Liver Transarterial Chemoembolization (TACE) Korean 환자교육 방사선과 / 영상서비스 간경동맥항암색전술 (TACE) 항암치료 이책자는간경동맥항암색전술 (TACE) 이무엇이며이항암치료를받으면일어날수도있는것들을설명합니다. 경동맥항암색전술은무엇입니까? 항암색전술은종양을치료하는데쓰입니다. 이것은많은용량의화학치료제 ( 항암 ) 를종양에직통으로집어넣습니다. 이것은더많은양의약을암세포에곧바로투여하고다른조직에끼치는영향을감소시킵니다. 경동맥항암색전술 (TACE) 의경우에는종양에혈액과영양을공급하는작은혈관들또한봉쇄시킵니다 ( 색전 ). 혈액공급을봉쇄함은종양이자라는것을늦추게합니다. 항암치료제 악성종양 항암색전술은화학치료제를종양에직접전달합니다.
Page 2 방사선과 / 영상서비스간경동맥항암색전술 (TACE) TACE 는언제사용됩니까? TACE 는간암을치료하는데가장흔히사용됩니다. 이것은또한신체의다른부분에서시작했지만간으로퍼진암을치료하는데도사용될수있습니다. 이렇게암이퍼지는것을전이라고부릅니다. 얼마나효과적입니까? TACE 는일반적으로간의종양을작아지게만듭니다. 때로는전이되는것을줄이기도합니다. 이치료의목적은종양을몇달동안그리고때로는몇해동안억제하는것입니다. 간종양의전문가들은 TACE 가지금현재환자분에게최상의치료라고결정했습니다. 이치료는그것자체만으로는환자분의암을완치시키지는않을것입니다. 환자분은수술이나방사선치료나고주파절제술 ( 남은종양을열탐색침을사용해서파괴함 ) 이필요할수도있습니다. TACE 가간종양에는어떻게작용합니까? 간은간문맥과간동맥의두가지큰혈관으로부터혈액을공급받기때문에독특합니다. 건강한간조직 : 대부분의혈액공급을간문맥으로부터받음 훨씬작은양의혈액공급을간동맥으로부터받음하지만, 간종양은 : 대부분의혈액공급을간동맥으로부터받음 혈액공급을간문맥으로부터거의받지않음이것은항암제가간동맥으로투여되면대부분의약이종양에가게되는것을뜻합니다. 극히적은양의약만이건강한간조직에도달합니다. 어떻게합니까? 중재방사선의사 (X 선영상을이용해서시술을하는전문의 ) 가 TACE 를시술합니다. 마취제 ( 감각을둔하게하는약 ) 를피부에주사할것입니다. 5 초에서 10 초동안따가울것입니다. 그리고나면그부분이감각이둔해질것이며서통증을느끼지않게될것입니다. 환자분의의사선생님이사타구니에아주작은절개선 (1/4 인치보다작은 ) 을낼것입니다.
Page 3 방사선과 / 영상서비스간경동맥항암색전술 (TACE) 그러면의사선생님이종양으로혈액을공급하는간동맥으로환자분의사타구니에있는동맥을통해서도관 ( 작은플라스틱튜브 ) 을꿰넣을것입니다. 아주정확히알맞는곳에도관을집어넣기위해서의사선생님이엑스레이영상을이용할것입니다. 항암치료제를도관을통해서종양속으로투여합니다. 그러고나면아주작은구슬들이동맥으로주사됩니다. 이구슬들은종양을향해서이동하고혈액공급을차단합니다. 종양 간동맥 장골동맥 간 복강동맥 대동맥 도관 간동맥항암색전술은도관을간에있는동맥으로꿰어넣습니다. 어떻게진행됩니까? 환자분은의사선생님과치료계획에관하여상담하기위해서만나게될것입니다. 다음은가장보편적인치료계획입니다 : 첫째주 : 항암색전술 1 회 간은이엽으로되어있습니다. 간항암색전술첫회에는 TACE 를한쪽엽에만합니다. 3 째와 4 째주 환자분은몸의상태와 TACE( 테이스 ) 가신체에미치는영향을상담하기위하여클리닉에오시거나전화상담을받게될것입니다. 4 째와 5 째주 : 항암색전술 2 회 ( 필요하면 ) 아니면방사선과검사 만일종양이간의양쪽엽에다있으면 TACE 를다른쪽엽에하게됩니다.
Page 4 방사선과 / 영상서비스간경동맥항암색전술 (TACE) 만일종양이간의한쪽에만있으면환자분은방사선과검사 (MRI 나 CT 촬영 ) 와혈액검사를하게될것입니다. 이검사들을통해서 TACE 가효과적인가를확인할것입니다. 담당의사선생님이이검사들의결과를바탕으로치료가더필요한가를결정할것입니다. 8 주나 9 주째 : 항암색전술 3 차 ( 필요하면 ) 아니면방사선과검사 종양이상당히많으면가장영향을받은간의부분에더 TACE 하게될것입니다. TACE 가더필요하지않으면효과가있는가를확인하기위해서방사선과검사 (MRI 나 CT 촬영 ) 를하게될것입니다. 담당의사선생님이이검사들의결과를바탕으로치료가더필요한가를결정할것입니다. 무슨항암제를사용합니까? 환자분의치료를위해서여러가지다른항암제를사용할수도있습니다. 대부분의사람들은닥소루비신 ( 애드리아마이신 ) 만받습니다. 어떤부작용들이있습니까? 대부분의약이간에만있게하는방법으로항암제를투여합니다. 이것은환자분의신체조직이아주천천히항암제를흡수한다는것을뜻합니다. 이방법은사람들에게종종항암치료로부터오는짧은기간의부작용을배제하지는못하지만감소시킵니다. 가장흔한부작용은메스꺼움증과피곤증입니다. 메스꺼움증은세가지약을섞어서사용할때더가능성이큽니다. 아주드믈기는하지만테이스를받는사람이머리가조금아니면거의다빠질경우가있습니다. 어떤위험성들이있나요? 모든의료시술은어느정도의위험을수반합니다. 허나테이스를받음으로써얻을수있는잠정적혜택은위험도를훨씬능가합니다. 많은양의닥소루비신은심장을손상시킬수있습니다. 일생에걸쳐서닥소루비신은일인당 500 mg 미만의양을권장합니다. 한번의테이스시술에쓰이느닥소루비신의양은 50 mg 입니다. 가장흔한합병증들은 : 사타구니의혈관도관이들어가는곳의출혈이나동맥관손상 간기능의악화 감염 ( 간농양과같은 )
Page 5 방사선과 / 영상서비스간경동맥항암색전술 (TACE) 심각한합병증의위헙성은대략 5% (100 명중 5 명 ) 정도입니다. 테이스를시작하기전에의사선생님중의한분이위험성에대해서상담을하실것입니다. 궁금하신모든점들을꼭물어보시고걱정되는사항에대해서상의하십시오. 시술전에 시술전날오후에진행담당간호사가전화를할것입니다. 시술일이월요일이면간호사가그전주금요일에전화할것입니다. 간호사가마지막지시사항을말씀드릴것이고모든질문에답을해드릴것입니다. 시술에관한지시사항이나상세한부분을충분히이해할정도로영어가이해되지않으시면되도록신속히말씀해줏십시오. 도와드릴병원소속통역을주선해드릴것입니다. 가족이나친구분이환자분을위해서통역을할수없을수도있습니다. 시술을하러오시면혈액검사를하게될것입니다. 알레르기가있거나이전에혈관조영제 ( 엑스레이염색약 ) 로부터나쁜부작용이있었으면이책자의마지막장에있는전화번호중의하나로진행담당간호사에게전화해주십시오. 시술전에이알레르기를위한약을복용하실필요가있을수도있습니다. 신장기능이비정상이고엑스레이염색약을주사해야할필요가있으면저희들이시술이전과이후에복용해야될약을처방해야할수도있습니다. 이약은환자분의신장을보호에도움이될것입니다. 시술전날수분을많이섭취하십시오. 혈액을묽게만드는약 ( 쿠마딘, 로브낙스, 프레그민이나플라빅스와같은 ) 을드시고계시면시술이전 3 일에서 9 일동안중단해야할필요가있을수도있습니다. 이것에대한지시사항을받으실것입니다. 당뇨가있으시고인슐린주사를맞거나멭포민 ( 글루코파지 ) 을복용하시면, 테이스시술당일에평상시에쓰는양을중단하거나조정하는것에대한지시사항을받으실것입니다. 수면마취 이치료를위해서는, 정맥도관을통해서진정제 ( 발리움이나몰핀과비슷함 ) 를투여받으실것입니다. 이약은환자분을졸리게하고긴장을풀리게하고통증을감소시킬것입니다. 환자분은깨어있으실것입니다. 이것은얕은진정이라고불립니다. 시술이끝나고난이후에도환자분은한동안여전히졸릴것입니다. 어떤사람들에게는얕은진정을사용하는것이안전하지않습니다. 이것이환자분에게도적용이되면환자분은전신마취 ( 시술동안환자분을주무시게하는약 ) 가필요할것입니다.
Page 6 방사선과 / 영상서비스간경동맥항암색전술 (TACE) 다음사항중에해당되는것이있으시면즉시알려주십시오 : - 전에기본적인시술을위해서전신마취가필요했었음 - 수면무호흡증이나만성호흡곤란문제 ( 잠잘때씨펩이나바이펩같은기구를사용하시면 ) 가있음 - 높은용량의마약성진통제를사용하고있음 - 심각한심장, 폐, 아니면신장질환이있음 - 척추나호흡에문제가있어서 1 시간동안편편한곳에똑바로누워있을수없음 - 의료시술을받는동안가만히움직이지않고누워있기힘듬 - 300 파운드 (136 킬로그램 ) 이상몸무게가나감 시술받기전날 수면마취를위해서준비를하려면은, 다음과같은지시사항을철저히따라하십시오 : 시술전날은평상시대로식사하십시오. 시술받기 6 시간이전부터는단지맑은물 ( 물이나, 사이다, 크렌베리쥬스, 아니면엷은차와같은투명한액체 ) 만드실수있습니다. 시술받기 2 시간이전부터는 : - 아무것도드시지마십시오. - 약을드셔야하면, 반드시약을넘길수있는정도의물과함께드십시오. - 비타민이나다른보충제를드시지마십시오. 공복에속을쓰리게할수있습니다. 시술받는날 시술받는날, 평상시드시는약들을다복용하십시오. 의사선생님이나간호사의지시가있지않는한에는건너뛰지마십시오. 오실때, 약병들을모두가지고오십시오. 진행관리담당간호사가다르게말하지않으면, 병원 3 층로비에위치한입퇴원과에가서접수하십시오. 입퇴원과는로비안내처뒷쪽오른편에위치하고있습니다. 만일시술시작이지연되면, 그것은보통예상하지못했던급한문제가있는다른환자분을치료하기위해서이기때문입니다. 이런경우가일어날경우를대비해서미리사과드립니다. 의료보조사가병원가운과소지품을넣을봉지를드릴것입니다. 이때에화장실에갔다오셔도됩니다.
Page 7 방사선과 / 영상서비스간경동맥항암색전술 (TACE) 직원이시술이전대기실로모시고갈것입니다. 그곳에서간호사가건강평가를할것입니다. 환자분의가족이나친구분들은그곳에같이계실수있습니다. 정맥도관 (IV) 이삽입될것입니다. 이도관으로수분과약이투여될것입니다. 미리하지않았으면, 중재방사선과의사가시술에관해서설명을할것이고동의서에서명을요청할것입니다. 이때궁금한것이있으면질문을할수있습니다. 시술 간호사가방사선과시술실로모시고갈것입니다. 이간호사는시술받으시는내내환자분을옆에서보살펴드릴것입니다. 필요하면통역사가시술실에같이있거나인터콤을통해서의사소통을할수있게해드릴것입니다. 시술동안납작한엑스레이검사대에누워계실것입니다. 심장박동을모니터로지켜보기위해서전극들이몸에붙여질것입니다. 혈압대를팔에차고계실것입니다. 혈압을재기위해서때때로이혈압대가부풀것입니다. 방사선과전문기술자가특별한비누로사타구니의피부를소독할것입니다. 어떤엘러지라도문제가있으면이사람에게말하십시오. 의사선생님이시술해야할부분의체모를이전문사가면도해야할필요가있을수도있습니다. 의료팀모두가성명과무슨시술을받을것인가를확인하기위해서질문을할것입니다. 이것은환자분의안전을위해서입니다. 그러고나면간호사가시술이시작되기전에졸립고편안하게만드는약을투여할것입니다. 시술이후 밤새우리가지켜보기위하여환자분은하루밤병원에입원하실것입니다. 2 시간에서 6 시간까지침대에누워계실것입니다. 그시간동안은도관이들어갔던자리의아래쪽다리를움직이지않고가만히있어야합니다. 이것이출혈의위험성을낯추는것을도울것입니다. 그이후에는움직일수있고화장실도사용할수있습니다. 아마도먹고마시는것을할수있을것이고가족이방문할수도있습니다. 어떤환자분은간경동맥항암색전술다음날컴퓨터단층촬영 (CT) 을찍게됩니다. 이사진은종양 ( 아니면종양들 ) 에게로항암제가얼마나잘퍼졌는가를보여줄것입니다. 시술다음날대부분의환자분은퇴원할수있습니다. 합병증은드믑니다. 만약에일어나면우리가환자분을지켜보고치료하기위해서병원에좀더계셔야할수도있습니다.
Page 8 방사선과 / 영상서비스간경동맥항암색전술 (TACE) 문의사항? 우리는환자분의질문을 중요하게여깁니다. 질문이나걱정되는것이 있으면담당의사나 의료관리제공자에게 연락하십시오. UWMC 클리닉직원들또한 도와드릴수있습니다. 방사선과 / 영상서비스 : 206-598-6200 집에가면 부작용항암색전술을받고나서대부분의환자분들은약간의부작용을겪습니다. 이것을색전술-이후증후군이라고부릅니다. 부작용들은 : 피곤증 통증 메스꺼움증 한주일동안지속될수있는미열이나오한통증은흔한부작용입니다. 이것은종양으로의혈액공급이막혔기때문에일어납니다. 활동 시술이후에는원하는대로샤워나목욕을하셔도됩니다. 2-3 일동안은심한운동은피하시고 20 파운드이상나가는것은들어올리지마십시오. 2 주일이나그이상아마도많이피로할것이고식욕도없을것입니다. 대부분의환자분들은일주일이내로정상활동으로복귀할수있습니다. 연락해야할때 병원에서퇴원할때진통제와메스꺼움증을가라앉히는약을타가실것입니다. 다음과같은증상이있으면즉시의사선생님에게연락하십시오 : 통증이갑자기악화되거나그외로달리변화가있음 화씨 101 도 ( 섭씨 38.3 도 ) 이상의열이나거나오한이남 사타구니의들어갔던자리의출혈이나부기 심각한복통 신경이쓰이는그외의것들 연락처 중재방사선과진행담당간호사... 206-598-6897 시술예약부... 206-598-6209 업무시간이후 ( 오후 5 시부터오전 7 시 ) 와, 주말, 그리고휴일중재방사선과당직전문수련의를요청하십시오... 206-598-6190 응급상황 Box 357115 1959 N.E. Pacific St. Seattle, WA 98195 206-598-6200 가장가까운응급실로곧장가거나 9-1-1 로전화하십시오. 병원직원에게서 연락이올때까지기다리지마십시오. University of Washington Medical Center Liver Transarterial Chemoembolization (TACE) Korean Published/Clinician Review: 02/2012 Translation by UWMC Interpreter Services Reprints on Health Online: http://healthonline.washington.edu
Patient Education Liver Transarterial Chemoembolization (TACE) Cancer treatment This handout explains what liver transarterial chemoembolization (TACE) is and what to expect with this cancer treatment. What is transarterial chemoembolization? Chemoembolization is used to treat tumors. It puts a large dose of chemotherapy (chemo) drugs right into the tumor. This puts more of the drugs right on the cancer cells and lessens their effect on other tissues. In transarterial chemoembolization (TACE), the small blood vessels that supply blood and nutrients to the tumor are also blocked (embolized). Blocking the blood supply slows tumor growth. In chemoembolization, chemotherapy drugs are delivered directly to the tumor.
Page 2 Liver Transarterial Chemoembolization (TACE) When is TACE used? TACE is used most often to treat liver cancer. It can also be used to treat cancer that started in another area of the body but has spread to the liver. This spreading of cancer is called metastasis. How effective is it? TACE usually makes liver tumors smaller. Sometimes it also reduces metastasis. The goal of this treatment is to keep the tumors under control for months and sometimes years. A group of experts on liver tumors has determined that TACE is the best treatment for you right now. This treatment will not cure your cancer by itself. You may also need surgery, radiation therapy, chemotherapy, or radiofrequency ablation (using a heat probe to destroy the rest of the tumor). How does TACE work on liver tumors? The liver is unique because it gets blood in 2 ways: from a large portal vein and from the hepatic artery. Healthy liver tissue: Gets most of its blood supply from the portal vein Gets a much smaller amount of blood from the hepatic artery But, a liver tumor: Gets most of its blood supply from the hepatic artery Gets almost no blood supply from the portal vein This means that if a chemotherapy drug is injected into the hepatic artery, most of the drug ends up in the tumor. Very little of the drug reaches healthy liver tissue. How is it done? TACE is done by an interventional radiologist (a doctor who specializes in procedures that are guided by X-ray images). An anesthetic (numbing medicine) will be applied to your skin. It will sting for 5 to 10 seconds. Then the area will be numb and you will not feel pain. Your doctor will make a very small incision (less than ¼ inch long) in your groin.
Page 3 Liver Transarterial Chemoembolization (TACE) Your doctor will then thread a catheter (small plastic tube) from an artery in your groin into the artery in your liver that carries blood to the tumor. X-ray images will help your doctor place the catheter in exactly the right place. Chemotherapy is sent through the catheter into the tumor. Then, tiny beads are injected into the artery. These beads travel toward the tumor and block its blood supply. In hepatic artery chemoembolization, a catheter is threaded into an artery in the liver. What can I expect? You will meet with your doctors to talk about your treatment schedule. This is the most common treatment schedule: Week 1: Chemoembolization Round #1 The liver has 2 lobes. In the first round of chemoembolization to the liver, TACE is done on 1 lobe. Week 3 or 4 You will have a clinic visit or phone consult to see how you are feeling and how TACE is affecting you. Week 4 or 5: Chemoembolization Round #2 (if needed) or Radiology Studies If there are tumors in both lobes of your liver, TACE is done on the other lobe.
Page 4 Liver Transarterial Chemoembolization (TACE) If the tumor was only in 1 lobe of your liver, you will have radiology exams (MR imaging or a CT scan) and blood tests. These tests will show how your liver is responding to TACE. Your doctors will decide if you need more therapy based on the results of these tests. Week 8 or 9: Chemoembolization Round #3 (if needed) or Radiology Studies If your cancer was very extensive, more TACE will be done to the most affected parts of your liver. If you do not need more TACE, you will have radiology exams (MR imaging or a CT scan) to find out how your liver is responding. Your doctors will decide if you need more therapy based on the results of these tests. What chemotherapy drugs are used? Many different chemotherapy drugs may be used in your treatment. Most people receive only doxorubicin (Adriamycin). What are the side effects? We deliver the chemotherapy drugs in a way that they mostly stay in the liver. This means that your system will absorb the chemotherapy drugs very slowly. This lessens, but does not get rid of, the short-term side effects that people often have from chemotherapy. The most common side effects are nausea and fatigue. Nausea is more likely when a mixture of 3 drugs is used. Very rarely, a person receiving TACE will lose some or most of their hair. Are there any risks? All medical procedures involve some risk. But, the potential benefits of TACE far outweigh the risks. In large doses, doxorubicin can damage the heart. It is recommended that a person receive no more than about 500 mg of doxorubicin over their lifetime. Each round of TACE uses 50 mg of doxorubicin. The most common complications are: Bleeding or artery injury where the catheter is inserted in your groin Liver function gets worse Infections (such as a liver abscess)
Page 5 Liver Transarterial Chemoembolization (TACE) The risk of a serious complication is about 5% (5 out of 100 people). One of your doctors will talk with you about your risks before you start TACE. Please be sure to ask all of your questions and talk about any concerns you have. Before Your Procedure A nurse coordinator will call you the afternoon before your procedure. If your procedure is on a Monday, the nurse will call you the Friday before. The nurse will give you final instructions and answer any questions you have. If you do not understand English well enough to understand these instructions or the details of the procedure, tell us as soon as possible. We will arrange for a hospital interpreter to assist you. A family member or friend may not interpret for you. You will have blood tests done when you arrive for your procedure. If you have had an allergy or bad reaction to contrast (X-ray dye) in the past, please call our nurse coordinators at one of the numbers on the last page of this handout. You may need to take medicine for this allergy before the procedure. If your kidney function is not normal and we need to give you X-ray dye, we may prescribe a medicine for you to take before and after your procedure. This medicine will help protect your kidneys. Drink plenty of fluids the day before your procedure. If you take any blood-thinning medicines (such as Coumadin, Lovenox, Fragmin, or Plavix), you may need to stop taking the medicine for 3 to 9 days before the procedure. You will receive instructions about this. If you have diabetes and take insulin or metformin (Glucophage), you will receive instructions about holding or adjusting your dose for the day of your TACE procedure. Sedation For this treatment, you will be given a sedative medicine (similar to Valium and morphine) through your IV. This medicine will make you sleepy, help you relax, and lessen your discomfort. You will stay awake. This is called conscious sedation. You will still be sleepy for a while after the procedure. For some people, using conscious sedation is not safe. If this is true for you, you will need anesthesia (medicine to make you sleep during the procedure).
Page 6 Liver Transarterial Chemoembolization (TACE) Let us know right away if you: - Have needed anesthesia for basic procedures in the past - Have sleep apnea or chronic breathing problems (you might use a CPAP or BiPAP device while sleeping) - Use high doses of narcotic painkiller - Have severe heart, lung, or kidney disease - Cannot lie flat for about 1 hour because of back or breathing problems - Have a hard time lying still during medical procedures - Weigh more than 300 pounds (136 kilograms) Day Before Your Procedure To prepare for sedation, follow these instructions closely: The day before your procedure, you may eat as usual. Starting 6 hours before your procedure, you may only have clear liquids (liquid you can see through such as water, Sprite, cranberry juice, or weak tea). Starting 2 hours before your procedure: - Take nothing at all by mouth. - If you must take medicines, take them with only a sip of water. - Do not take vitamins or other supplements. They can upset an empty stomach. On the Day of Your Procedure Take all of your other usual medicines on the day of the procedure. Do not skip them unless your doctor or nurse tells you to. Bring a list of all the medicines you take with you. Unless the nurse coordinator tells you otherwise, check in at Admitting on the 3rd (main) floor of the hospital. Admitting is to the right and behind the Information Desk in the lobby. If there is a delay in getting your procedure started, it is usually because we need to treat other people with unexpected and urgent problems. Thank you for your patience if this occurs. A medical assistant will give you a hospital gown to put on and a bag for your belongings. You may use the restroom at that time. A staff member will take you to a pre-procedure area. There, a nurse will do a health assessment. Your family or friend can be with you there.
Page 7 Liver Transarterial Chemoembolization (TACE) An intravenous (IV) line will be started. You will be given fluids and medicines through the IV. An interventional radiology doctor will talk with you about the procedure and ask you to sign a consent form if that has not already been done. You will be able to ask questions at that time. Your Procedure The nurse will take you to the radiology suite. This nurse will be with you for the entire procedure. If needed, an interpreter will be in the room or will be able to talk with you and hear you through an intercom. You will lie on a flat X-ray table for the procedure. Wires will be placed on your body to help us monitor your heart rate. You will have a cuff around your arm. It will inflate from time to time to check your blood pressure. A radiology technologist will clean your skin around your groin with a special soap. Tell this person if you have any allergies. The technologist may need to shave some hair from the area where the doctor will be working. The entire medical team will ask you to confirm your name and will tell you what we plan to do. This is for your safety. Then, your nurse will give you medicine to make you feel drowsy and relaxed before we begin. After Your Procedure You will stay overnight in the hospital after your procedure so that we can monitor you. You will need to rest in bed for 2 to 6 hours. You must keep the leg below where the catheter was inserted very still for that time. This will help lower the risk of bleeding. After that you can move around and use the restroom. You will most likely be able to eat and drink, and your family may visit you. Some people have a computed tomography (CT) scan the day after their TACE. This scan will show how well the chemotherapy drug has spread through the tumor (or tumors). Most people can go home the day after their procedure. Complications are rare. If they occur, we may need to keep you in the hospital longer so that we can keep watching you or treat you.
Page 8 Liver Transarterial Chemoembolization (TACE) Questions? Your questions are important. Call your doctor or health care provider if you have questions or concerns. UWMC clinic staff are also available to help. Radiology/Imaging Services: 206-598-6200 When You Get Home Side Effects Most people have some side effects after chemoembolization. This is called post-embolization syndrome. These side effects include: Fatigue Pain Nausea Slight fever or chills that can last about a week Pain is a common side effect. It occurs because the blood supply to the tumor is blocked. This pain can usually be treated with pain medicines. Activity You may shower or bathe as soon as you wish after your procedure. For about 2 to 3 days, avoid strenuous activity and do not lift anything that weighs more than 20 pounds. You will most likely have fatigue and a loss of appetite for 2 weeks or longer. These are normal after TACE. Most people can return to their normal activities within 1 week. When to Call You will leave the hospital with prescriptions for pain and nausea medicines. Call your doctor right away if you have: Pain that suddenly gets worse or changes in any other way A fever higher than 101ºF (38.3ºC) or chills Bleeding or swelling at the groin puncture site Severe abdominal pain Any other changes that concern you Who to Call Interventional Radiology nurse coordinator... 206-598-6897 Procedure Scheduling... 206-598-6209 After hours (between 5 p.m. and 7 a.m.), and on weekends and holidays Ask for the Interventional Radiology Fellow on call... 206-598-6190 Box 357115 1959 N.E. Pacific St. Seattle, WA 98195 206-598-6200 If You Have an Emergency Go directly to the nearest Emergency Room or call 9-1-1. Do not wait to contact one of our staff. University of Washington Medical Center Published/Clinician Review: 02/2012 Reprints on Health Online: http://healthonline.washington.edu