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Fever and pain after TACE: post-embolisation syndrome | CION Cancer Clinics
Post-embolisation syndrome is the fever, pain under the right ribs, feeling sick and tiredness that many people have after TACE. It happens because the tumour loses its blood supply and breaks down, and it usually eases over several days. It is expected, but some symptoms are not part of it. This page explains what is normal, what helps at home and when to go to hospital. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
MI
Medically reviewed by Dr. Mohammed ImaduddinConsultant Surgical Oncologist · MBBS, MS (General Surgery), MCh (Surgical Oncology) · last reviewed September 2026, next review due September 2027
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The short answer
What is post-embolisation syndrome?
Post-embolisation syndrome is the fever, pain, feeling sick and tiredness that many people have in the days after TACE. It is the body's response to the tumour losing its blood supply and breaking down, and it is expected rather than a sign that something went wrong.
Why it happens
When the artery feeding a tumour is blocked, tumour tissue dies. The body clears that dead tissue, and the process causes inflammation, the same reaction that makes a wound hot and sore. The liver capsule, the thin skin around the liver, can stretch as the area swells, which causes the ache under the right ribs.
How common it is
It is one of the most common effects after TACE and other forms of embolisation. Some people have only a mild ache and a slight temperature. Others feel quite unwell for several days. How strongly it hits does not reliably tell you how well the treatment worked.
Post-embolisation syndrome is a diagnosis the team makes after ruling out other causes. Always tell them about a fever rather than deciding it is harmless yourself.What you may notice
What are the usual symptoms?
Most people have some of these, not necessarily all of them. Each is treated on its own.
Pain
A dull ache or cramping under the right ribs, sometimes felt in the right shoulder or back. It is usually worst in the first days.
Usually managed with
- Regular pain relief, not only when it hurts
- Stronger medicine in hospital if needed
Fever
A raised temperature, often coming and going, without the shivering attacks of an infection. The team may still take blood tests to check for infection.
Feeling sick and not eating
Nausea, some vomiting and a poor appetite. Anti-sickness medicine helps. Small, frequent sips and light meals are easier than full plates.
Tiredness
A heavy, washed-out feeling that can last longer than the pain and fever. Short walks and rest in between usually help more than staying in bed all day.
Not sure whether this applies to you?
Ask an oncologistHow it usually runs
How long does it last?
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The first hours
Pain can start during or soon after the procedure. You are given pain relief and anti-sickness medicine on the ward, and nurses check your temperature regularly.
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The first few days
This is usually when fever, pain and feeling sick are strongest. Many people are still in hospital for part of this time. Some go home with tablets and clear instructions. Before leaving, make sure you know which number to call at night and which symptoms mean coming straight back.
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Towards the end of the first week
For most people the fever and pain begin to ease. Appetite slowly returns. Tiredness is often the last thing to lift.
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The following weeks
Some people take longer to feel themselves again, particularly after a large tumour was treated. A fever that comes back after settling, or pain that returns and worsens, is not the usual pattern and needs to be checked.
!
When it may not be post-embolisation syndrome
Go to an emergency department the same day if there is fever with shivering fits, a fever that returns after settling, yellowing of the eyes or skin, confusion or unusual drowsiness, severe pain that keeps getting worse, vomiting blood, black stools, or very little urine. Say the person recently had TACE. Do not give extra fever tablets and wait to see.
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Looking after someone at home
What helps at home, and what should the family watch?
Give the medicines exactly as the team prescribed, on time rather than waiting for pain to build. Keep a simple notebook of temperatures, pain and what was eaten and drunk. It helps the doctor on the phone far more than a general description.
Eating and drinking
Fluids matter more than food in the first days. Offer water, buttermilk, coconut water or thin soups often. Light meals such as idli, curd rice or khichdi are easier than rich or fried food. If the person has diabetes or a fluid limit, follow that advice first.
Who is more likely to feel it strongly
Larger tumours, a bigger area treated, and livers that were already under strain tend to bring stronger symptoms. Your team takes this into account when planning pain relief and the length of stay.
What this page cannot tell you
It cannot tell you whether a particular fever or pain is harmless. Only someone who can examine the person and see their blood results can judge that. It also cannot tell you how well the TACE worked, because the symptoms afterwards are not a measure of the result. When in doubt, call the team that did the procedure and describe exactly what you are seeing.
Never stop, start or change any medicine at home without asking the team. That includes painkillers bought at a local pharmacy, some of which are hard on the liver.Commonly believed
What do families often misread about it?
"Fever means the procedure has failed."
A fever in the first days usually reflects tumour tissue breaking down. It says nothing on its own about whether the treatment worked. The check scan some weeks later answers that question.
"No symptoms means the tumour was not hit."
Some people feel very little afterwards, and their scans still show a good response. The strength of the symptoms is not a reliable guide to the result.
"We should give antibiotics from the pharmacy just in case."
Antibiotics taken without advice can hide an infection and cause other problems. Some teams give them around the procedure for their own reasons. Any extra medicine should come only from the treating team.
"It will be the same every time."
People who have more than one session often notice a difference between them. A later session may be milder or stronger, depending on how much tumour is treated.
Did you know
Post-embolisation syndrome is not limited to TACE. It can follow any procedure that cuts the blood supply to a tumour, including embolisation of the kidney, and the same principles of care apply.
Questions we are asked
Common questions about post-embolisation syndrome
Is post-embolisation syndrome dangerous?
On its own it is an expected reaction that settles with time and care. The concern is that its symptoms can look like other problems, such as infection or strain on the liver. That is why the team wants to know about any fever, and why some symptoms need a doctor the same day.
How is it treated?
By treating each symptom. Regular pain relief, anti-sickness medicine, fluids, and medicine to bring the temperature down. Some people need these through a drip in hospital for a few days. There is no single medicine that stops the syndrome itself. It settles as the body clears the dead tissue.
Can it be prevented?
Not completely. Many teams give medicines around the procedure to reduce pain, sickness and fever, and the approach differs between centres. Ask your team what they plan to give and what you will take home, and never add your own tablets to that plan without asking.
Which painkillers are safe with a liver tumour?
This depends on how well your liver and kidneys work, so only your team can answer it for you. Some common painkillers can harm the liver or kidneys, or raise the risk of bleeding. Use only what the team prescribes, at the timing they give, and ask before taking anything else.
Is it normal to lose appetite for a while?
Yes, appetite usually drops in the first days and comes back slowly. Small, frequent meals and plenty of fluids help. If the person cannot keep fluids down, is passing very little urine or is losing weight quickly, tell the team, because they may need fluids through a drip.
Why did they keep him in hospital longer than expected?
Usually because the fever, pain or sickness needed medicine through a drip, or the team wanted blood tests to rule out infection or strain on the liver. A longer stay is not by itself a sign of a problem. Ask the ward doctor what they are waiting for before discharge.
When can he go back to work?
It depends on the job and how the recovery goes. Many people with desk work feel ready once the fever and pain have settled and energy starts returning. Heavy physical work usually needs longer. Ask the team at the follow-up visit, and plan around the check scan and any further sessions.
Will it happen again at the next session?
It may. Many people have some symptoms after each session, though the strength varies with how much tumour is treated and how the liver is doing. Knowing what happened last time helps. Tell the team what you experienced so they can plan pain and sickness control earlier.
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Sources
- American Cancer Society — Embolization therapy for liver cancer
- Cancer Research UK — Treatment for liver cancer
- Macmillan Cancer Support — Liver cancer
- National Cancer Institute — Liver cancer treatment (PDQ), patient version
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
What Happens During TACEThe procedure day that comes before thisLiver Function Before and After EmbolisationThe blood tests the team watches afterwardsComplications and Red FlagsWarning signs after any cancer procedureCaretaker and Family Guide to SurgeryFor the family member looking after them at home
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