What Is Intra-Arterial Chemotherapy?

Intra-arterial chemotherapy is a way of delivering high doses of cancer-fighting drugs directly to a tumor's location. With intra-arterial chemotherapy, cancer drugs are delivered into the artery or arteries located closest to the tumor. Very little medication circulates throughout the rest of the body.

This reduces certain side effects while providing a high dose of cancer-fighting medication where it is needed. In contrast, traditional chemotherapy is delivered through a peripheral vein, so it can attack cancer that has spread.

Unlike traditional chemotherapy, intra-arterial chemo is not a systemic treatment. It treats tumors at a specific location.

This article will discuss how intra-arterial chemotherapy is administered, and the types of cancers it is used to treat.

Intra-Arterial Chemotherapy: Definition

Intra-arterial chemotherapy delivers concentrated doses of cancer-fighting drugs through an artery that is located close to cancer. It differs from chemotherapy which is given intravenously through a peripheral vein. With intra-arterial chemotherapy, the medication dose is released directly into the artery that supplies blood to the tumor.

The type and stage of cancer you have will determine if intra-arterial chemotherapy is an appropriate treatment choice.

Intra-arterial chemotherapy may be used as a first-line treatment. It may also be used as a second-line treatment after trying other therapies.

Types of Cancers Treated With Intra-Arterial Chemotherapy

Intra-arterial chemotherapy is often used to treat liver cancer. For this treatment, chemotherapy drugs are injected directly into the hepatic artery, which delivers blood to liver tumors.

Intra-arterial therapy may be combined with embolization therapy. Embolization therapy for liver cancer blocks or reduces blood flow into the liver tumor from the hepatic artery. Embolization combined with chemotherapy is called chemoembolization. There are several types used to treat liver cancer:

• Trans-arterial chemoembolization (TACE): Chemo drugs are administered through a catheter into the hepatic artery, which is then plugged with injected substances, so the drugs remain near the tumor.
• Drug-eluting bead chemoembolization (DEB-TACE): Tiny beads that slowly release chemotherapy medication are injected into the hepatic artery, then plugged shut.

Intra-arterial chemotherapy is used to treat several other types of cancer, including brain tumors and cancers of the head and neck, such as throat cancer. 

It is also used to treat retinoblastoma, a rare eye cancer that usually affects children. Retinoblastoma starts in the nerve tissues that coat the retina, located in the back of the eye. Intra-arterial chemotherapy is only used if cancer has not spread to the optic nerve and there is no risk of spread beyond the affected eye.

How Is Intra-Arterial Chemotherapy Done?

Intra-arterial chemotherapy is typically done as an outpatient procedure (without a hospital stay) under general anesthesia (you will be unconscious). But based on your age, overall health, and the type of cancer, you may require a one-night stay in the hospital after treatment.

After you are anesthetized, a catheter may be surgically placed directly into the artery that supplies blood to the tumor. Or, it may be placed into the femoral artery in the groin and threaded up into the targeted artery.

The catheter will be guided through the use of X-ray imaging. Once it is in place, one or more chemotherapy drugs will be injected into the catheter for around 30 minutes. The catheter will be removed once the procedure is complete.

Intra-arterial chemotherapy may be repeated several times. For retinoblastoma, this procedure is typically done three times, once every four weeks.

Professionals Involved in Treatment

Intra-arterial chemotherapy requires a surgical team. The members of your team will be determined, in part, by the type of cancer you have. In general, you can expect these professionals to be involved in your care during the procedure:

• Oncologist (cancer specialist)
• Radiologist (imaging specialist)
• Anesthesiologist
• Pharmacist
• Nurses and other ancillary staff members 

How to Prepare

It can be stressful preparing for any type of chemotherapy. Since this procedure is done under anesthesia, you will also have to take precautions such as forgoing food and drink for a specified period before the procedure.

Having full information about the goals of the procedure and what to expect will help you prepare physically and mentally. Talk to your oncologist and other cancer team members about what will happen during and after intra-arterial chemotherapy.

This procedure releases less toxicity into the body than standard chemotherapy. Even so, you may experience side effects you should be prepared for, such as nausea and vomiting. Ask your healthcare team if you should have certain medications on hand if you feel ill. Other temporary side effects may include swelling and fatigue.

Eligibility

This procedure targets localized tumors. Sometimes, intra-arterial chemotherapy can be used to treat metastatic tumors in the liver that originated from other parts of the body (such as colon cancer that has spread to this liver).

The healthcare provider evaluates people for this procedure on a case-by-case basis to decide whether intra-arterial chemotherapy can prolong life and reduce morbidity.

Outcomes and Recovery

Survival rates and outcomes vary, based on the type of cancer being treated. Other factors, such as your age and overall health, may also play a role.

Intra-arterial chemotherapy may be used alone or with other treatments. These include cryotherapy, which kills cancer cells with extreme cold, and systemic chemotherapy. When Intra-arterial chemo is used with other treatments for retinoblastoma in children, the survival rate and retention of vision are close to 100%.

Risks and Side Effects

Intra-arterial chemotherapy is not without risk. Much of this has to do with undetected cancer spread. If cancerous cells have spread outside the treatment area, cancer may reappear months or years after treatment.

It is also important to be aware of potential risks and side effects from the treatment itself. For retinoblastoma treatment, these include:

• Radiation exposure
• Swelling of the optic nerve
• Bleeding
• Retinal detachment (the light-sensitive layer at the back of the eye comes loose)
• Irreversible vision loss caused by loss of blood supply to the eye
  

For liver cancer treated with intra-arterial chemotherapy and embolization, side effects may include:

• Liver infection
• Blood clots in the liver’s main blood vessels
• Abdominal pain
  

Summary

Intra-arterial chemotherapy refers to placing chemotherapy drugs directly into the arteries closest to the site of cancer. This treatment is usually used when cancer is localized.

It has been shown to be effective in treating several types of cancer, including liver cancer, retinoblastoma, and head and neck cancers.  

A Word From Verywell

A diagnosis of cancer brings up many emotions. You may feel fear or stress in facing chemotherapy to treat cancer. If your oncologist has recommended intra-arterial chemotherapy, you may be concerned about the treatment, even though it has a good success rate.

Talking to your cancer team is a good strategy for handling your concerns. Don’t be concerned about asking too many questions. Keeping yourself informed about your treatments and progress is an excellent way to maintain balance and optimism.