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TACE: chemoembolisation of the liver, explained | CION Cancer Clinics
TACE is a procedure for liver cancer that sends a chemotherapy drug straight into the tumour through its artery, then blocks that artery so the drug stays in and the tumour loses its blood supply. It is done through a small puncture in the leg or wrist, not an open operation. This page explains how it works, why it is offered, who it does not suit and what happens afterwards. 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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The short answer
What is TACE, in plain words?
TACE puts a chemotherapy drug straight into a liver tumour and then blocks the artery feeding it. The full name is transarterial chemoembolisation, which simply means chemotherapy plus blocking, delivered through an artery.
Why the liver suits this approach
Healthy liver gets most of its blood from a large vein. A liver tumour gets most of its blood from the hepatic artery. So when a doctor sends drug and blocking material into that artery, most of it goes to the tumour, and the healthy liver keeps its own supply.
What it is meant to do
TACE aims to shrink a tumour or stop it growing for a time. It keeps a high dose of drug inside the tumour while less of it reaches the rest of your body. It does not usually remove a cancer completely, so it is almost always part of a longer plan with regular scans.
TACE is used mostly for cancer that started in the liver, called hepatocellular carcinoma or HCC. It is sometimes used for cancers that have spread to the liver.Side by side
Which kind of TACE will I have?
Conventional TACE
Drug-eluting bead TACE
The drug is mixed with an oily liquid that shows up on X-ray
The drug is soaked into tiny beads before they go in
Blocking particles follow the drug mixture
The beads block the vessel and release the drug slowly
The oily liquid stays visible on later scans
Less of the drug tends to reach the blood
Used widely for many years
Chosen by some teams for particular tumours or patients
Not sure whether this applies to you?
Ask an oncologistThe pathway
What happens from referral to follow-up?
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Scans and blood tests
A CT or MRI of the liver shows the size, number and position of the tumours. Blood tests check how well your liver and kidneys are working and whether your blood clots normally.
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The team decides together
Surgeons, liver specialists, oncologists and radiologists look at the whole picture. They weigh TACE against surgery, a transplant, ablation, TARE and medicines before anything is booked.
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The procedure
A thin tube goes into an artery at the top of the leg or the wrist and is steered to the liver on X-ray. The drug and blocking material are released into the branch feeding the tumour. You are usually awake but sedated.
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The first days
Most people stay in hospital at least one night. Fever, pain under the right ribs, feeling sick and tiredness are common as the tumour breaks down. This is called post-embolisation syndrome.
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The check scan
Some weeks later a scan shows how the tumour responded. Your team uses it, with fresh blood tests, to decide whether another session makes sense or whether the plan should change.
The aim
Why would a team suggest TACE?
The same procedure can be offered for quite different reasons. Ask which one applies to you, because it changes what counts as success.
To control the tumour
When the cancer is confined to the liver but cannot be removed by surgery or treated by ablation, TACE can hold it back and ease symptoms for a period.
To bridge to a transplant
While a person waits for a liver, TACE can keep the tumour within the limits that transplant teams accept.
To shrink it first
Sometimes the aim is to reduce the tumour enough that surgery or a transplant becomes possible later. This is called downstaging.
It does not work for everyone, and the team will say so plainly.Alongside other treatment
TACE may be combined with ablation or followed by medicines, depending on how the tumour responds.
Usually decided by
- The check scan after TACE
- How well the liver is coping
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After TACE: when not to wait
Fever and an ache are expected. Go to an emergency department the same day if there is a high fever with shivering, yellow eyes or skin, confusion or unusual sleepiness, vomiting blood, black stools, a quickly swelling tummy, or bleeding and swelling where the tube went in. Say the person recently had TACE. Do not wait to see if it settles overnight.
Commonly believed
What do families often misunderstand about TACE?
"It is chemotherapy, so hair will fall out."
Because most of the drug stays inside the liver, hair loss and low blood counts are much less common than with chemotherapy through a drip. The effects people notice more are fever, pain and tiredness in the first days.
"One TACE and the tumour is finished."
Many people need more than one session. Parts of a tumour can survive, and new tumours can appear elsewhere in the liver. The check scan tells the team what has happened.
"TACE will damage the liver, so it is better to avoid it."
Some strain on the liver is expected, which is exactly why liver function is tested before every session. The team only proceeds when they judge the liver can cope, and they stop when it cannot.
"It is a keyhole operation."
There is no cut into the belly at all. The only opening is a small puncture in the leg or wrist.
Being straight with you
Who does TACE not suit, and what can this page not tell you?
TACE is not for everyone with a liver tumour. It needs a liver that still works reasonably well and a tumour that gets its blood from the artery the doctor can reach.
When other options are usually weighed
Teams often look elsewhere when the liver is failing, with fluid in the belly or deep yellowing. The same applies when the main vein into the liver is blocked by clot or tumour, or when the cancer has spread outside the liver. Poor kidney function, a bleeding problem or being very unwell in general also count. A small tumour that could be removed or burnt away may be better treated another way.
What this page cannot tell you
It cannot tell you whether TACE is right for you, how your tumour will respond, or what the future holds. Those depend on your scans, your liver and your whole history, which only your team can see.
Ask your team what the aim of TACE is in your case, and what the alternatives would be.Questions we are asked
Common questions about TACE for liver cancer
Is TACE surgery?
No. It is a procedure done through a blood vessel by an interventional radiologist, a doctor who treats disease using live X-ray pictures as a guide. There is no cut into the belly. The only wound is a small puncture in the leg or wrist, which is pressed or sealed at the end.
Will I be put to sleep?
Most people are awake but drowsy. The skin where the tube goes in is numbed, and medicine through a drip helps you relax and controls pain. Some centres use a general anaesthetic in particular cases. Ask your centre what they plan, and tell them if you have had a difficult experience with sedation before.
How long does it take?
The procedure itself usually takes an hour or two, though it can run longer when there are several tumours or the arteries are hard to reach. Preparation beforehand and a period of lying flat afterwards add to the day. Plan for an overnight stay unless the team tells you otherwise.
Will TACE make me very sick?
Many people feel unwell for some days, with fever, pain under the right ribs, feeling sick and low appetite. This is expected and is treated with regular medicines. It is usually easier than chemotherapy through a drip, but it is not nothing. A family member at home for the first days helps.
Can TACE be done if I have cirrhosis?
Often yes. Many people with liver cancer also have cirrhosis, which is long-term scarring of the liver. What matters is how well the scarred liver still works. Blood tests and signs such as fluid in the belly or yellowing help the team judge whether it can cope with the procedure.
What does the check scan look for?
It looks at whether the tumour still takes up dye on the scan, which suggests living tissue, or whether it looks dead. It also looks for new tumours. The report may use words like complete or partial response. Your team explains what those mean for the next step.
Should my regular medicines be stopped before TACE?
Do not stop, start or change any medicine on your own. Bring a full list, especially blood thinners, diabetes medicines and anything for the heart or kidneys. The doctor doing the procedure and the doctor who prescribes each medicine will tell you exactly what to do and when.
Is TACE covered by Aarogyasri or insurance?
It is often covered when it is part of an approved cancer treatment plan. Aarogyasri, CGHS, ECHS and EHS may apply, and many cashless insurers include it. Cover differs by scheme and policy, so call the helpline with your card details and ask for your own cover to be checked before the date is set.
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Sources
- American Cancer Society — Embolization therapy for liver cancer
- Cancer Research UK — Treatment for liver cancer
- National Cancer Institute — Liver cancer treatment (PDQ), patient version
- Cancer.Net — Liver cancer: types of treatment
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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