Transarterial Radioembolization (TARE), also known as radioembolization, is an advanced and minimally invasive procedure used primarily for treating liver cancers, including Hepatocellular Carcinoma (HCC) and metastatic liver tumors. It involves the injection of tiny radioactive beads (usually containing Yttrium-90) directly into the arteries supplying the liver tumor, delivering high doses of radiation to kill cancer cells while sparing surrounding healthy tissue. This palliative treatment aims to extend patient survival and improve the quality of life but does not cure the disease.
Indications for TARE
TARE is recommended for patients with:
- Unresectable HCC or liver metastases from other cancers.
- Localized liver tumors that occupy less than 70% of the liver volume.
- Those who are not candidates for surgical resection, liver transplantation, or other local therapies like ablation.
- Significant vascular involvement in the tumor.
Procedure Details
The TARE procedure is typically performed in two stages:
- Pre-procedure Mapping: An initial hepatic angiography is conducted to map the blood vessels in the liver and plan the delivery of radioactive beads. During this stage, non-target vessels are embolized to prevent unintended radiation exposure.
- Radioembolization: In the second session, the radioactive beads are delivered via a catheter into the hepatic artery feeding the tumor. The beads lodge in the tumor’s blood vessels, emitting localized radiation over time.
Costs of TARE in India
The cost of the TARE procedure in India varies significantly based on several factors, including the hospital’s location and type, the patient’s overall health, the stage and spread of the cancer, and the experience of the medical team. Generally, the cost ranges from USD 9,000 to USD 25,000 (approximately ₹7,50,000 to ₹20,50,000) (Medsurge India) (Lyfboat –) (Vaidam). This cost includes the following components:
- Hospital charges for the procedure and post-procedure care.
- Fees for the interventional radiologist, oncologist, and nuclear medicine specialist.
- Imaging tests such as CT scans and MRI required before, during, and after the procedure.
- Costs for the radioactive beads and other medical supplies used during the procedure.
Factors Affecting Cost
Several factors influence the total cost of the TARE procedure:
- Hospital Type and Location: Hospitals in metropolitan cities or those with advanced facilities tend to charge more.
- Patient Condition: The complexity of the patient’s condition, including the extent of liver dysfunction or co-morbidities, can affect the treatment plan and overall cost.
- Tumor Characteristics: The size, number, and location of the tumors influence the amount of radioactive material required and the complexity of the procedure.
- Experience of the Medical Team: Highly experienced interventional radiologists and oncologists may charge higher fees due to their expertise.
Benefits and Limitations
Benefits:
- Minimally Invasive: TARE is less invasive than surgical options, reducing recovery time and hospital stay.
- Targeted Therapy: The treatment delivers high doses of radiation directly to the tumor, minimizing damage to healthy tissue.
- Palliative Care: It helps in managing symptoms and improving quality of life for patients with advanced liver cancer.
Limitations:
- Palliative Nature: TARE does not cure liver cancer but aims to control the disease and prolong life.
- Side Effects: Patients may experience side effects like fatigue, abdominal pain, nausea, and fever.
- Suitability: Not all patients are suitable for TARE, especially those with severe liver dysfunction or extensive metastasis outside the liver.
Preparations for TARE
Before undergoing TARE, patients need to:
- Medical Evaluation: Comprehensive evaluation including blood tests (CBC, liver function tests), imaging studies, and assessment of kidney function.
- Medication Adjustment: Patients may need to stop taking certain medications like blood thinners.
- Pre-procedure Planning: Detailed consultation with the interventional radiologist to understand the procedure, its benefits, and risks.
Recovery and Follow-Up
After the procedure, patients typically stay in the hospital for a short period for observation. They may experience mild to moderate side effects, which are usually managed with medications. Follow-up includes:
- Regular Imaging: CT or MRI scans to assess the response of the tumor to treatment.
- Blood Tests: Monitoring liver function and other relevant parameters.
- Consultations: Regular visits with the oncologist and interventional radiologist to manage any complications and plan further treatment if necessary.
Conclusion
TARE is a significant advancement in the treatment of liver cancer, offering hope to patients with limited options. While it does not cure the disease, it can significantly improve life expectancy and quality of life. The cost of TARE in India is relatively affordable compared to developed countries, making it an attractive option for both domestic and international patients seeking effective cancer care. With experienced medical professionals and advanced healthcare infrastructure, India continues to be a leading destination for such specialized treatments.