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Cancer Treatment
Transarterial Chemoembolisation

Transarterial chemoembolisation (TACE) is a minimally invasive procedure used to treat cancer by delivering chemotherapy impregnated beads directly into the blood vessels supplying a tumour.  This concentrates chemotherapy within the tumour, while simultaneously blocking its blood supply. It is most commonly used to treat hepatocellular carcinoma (HCC), the most common form of primary liver cancer, and has selective use in other organs and tumours that have metastasised to the liver. TACE is not curative; it is primarily used to slow tumour growth, manage symptoms, extend survival or bridge to transplantation.

 

Using imaging guidance, a thin catheter is inserted through an artery in the wrist or groin and advanced into the arteries supplying the liver tumour. Chemotherapy and tiny embolic particles are then injected to destroy cancer cells and reduce blood flow to the tumour, causing it to shrink or stop growing.

 

Treatment may need to be repeated, and careful assessment of liver function is essential. The procedure is usually performed under local anaesthesia with sedation, with a short hospital stay and follow-up imaging to assess treatment response.

Referrals are typically the result of specialist multidisciplinary team discussion.

 

Benefits include:

  • Control of tumour growth and progression (primarily hepatocellular carcinoma)

  • Reduction in tumour size, which may bridge to surgical resection or transplantation.

  • Improved survival in appropriately selected patients

  • Treatment of selected cancers that have spread to the liver

  • Delivery of chemotherapy directly to the tumour, reducing systemic chemotherapy

  • Preservation of surrounding healthy liver tissue through targeted treatment

  • Can be repeated if tumours persist or recur

  • Minimally invasive treatment without open surgery

  • Usually no general anaesthesia

  • Short hospital stay and relatively rapid recovery compared with major liver surgery

Selective Internal Radiation Therapy

Selective Internal Radiation Therapy (SIRT), also known as Transarterial Radioembolisation (TARE), is a minimally invasive procedure that delivers targeted radiation directly into the blood vessels supplying a tumour. It is commonly used to treat hepatocellular carcinoma (HCC), the most common form of primary liver cancer, and may selectively be used in certain liver metastases or cholangiocarcinoma.

Unlike TACE, SIRT offers potentially curative outcomes in select patients with liver cancer that cannot be treated with surgery or percutaneous thermal ablation. It may also be used to shrink tumours before surgery or control tumour growth while awaiting liver transplantation.

Using imaging guidance, a thin catheter is inserted through an artery in the wrist or groin and advanced into the arteries supplying the liver tumour. Millions of tiny radioactive microspheres, usually containing yttrium-90, are then injected into these vessels, delivering high doses of radiation directly to the tumour while limiting exposure to surrounding healthy liver tissue. A preliminary planning procedure is required to assess blood flow and ensure safe radiation delivery.

Treatment is usually performed under local anaesthesia with sedation, with a short hospital stay and follow-up imaging to assess treatment response.

Referrals are typically the result of specialist multidisciplinary team discussion.
 

Benefits include:

  • Effective treatment of selected primary and secondary liver cancers

  • Control of tumour growth and progression

  • Potentially curative treatment of selected localised liver tumours

  • Delivery of radiation directly to the tumour, with reduced radiation exposure to surrounding healthy liver tissue

  • May bridge to surgery or liver transplantation in selected patients

  • Generally fewer immediate post-embolisation symptoms than conventional TACE

  • Minimally invasive treatment without open surgery

  • Usually no general anaesthesia

  • Short hospital stay and relatively rapid recovery compared with major liver surgery

Please Note: This service is only available in my public hospital position at this time, due to equipment availability.

Tumour Ablation

Percutaneous tumour ablation is a minimally invasive procedure used to destroy cancerous tumours without the need for surgical removal. It is commonly used to treat small primary cancers and metastatic tumours involving the liver, kidneys, lungs and bones. Tumour ablation can provide potentially curative treatment for selected small, localised cancers. Ablation can also be combined with surgery, chemotherapy or other cancer treatments.

Using ultrasound or CT guidance, one or more thin probes are inserted directly through the skin into the tumour, where heat, extreme cold or electrical energy is applied to destroy the cancer cells. Several ablation technologies are available, with the most appropriate technique selected according to the tumour's size, location and proximity to surrounding structures.

  • Microwave ablation (MWA) uses microwave energy to generate intense heat.

  • Radiofrequency ablation (RFA) uses electrical energy to generate heat.

  • Cryoablation uses extreme cold to freeze and destroy tumour cells.

  • Irreversible electroporation (IRE) uses short, high-voltage electrical pulses to destroy tumour cells without relying primarily on temperature.


The procedure is performed under imaging guidance, using sedation or general anaesthesia depending on the tumour and technique, with follow-up imaging to assess treatment response.

Referrals are typically the result of specialist multidisciplinary team discussion.
 

Benefits include:

  • Effective destruction of cancerous tumours without surgical removal

  • Potentially curative treatment for selected small, localised cancers

  • Preservation of surrounding healthy tissue and organ function

  • Alternative treatment for patients unsuitable for major surgery

  • Can be combined with chemotherapy, surgery or other cancer treatments

  • Can be repeated if tumours persist or recur

  • Minimally invasive treatment without large surgical incisions

  • Reduced procedural blood loss and complication risk compared with major surgery in selected patients

  • Short hospital stay and relatively rapid recovery compared with open surgery

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