On the day of your procedure you will be taken to the procedure room. Your doctor will give you general anaesthesia (medicine to put you into a deep sleep). You will not feel anything during the procedure.

When you are asleep, your doctor will place three catheters (small plastic tubes) in your body, two in your groin and one in your neck.

• One catheter will be used to put two small balloons around your liver to “seal off” the blood in your liver from the rest of your body.
• Another catheter will be used to give the anti-cancer drug during your procedure.
• A third catheter, placed in the neck, will be used to return the filtered blood back into the body.

The treatment usually takes about three to five hours, this may include preparation, the procedure itself and post procedural care. Talk to your doctor to find out more information.

A multi-disciplinary team including an Interventional Radiologist, Perfusionist and Consultant Anaesthetist will deliver your treatment. The procedure is carried out in 3 steps; isolation, saturation and filtration (further information on this can be found in the section above 'what is chemosaturation therapy').

The balloons around your liver and the catheters in your legs will be removed and you will be moved to a recovery room. Your doctor may leave the catheter in your neck after the procedure in case they need to give you more drugs.

Your doctor will be watching you closely after the procedure. You may feel tired and you may have an upset stomach.

You will spend some time in the hospital while you recover from the procedure.

Following your procedure you will be monitored very closely by your medical team.

After your procedure, you will have:

• Blood tests every 2-3 days.
• New drugs if you need them.
• Scans after 6 weeks to monitor your cancer.

The post procedure follow-up will be dependent on individual and clinical needs.

As with any cancer therapy, treatment with chemosaturation therapy is associated with side effects. During chemosaturation therapy you will also undergo a general anaesthesia, which may result in you feeling drowsy and nauseous, with a headache and sore throat. These side effects usually pass relatively quickly. Your doctor can take the necessary steps to manage any unwanted side effects. In order to help your doctor you should document and report the following side effects.

You need to call your doctor or support nurse IMMEDIATELY if you have any of these problems:

• Sudden onset of pain in your calves or breathlessness.
• Fever higher than 101°F, or 38.5°C, or shaking chills whether you have a fever or not.
• Blood in your urine (pink or red).
• Blood (bright red, black, or coffee-ground appearance) or pus in stools.
• Any other unexplained bleeding or bruising; for example, from gums or nose, or a cough.
• Inability to eat or drink for 6–12 hours due to severe nausea and/or vomiting.
• New onset of pain with urination.
• Redness, swelling, drainage or pain with any vein or central line site.

You need to CALL WITHIN 24 HOURS if you have any of these problems:

• Diarrhea/loose bowel movements – more than 5 times daily.
• Cough that brings up yellow and/or green sputum.
• Burning or pain when you urinate.
• Nausea – unable to eat or drink for more than 8 hours – or vomiting uncontrolled by prescribed medications - Sore throat, new mouth or lip sores.
• New abdominal pain or cramping.

FIRST:
Call your local medical oncologist or primary care physician. Be sure to keep your chemosaturation therapy team informed also.

SECOND:
If you are unable to reach your local medical oncologist or primary care physician, contact a member of the chemosaturation therapy treatment team at the hospital in which you received treatment.

THIRD:
When the crisis has been resolved, notify your assigned nurse at the chemosaturation therapy treatment centre so that they are aware of any symptoms or side effects you have experienced.