Medical Oncologist
CION Cancer Clinics
How many TACE sessions will I need? | CION Cancer Clinics
There is no fixed number of TACE sessions for liver cancer. Many people need more than one, and each repeat is decided by the scan after the last session, how well the liver coped and whether the cancer has spread. Some need a single session, others several over months or years. This page explains how that decision is made, what the scan words mean and what to ask. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
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Medically reviewed by Dr. Muralidhar MuddusettyConsultant Surgical Oncologist · MBBS (AIIMS), MS (Surgery, AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh) · last reviewed September 2026, next review due September 2027
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On this page
- How many TACE sessions will be needed?
- What happens between one session and the next?
- What decides whether another session is offered?
- What tends to lead to a repeat, and what tends to lead to a change?
- What do the response words on the scan mean?
- What do families often assume about repeat sessions?
- What can this page not tell you?
- Common questions about the number of TACE sessions
The short answer
How many TACE sessions will be needed?
There is no fixed number of TACE sessions. Many people need more than one, and each further session is decided by the scan after the last one and by how well the liver is coping. Some need a single session, while others have several over months or years.
Why it is not planned as a fixed course
Chemotherapy through a drip is often planned as a set number of cycles. TACE usually is not. Most teams treat, scan, and then decide again. This approach is sometimes called on-demand TACE. It avoids repeating the procedure when it is not needed, and avoids stopping when more could help.
When sessions are planned in advance
Sometimes the team knows from the start that more than one session will be needed. Tumours on both sides of the liver, for example, may be treated one side at a time to protect the liver. In that case you may be told about a second session before the first is done.
The number of sessions says little about your outlook. More sessions do not mean things are going badly, and fewer do not mean the cancer has gone.The pattern
What happens between one session and the next?
The session
TACE is done and you recover from the fever, pain and tiredness that often follow. Most people are home within a day or so and feel more themselves over the next week or two.
The check scan
Some weeks later, a CT or MRI with dye shows whether the treated tumour still has living tissue and whether new tumours have appeared anywhere in the liver.
Blood tests
Liver function tests show how the liver has handled the session. A tumour marker such as AFP, where it was raised before, may also be compared with earlier results.
The team decides again
With the scan and blood results side by side, the team decides whether to repeat TACE, watch and scan again later, or move to a different treatment. They explain the reasoning to you.
Not sure whether this applies to you?
Ask an oncologistWhat the team weighs
What decides whether another session is offered?
No single result settles it. These are the things your team looks at together each time.
What the scan shows
Living tumour that is still reachable through its artery often points towards another session. A tumour that looks fully dead may simply be watched.
How the liver is coping
If liver function has dropped after the last session, repeating it may do more harm than good. The team may wait for it to recover or change course.
Whether the cancer has spread
TACE treats only the liver. New spread to the lungs, bones or the main liver vein usually means a different treatment is discussed.
How you are doing
How you recovered last time, and how you are managing day to day, matter as much as the scan.
Tell the team about
- How long the tiredness lasted
- Any hospital visits after going home
- What you want from treatment now
Side by side
What tends to lead to a repeat, and what tends to lead to a change?
Often leads to another session
Often leads to a change of plan
Some living tumour left that TACE can reach
The tumour keeps growing despite repeated sessions
A new tumour appears inside the liver only
Cancer appears outside the liver
Liver function stays reasonably steady
Liver function worsens after sessions
You recovered well last time
You are much less fit than before
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On your scan report
What do the response words on the scan mean?
- Complete response
- No living tumour can be seen in the treated area on this scan. It does not mean the cancer can never return.
- Partial response
- The living part of the tumour has shrunk clearly, but some remains.
- Stable disease
- The tumour has not clearly shrunk or grown.
- Progressive disease
- The tumour has grown, or new tumours have appeared.
- mRECIST or LI-RADS
- Scoring systems radiologists use to describe response in liver tumours, based on which parts still take up dye.
- TACE refractory
- The tumour is no longer responding to repeated TACE, so another treatment is usually considered.
Commonly believed
What do families often assume about repeat sessions?
"If a second session is needed, the first one failed."
A repeat is part of how TACE is normally used. Large tumours rarely die completely in one go, and new tumours can appear in a liver that is already scarred.
"More sessions are always better, so we should keep going."
Each session puts strain on the liver. When a tumour stops responding, repeating TACE can harm the liver without helping. Switching treatment at that point is a judgement, not a sign of giving up.
"Once the scan is clear, no more checks are needed."
A clear scan is good news, but regular scans usually continue, because liver cancer can return in another part of the liver. Keep every follow-up appointment.
"We can ask for a fixed number up front and budget for it."
Teams can give a likely plan, but not a firm count. Ask what a first session involves and what would lead to another, so the family is prepared either way.
Being straight with you
What can this page not tell you?
It cannot tell you how many sessions you or your parent will need. That depends on the size and number of tumours, how they respond, and how the liver copes, none of which can be known before treatment starts.
Who repeat TACE does not suit
Repeat sessions are usually not offered when the liver has become too weak, when the cancer has spread outside the liver or into the main liver vein, or when the tumour has kept growing after repeated treatment. Other options, including medicines or care focused on comfort, may then be discussed.
Questions worth asking after each scan
What does this scan show compared with the last? How is the liver doing? Is another session being recommended, and why? What would make you stop? Asking the same questions each time helps the family follow the thread across months of treatment.
Planning cost across several sessions? Ask the centre to check what Aarogyasri, CGHS, ECHS, EHS or your cashless insurer covers per session.Questions we are asked
Common questions about the number of TACE sessions
How long is the gap between TACE sessions?
It varies. A repeat is usually decided after the check scan, which is done some weeks after a session, so gaps are commonly weeks to months. When sessions are planned in stages, the gap may be shorter. Your team sets the timing around your scan results and how the liver recovers.
Is there a maximum number of sessions?
There is no fixed maximum. What limits TACE is usually the liver, whether the tumour is still responding, and whether the cancer has spread. Some people have many sessions over years. For others, the team advises a change after only a few, because TACE is no longer helping.
What happens if TACE stops working?
The team discusses other options. These may include TARE, medicines taken by mouth or through a drip, radiotherapy, or care focused on comfort, depending on the liver and general health. Ask what each would involve, what it aims to do, and what the side effects are likely to be.
Does each session feel the same?
Not always. The fever, pain and tiredness afterwards depend partly on how much tumour is treated. A smaller repeat session may feel milder. Tell the team how you felt last time, so they can plan pain and sickness medicine earlier if it was difficult.
Will I need the check scan every time?
Yes, a scan after each session is standard, because it is what the next decision rests on. Blood tests go with it. Bring earlier scans on disc to each visit if they were done at a different centre, so the images can be compared properly.
Can a tumour marker replace the scan?
No. A marker such as AFP can help when it was raised before treatment, but some liver cancers never raise it. The scan remains the main way to judge response. A falling marker is encouraging but is read alongside the images, not instead of them.
If the scan is clear, is TACE over for good?
Not necessarily. Scans usually continue at regular intervals, and if a new tumour appears in the liver, TACE may be considered again. Some people also move on to surgery or a transplant after a good response. Your team will set a follow-up plan.
Can we space sessions out to spread the cost?
Timing is set by medical need, and delaying a recommended session can let a tumour grow. Talk to the centre about cost early instead. Aarogyasri, CGHS, ECHS and EHS may cover repeat sessions, as do many cashless insurers, so ask for your cover to be checked.
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Sources
- American Cancer Society — Embolization therapy for liver cancer
- National Cancer Institute — Liver cancer treatment (PDQ), patient version
- Cancer.Net — Liver cancer: types of treatment
- 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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