Transarterial Chemoembolisation (TACE)

What is TACE?

Transarterial chemoembolisation (TACE) is a type of treatment for liver cancer. It delivers cancer-fighting drugs (chemotherapy) straight to tumour through the hepatic artery (a blood vessel that goes to the liver).  

At the same time, the procedure blocks the artery to cut off the tumour’s blood supply. This process is called embolisation. It helps kill the tumour by starving it of blood. 

Liver tumours can grow their own new blood vessels, which mainly get blood from the hepatic artery. The rest of the liver gets most of its blood from a different vessel called the portal vein. As long as the portal vein is still working properly, doctors can block the tumour’s blood supply without harming the healthy parts of the liver.  

TACE uses cancer-fighting drugs to treat tumours. But there are a some differences to traditional chemotherapy: 

• TACE delivers the drugs directly to the tumour. With standard chemotherapy, the drugs travel throughout your whole body through your bloodstream. 

•  As the drugs go directly into the tumour, you’re less likely to experience severe side effects. 

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What happens during TACE?

First you get local anaesthetic to the skin over the artery in your groin or wrist. You are also given some medicines to make you feel relaxed and sleepy (sedation).  

The interventional radiologist makes a small cut (a few millimetres) in the artery near your groin or wrist.  A thin plastic tube called a catheter is then inserted through the cut and fed to the liver and into the hepatic artery. 

Dye is injected through the catheter to make it easier to see the finer details of the tumour and the nearby blood vessels around the tumour, which the interventional radiologist can see on imaging. 

The interventional radiologist injects the tumour with a mix of chemotherapy drugs and a substance that blocks the blood vessel that is feeding the tumour (called an embolic agent).  

When the procedure is finished, the interventional radiologist removes the catheter. The small cut is covered with a bandage. Stiches are not usually necessary. 

After TACE, you have to remain lying down for about 4 hours. You may also need to stay in hospital for a night or a few days. 

You will have a CT or MRI scan about 6 to 12 weeks after the procedure to see how well the treatment is working. 

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What are the side effects of TACE?

It is common to have a mild fever for up to a week after the procedure. This can usually be managed with paracetamol. You may also experience: 

• nausea and vomiting  

• loss of appetite 

• some pain 

• feeling tired or flu-like symptoms for up to a week after the procedure. 

These symptoms can be controlled with medicines which your medical team can prescribe. Most side effects should go away after a few weeks. 

If you have side effects that are not going away or are getting worse, you need to contact your medical team. 

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What are the benefits of TACE?

TACE offers several benefits for patients with liver cancer: 

• Targeted treatment – TACE delivers chemotherapy directly to the liver tumour through the hepatic artery., This allows for higher doses of chemotherapy to the tumour and fewer side effects in the rest of the body. 

• Slowing tumour growth – TACE helps keep liver cancer under control by slowing the growth of tumours, potentially extending survival. 

• Multiple treatments – if new liver tumours develop or existing ones aren’t completely treated, TACE can be repeated to manage the cancer’s progression. 

• Improved quality of life – by controlling tumour growth, TACE can help patients experience fewer symptoms and maintain a better quality of life compared to other treatments.  

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Who is TACE for? 

You will be offered TACE only if you have good liver function, you don’t have any fluid in your belly (ascites) and there are no blood clots in the portal vein (called portal vein thrombosis). 

If your liver isn’t working as well as it should, you might have TACE with smaller doses of chemotherapy spread over more than one session. This tries to lessen the effect on the normal liver. 

TACE may be used if your liver cancer: 

• can’t be removed with surgery 

• can’t be treated with ablation therapy  

• hasn’t spread to the major blood vessels in the liver or other parts of the body (metastasised).  

You may also be offered TACE to shrink and contain a liver tumour if you are waiting for a liver transplant (called bridging therapy). 

Doctors may offer TACE to treat liver tumours that are larger than 5 cm, but it may take more than one treatment to shrink these larger tumours. If cancer is in both lobes of the liver, doctors will treat one lobe at a time. Treatment to each lobe is sometimes given a few weeks apart so that you have time to recover in between. 

TACE is not recommended if: 

• You have large tumours that are on both sides of your liver 

• You have severe liver or kidney dysfunction 

• You have abnormal blood clotting (this could increase the risk of bleeding) 
• You have stents or blockage of the bile duct(s).

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Will I need other treatments for my liver cancer? 

TACE is a treatment, and not necessarily a cure. About 7 in 10 patients will see the liver tumour shrink  and may also have improved survival rates and quality of life. 

For some people, TACE is the only treatment necessary as the tumour is killed and doesn’t grow back.. 

In other cases, TACE is one of many treatments. The multidisciplinary team at your hospital will help decide which treatments are right for you. Other treatments may include: 

• Ablation 

• Surgery to remove the tumour if it comes back 

• Systemic therapy, cancer-fighting drugs that travel through the bloodstream and destroy abnormal cells. These are often given as tablets or capsules 

• Immunotherapy 

• Radiation therapy 

• Liver transplant 

• SIRT 

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What are the risks of TACE? 

TACE is generally considered safe. But there are some risks to be aware of: 

• Liver function – in some cases, TACE can cause a temporary decline in liver function. 

• Infection or bleeding – as with any procedure involving the blood vessels, there is a small risk of infection or bleeding where the catheter goes in. The chance of infection requiring antibiotic treatment is less than one in 1,000. 

• Gallbladder issues – in rare cases, TACE can lead to a gallbladder inflammation or infection due to blocked blood flow through the blood vessels. 

• Problems with other organs – a very rare complication may be kidney or heart issues after TACE. This happens in less than 1 in 100 patients. 

• The material used to block the blood vessel may lodge in the wrong place and starve healthy tissue of its blood supply. This is uncommon, because the pathway of the blood supply to the tumour is carefully mapped. 

• There is a risk of an allergic reaction to the dye. The radiology staff will ask about your allergies prior to the procedure. 

• Because dye is used, there is a risk of kidney damage in patients with diabetes or other pre-existing kidney disease. It is important that your medical team has your full medical history. 

• Serious complications from TACE can occur after about 1 in 20 procedures. Most major complications involve either infection in the liver or damage to the liver. Liver failure leading to death can occur in approximately 1 in every 100 procedures. 

Your interventional radiologist will carefully evaluate your condition and health of your blood vessels to minimise risks and ensure TACE is a safe option for you. 

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How much does TACE cost? 

If you have TACE in a public hospital you will not pay for it. If you have TACE in a private centre, your private health may cover some of the cost. You should talk to your doctor about the best option for you. 

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Resources

Liver Foundation Nurse Led Support Line: call 1800 841 118 or email support@liver.org.au to talk to a friendly, expert hepatology nurse. 

Reviewed Jan 2026