin or wrist. It is steered up to the liver using X-ray pictures. You do not feel the tube moving inside.
Treating the tumour
The radiologist finds the small arteries feeding each tumour. A mixture of chemotherapy and blocking material is released into them, so the drug stays in the tumour and its blood supply is cut off.
Afterwards
You lie flat for some hours so the artery seals. Most people stay in hospital overnight or a little longer while pain, fever and sickness settle. See what happens on the day of TACE for the full sequence.
On your report
What do the words on a TACE plan mean?
- cTACE
- Conventional TACE. The chemotherapy is mixed with an oily contrast liquid called lipiodol, which also shows up on later scans.
- DEB-TACE
- Drug-eluting bead TACE. Tiny beads soaked in chemotherapy release it slowly inside the tumour.
- Embolisation
- Deliberately blocking a blood vessel. Without blood, the tumour starves of oxygen.
- Post-embolisation syndrome
- Pain on the right side, fever and nausea in the first few days after TACE. It is common, expected and usually passes.
- mRECIST
- The way follow-up scans measure response. It looks at how much of the tumour still has a blood supply, not only its size.
- Superselective
- Treating through the smallest possible artery, so less healthy liver is affected.
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Commonly believed
Four things families assume about TACE, and what is true
"TACE is chemotherapy, so hair will fall out and the whole body will suffer."
The drug goes into the liver tumour and most of it stays there. Hair loss and severe whole-body effects are much less common than with chemotherapy given through a drip.
"If TACE is offered, the doctors have given up."
For most people TACE controls the cancer rather than removing it. In some, it shrinks the tumour enough to make surgery or a transplant possible later. It is active treatment, not a last resort.
"One session will finish it."
Many people need more than one session, planned according to the follow-up scan. Read how many TACE sessions you may need.
"More sessions are always better."
Each session stresses the liver. If the tumour stops responding, or liver function slips, repeating TACE can do more harm than good. The team will move to another treatment instead.
Who should not have it
Who is TACE not suitable for?
TACE does not suit everyone with liver cancer. It is usually not offered when the cancer has spread outside the liver, when tumour has grown into the main portal vein, or when the liver is already failing, with jaundice or fluid in the abdomen that is hard to control. In those situations, blocking an artery can tip a fragile liver into failure.
When something else is better
A single small tumour is often better treated with surgery or ablation, which aim to remove or destroy it completely. Cancer that has spread is treated with immunotherapy or targeted tablets. Very large or widespread tumours may be weighed against TARE (radioembolisation) or systemic treatment.
Who arranges it
CION's oncologists assess you, plan TACE with the tumour board and coordinate the procedure through NABH-accredited partner hospitals with interventional radiology. Your team will tell you where it takes place, and CION follows you up afterwards.
Being straight with you
What this page cannot tell you
It cannot tell you whether TACE is right for you, how many sessions you will need, or how long it will control your cancer. Those answers depend on your own scans, your liver blood tests and how you are, and they come from the tumour board that has seen them.
It cannot predict your outcome
Results vary widely from person to person, and nobody can tell you in advance how your tumour will respond. Ask your oncologist what the aim of treatment is in your case: control, shrinking for surgery, or keeping you on a transplant list.
If you have been offered TACE and want a second opinion, bring your CT or MRI films and recent blood reports to a CION consultation.Questions we are asked
Common questions about TACE
Is TACE a surgery?
No. There is no cut on the abdomen. A thin tube enters an artery through a small puncture at the groin or wrist, and the tumour is treated from inside the blood vessel. It is done under local anaesthetic with sedation, and most people leave hospital after a short stay.
Is TACE painful?
The procedure itself is usually not very painful because of the sedation. Pain on the right side of the abdomen in the first few days afterwards is common and is treated with painkillers. Read is TACE painful for what to expect and when to call.
What chemotherapy drug is used?
Doxorubicin is the drug most commonly used, and some centres use cisplatin or others. The choice and the amount are decided by the radiologist and oncologist for your tumour. Because it stays mostly in the liver, whole-body side effects are milder than with a drip.
Can TACE remove the cancer completely?
For most people TACE controls the cancer rather than removing every cell. Occasionally a tumour responds so well that nothing active is seen on the scan. TACE can also shrink a tumour enough for surgery or keep it in check while someone waits for a transplant.
Can I have TACE if I have cirrhosis?
Often yes. Most people who have TACE also have cirrhosis. What matters is how well the liver still works. People with Child-Pugh A, and some with early Child-Pugh B, are usually considered. A badly failing liver usually rules it out.
Can TACE be combined with other treatment?
Yes, sometimes. It may be combined with ablation, radiation, or immunotherapy and targeted tablets, depending on the tumour. Combinations are a fast-moving area and the evidence is still settling. Read TACE combined with tablets or immunotherapy.
How will we know if TACE has worked?
A contrast CT or MRI is done some weeks after the session. The radiologist looks at how much of the tumour still lights up with blood supply. AFP, a blood marker, may also be repeated if it was raised before. The next step is planned on these results.
Does Aarogyasri or insurance cover TACE?
TACE is often covered by health insurance and government schemes, but the rules and package details change and must be checked at the time. Ask for a written, itemised estimate and let the CION team help with the scheme paperwork before your session is booked.
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
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Sources
- American Cancer Society — Embolization Therapy for Liver Cancer
- RadiologyInfo.org (RSNA/ACR) — TACE Cancerous Tumor Therapy
- EASL — EASL Clinical Practice Guidelines: management of hepatocellular carcinoma
- Cancer Research UK — Treatment for liver cancer
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.
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Have you been offered TACE and want it checked?
Bring your scans and liver blood reports, and a CION oncologist will go through whether TACE fits your tumour and your liver. One helpline serves every CION centre.