Case Report: Hepatocellular Carcinoma (HCC) Successfully Managed with TACE

Dear Friends,

Below is a case report I recently received from Stefan, a visitor of this website. The case report is related to his sister-in-law, a 74-years lady, who has successfully managed a Hepatocellular Carcinoma (HCC) with a transarterial chemoembolization (TACE) performed at a hospital in Romania, Cluj.

My purpose in sharing this with you is to create positive reference points for you. To see and believe that tumors can be destroyed regardless of their type and stage. There are different solutions for that and TACE is one such solution.

Although I did not had the chance to allocate a specific article to TACE, we have often discussed TACE as a good tool to locally address tumors. Nearly 3 years ago, I mentioned TACE as one of the most effective solutions in my view, to address tumors locally This can be a great tool to address tumors (primary or metastasis) located at the liver and lungs. I heard of doctors open to even perform such intervention for brain tumors. It can be given with embolization or regionally by releasing chemo into a region of the body without embolization (when more tumors need to be addressed at the same time). The major advantage is that higher dose can be given at a specific location, while the dose is small enough from a systemic point of view so that there are much much less side effects compared to the typical IV (systemic) administration of chemo. The disadvantage is that tumors can only be addressed locally and not in the whole body at the same time. And the price may be high (about 5000USD) if this is not covered by insurance. But still accessible for many. And again, its a great tool to address locally tumors, specifically the large ones. For those who would like to know more about TACE, here is a short summary of that, but you can also address questions via the comments field located at the bottom of this page.

Back, to the case report I would like to share with you here, Stefan has kindly asked his sister in law to consolidate her treatment history and related results, and shared that with be so that in turn I can share it with you.

Its a pleasure for me to be able to share this successful results, and I promise there are more great case reports that will be coming soon.

Case Report:

Hello Daniel,

I got the latest information from the sister, but I understand it.

Woman, 74 years old.

2008 – Diagnostic-Hepatic Cirrhosis.

03.2014 – alpha feto protein (AFP)-4.53

03.2015 – AFP-118.

10.2015 – Diagnostic-hepatocarcinoma 21 / 9mm

11.2015 – AFP-400 Performed radiofrequency ablation

02.2016  – AFP 4.59

03.2016 – diagnostic-hepatocarcinoma in segment 6-7

12.2016 – AFP-300

02.2017 – AFP-1366

02.2017 – chemotherapy with nexavar begins

04.2017 – a 35 mm nodular structure appears on the ultrasound

05.2017 – stops chemo for 7 days for platelet recovery as it decreased to less than 62. Restarts chemo for a week after which it is definitively discontinued. During the chemo period, cachexia manifested itself very aggressively and in all its forms, with drastic effects on the body. Weight recovery was very slow and long

06.2017 – radiofrequency ablation without positive effects

06.2017 – CT-to lung, 11mm star-node. From 06.017 to 12.2017, AFP evolved from 2015 to 14357

01.2018 – PET-CT confirms 55/28 mm hipodense liver tumors, bilobate and non-homogeneous FDG (suv max. 7.5). Subsequently, in the neighboring segment 7 inferolateral, a 15 mm cyst without FDG capture is distinguished. FDG capture form (max. 6) of 40/20 mm diameter, located endoluminal to the check level. The lungs, bilaterally expanding, present in LSD segment 2, a 6 mm node, not sufficiently characterizing PET. PET Conclusions: liver tumor, metabolic activity is maintained; active metabolic cecal node; biopsy and endoscopic assessment

02.2018 – Endoscopy

02.2018 – AFP 23000

04.2018 – programming for TACE (Oncology Hospital in Cluj, Romania) on 12.06

12.06.2018 – AFP over 30000

12.06.2018 -TACE with 75 mg doxorubicin, including 5-10 ml gelaspon

05.07.2018 – AFP dropped to 2000

20.07.2018 – CT indicates – embolized node was reduced from 60 to 40 mm. The 2015 ablation scar was diminished. Dimensionally reduced also the nodule near the diaphragm

08.09.2018 – AFP 4.8 at 2 months from TACE

20.09.2018 – MRI with Primovist contrast substance. Cirrhosis-shaped liver with irregular capsular contours. Segment 7 reveals two necrotic beaches following treatment of HCC nodules at these 35 / 25mm and 28/21mm levels respectively. In segment 3 close to the round ligament crack is shown a small 9 mm hipercaptant node, possibly the dysplastic node (10-11 mm) without dilated bile ducts. Intra and extrahepatic. No thrombosis at the port axis. Spline increased in volume with an axle of about 18 mm. Pancreas, adrenal glands of normal MRI appearance. Without ascites fluid

I wrote here exactly what I received from my sister-in-law.

Good bless you all,


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4 thoughts on “Case Report: Hepatocellular Carcinoma (HCC) Successfully Managed with TACE

    1. It depends on what is expected from the specific chemo/substance used. If necrosis is expected, TLS will also come with that such as in the case of the boy treated with 3BP at the hospital in Frankfurt, Germany. If the cancer cell is dying via apoptosis which is the case for many chemotherapies, there should be no TLS issue. In the above case, the patient did not stated anything about TLS related complications.

      Besides the above, I have received recently several great reports from advanced and diificult to treat cancer patinets with amazing results in short time (a few months) when combining IPT or normal chemo with metabolic treatments. As soon as I can I will report on that but I think we are on to something big there. A pattern is emerging.

      1. Yeah I remember that case. Sad. With new therapies (and really, possibly with every cancer, because each is different) cell death can be too high for apoptosis to happen. TACE is one of multiple new exciting tumor-targeting strategies that almost act as non-invasive spot-treatment for cancer. Ultrasonic O2 bubbles in sequence with other O2 therapies is a similar non-invasive localized treatment I’m super interested.

        I think one of the great things about localized treatments like this is that if TLS does occur, you can limit the potential of kidney failure or urea acidosis by means of treating only one tumor at a time.

        I’m looking forward to hearing about your new data. IPT is a great way to leverage the warburg effect to get chemo in the cell.

  1. Stiu acum-gratie acestui site- ca orice chemo prezinta 3 riscuri majore:TLS,ascitasi casexie.Cred ca prin TACE se reduc substantial aceste riscuri.Exista un argument cel putin in ceea ce priveste casexia.Aceasta s-a manifestat virulent in perioada de chemo(02-05.2017) iar acum,dupa TACE, au fost forme usoare care au fost depasite dupa 5 zile.

    Google translation of the above:

    “I know now – thanks to this site – that any chemo shows 3 major risks: TLS, ascites casex. I think TACE significantly reduces these risks. There is an argument at least regarding casexia. This has been virulent during the chemo period ( 02-05.2017) and now, after TACE, there were mild forms that were exceeded after 5 days.”

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