ENChemoembolisation treats liver tumours through the artery that feeds them. Families often hear of it when liver cancer or liver metastases cannot be operated on and the doctor at home mentions “chemoembolisation”, which is not available locally; they want to know what it is and whether chemoembolisation of liver tumours in Germany is worth the trip.
In Germany, chemoembolisation of liver tumours is carried out by interventional radiologists at university and major hospitals, who treat through thin tubes (catheters) guided through blood vessels under X-ray control, after a decision by the liver tumour board. This page covers how the method works, which tumours it treats, the procedure and after-effects, where it is done and how treatment is arranged.
What transarterial chemoembolisation is
Transarterial chemoembolisation (TACE) is treatment through the artery: an anticancer drug is injected into the vessel feeding the tumour, which is then blocked. Healthy liver receives most of its blood from the portal vein, which carries blood from the intestine, whereas liver tumours are fed mainly by the hepatic artery; this difference makes targeted treatment possible.
A thin catheter is guided from an artery in the groin to the vessels supplying the tumour, and a chemotherapy drug is injected with a substance that blocks the vessel: an oily contrast agent or tiny drug-eluting beads, microspheres that release the drug slowly (DEB-TACE). The tumour receives a high local dose and loses its blood supply, while the rest of the body gets far less drug than with conventional chemotherapy.
Which tumours are treated with TACE
The main indication is hepatocellular carcinoma (primary liver cancer) at an intermediate stage: several nodules in the liver, no spread beyond it, adequate liver function, and no other way to remove or destroy the nodules. The decision rests on the Barcelona (BCLC) staging system, which matches the tumour, liver function and general condition to suitable treatment. Further options are described under liver cancer treatment.
TACE also serves as a bridge: it keeps the tumour under control while a patient waits for a liver transplant, or shrinks it before other treatment.
Liver metastases, for example from bowel or neuroendocrine tumours, are treated with TACE only in selected cases (see liver metastases). TACE is unsuitable with severely impaired liver function, a tumour thrombus in the portal vein or widespread disease, such as metastases outside the liver. These limits come from the TACE section of the German S3 guideline on hepatocellular carcinoma. Its version 5.2 remains current: the validity period stated in it has passed, and an update is being finalised.
The procedure, after-effects and follow-up
Treatment involves examination and blood tests (liver, kidneys, clotting), the procedure under local anaesthesia and usually a short hospital stay. Many patients then develop post-embolisation syndrome: fever, upper abdominal pain and nausea for a few days, the body’s reaction to dying tumour tissue. It is treated with medication: painkillers, anti-sickness and fever-reducing drugs.
CT or MRI some weeks later shows the response. TACE is often repeated or combined with other methods: thermal ablation (heat destroys a nodule through a thin probe), systemic therapy or surgery such as liver resection, the removal of part of the liver. The tumour board plans the sequence for each patient; the outcome cannot be known in advance.
Chemoembolisation in Frankfurt and other German cities
Chemoembolisation is done in interventional radiology departments of major hospitals across Germany, and many families ask specifically about Frankfurt, close to a major airport. Bürgerhospital Frankfurt lists interventional radiology among its services, described on its website mainly as treatment of blood vessels, and thermal ablation, used there for benign nodules of the thyroid, breast and prostate. At Agaplesion Frankfurter Diakonie Kliniken, Prof. Axel Dignass heads the Department of Gastroenterology, Hepatology and Oncology. For the city’s oncology departments, see cancer treatment in Frankfurt.
Elsewhere, at Marienkrankenhaus Hamburg, Prof. Christian R. Habermann heads the Institute of Diagnostic and Interventional Radiology, and TACE is explicitly among his areas of work. At Heidelberg University Hospital, Prof. Hans-Ulrich Kauczor leads the Department of Diagnostic and Interventional Radiology. Yet the hospital is chosen by the tumour board’s assessment and timing, not by the city.
Frequently asked questions
Is chemoembolisation painful?
Some pain is possible, but it is anticipated and treated. The groin is numbed with a local anaesthetic, and a sedative as well as drugs against pain and nausea may be given during the procedure. Afterwards, upper abdominal pain is part of post-embolisation syndrome; pain relief continues in hospital, and on discharge patients learn which symptoms need an urgent call to a doctor.
Is chemoembolisation possible with cirrhosis?
Yes, if the cirrhotic liver still copes: the method requires preserved liver function, which is assessed with blood tests and an examination. In severe, decompensated cirrhosis, TACE is not performed, because the part of the liver deprived of arterial blood may die and liver function would worsen further. The tumour board then discusses other options and support for the liver itself.
How many TACE sessions are usually needed?
The number is not fixed in advance: TACE is repeated as long as the tumour responds and treatable parts remain. With several or large nodules, more than one session may be needed, because only limited amounts of drug and blocking agent can be given at a time. After two sessions, as the German guideline advises, the tumour board reviews whether to continue or switch to another method.
Can TACE cure a liver tumour?
Usually the aim is control rather than cure: TACE is offered when the nodules cannot currently be removed or ablated and a transplant is not possible. How far the disease is held back depends on the nodules and on liver function. Sometimes TACE bridges the wait for a transplant or shrinks the tumour enough for other treatment; the tumour board names the realistic aim after reviewing the scans.
How AlenMed arranges chemoembolisation in Germany
It starts with documents: a recent contrast CT or MRI of the liver on disc, blood tests with liver values and tumour markers, histology if available, and reports on previous treatment. AlenMed translates them and submits them to the liver tumour board of a partner hospital, which confirms whether TACE is suitable; the hospital then prepares a cost estimate.
AlenMed then arranges the visa invitation, an interpreter and accommodation near the hospital. Because TACE is often repeated, follow-up scans and further sessions are scheduled in advance. The AlenMed office is in Munich; partner hospitals are across Germany.
This material is for reference only and is not an offer; treatment is decided by the doctor at an in-person consultation.
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