Transarterial chemoperfusion (TACP) delivers chemotherapy through the arteries supplying a tumour without blocking them. In prostate cancer it is rarely used and is supported only by small reports, so it is not a standard treatment. Whether it could be considered depends on disease extent, previous treatment, scans, artery anatomy and general health. In Germany, TIG GmbH can help coordinate specialist review.

TACP for Prostate Cancer in Germany: Candidates and What to Expect

Transarterial chemoperfusion (TACP) is a regional treatment that delivers chemotherapy through a thin tube (catheter) into the arteries feeding a tumour, without deliberately blocking the vessels. In prostate cancer it is rarely used and has been reported in only a few carefully selected patients, so it is not a standard treatment. It differs from transarterial chemoembolisation (TACE), which also blocks the vessels [1].

In Germany ,TACP for prostate cancer is not a routine option. Whether it could be considered for prostate cancer is decided case by case by the treating specialists. They look at the pattern and extent of the disease, earlier treatment, scan findings, artery anatomy and general health. 

TACP Treatment Selection for Prostate Cancer

The published reports describe three quite different situations, shown below. Selection is a case-by-case decision by a multidisciplinary team, usually made after established options have been reviewed, and no guideline recommendation or clinical trial identified for this article defines who should receive TACP [2].

The table above shows when TACP or a related technique has been reported, why it was used and the main limit of each report. Before any decision about prostate cancer treatment.

• Stage, extent and earlier treatment, including surgery, radiotherapy and hormone therapy for prostate cancer.
• The trend in prostate-specific antigen (PSA) levels, and prostate cancer imaging such as MRI, CT or prostate-specific membrane antigen (PSMA) PET.
• Whether the tumour can be reached through its blood supply, judged on CT or MR angiography.
• Kidney function, because contrast dye is used, and any contrast allergy.
• Bleeding risk, including blood-thinning medicines, and fitness for a catheter procedure.

The patient's goals, and whether a standard treatment or prostate cancer clinical trials are still available.

Where TACP Fits in Prostate Cancer Treatment

Standard treatment for prostate cancer, including surgery, radiotherapy, androgen deprivation therapy and systemic drugs chosen by stage, is set out in the German S3 guideline, and TACP is not part of it. Where TACP has been used, it was proposed as a palliative regional option for recurrent pelvic tumours. Published evidence includes small, mixed-tumour series; it does not establish TACP as a standard palliative treatment for recurrent prostate cancer.

TACP, TACE and prostatic artery chemoembolisation are related but different [1] [2] [3] [4] [5] [6]:

• TACP: chemotherapy is infused into the arteries that feed the tumour, and the vessels stay open. In published pelvic series the infusion lasted about 20 to 60 minutes, and some protocols repeated the sessions.
• TACE: embolisation is added to cut blood flow to the treated area.
• Prostatic artery chemoembolisation: a prostate-specific variant that uses drug-loaded particles, as in the studies discussed under Results.

A tumour that a catheter can reach does not necessarily benefit. Being technically possible does not show better symptoms, PSA control or survival, and it does not make TACP preferable to standard options such as systemic chemotherapy for prostate cancer. A specialist review of your records can help show which options remain open, and patients can request one before planning travel to Germany.

TACP Procedure and Follow-Up for Prostate Cancer

Protocols differ between centres. The steps below follow how TACP has been described in published pelvic series, so they are not specific to prostate cancer [1] [3]:

• Before treatment: blood tests, including kidney function, and a review of the scans.
• Access: a thin catheter is advanced through an arterial puncture, typically at the groin, under X-ray guidance.
• Mapping: contrast dye shows which vessels feed the tumour and whether nearby organs share them.
• Infusion: chemotherapy is given over roughly 20 to 60 minutes. The treating team chooses the drugs and doses, and published examples are given under Results.
• Recovery: the puncture site and circulation are checked. Patients in the German series were treated as outpatients, and the 2024 series used CT after each treatment.

Follow-up usually combines symptom review, PSA measurement and MRI or CT to judge the response, and the team sets the schedule. In the German pelvic series, treatment was a course of at least three sessions, on average five, at four-week intervals, and no schedule has been established for prostate cancer .

TACP Side Effects and Procedure Risks

Side effects can come from the catheter procedure and from the chemotherapy. Safety data for prostate cancer come from very few men, so uncommon problems may be missed.

Risks of the Arterial Procedure

Any catheter procedure carries risks, which the team discusses beforehand:

• Bleeding or bruising at the puncture site, and injury to the artery.
• Reaction to contrast dye, or strain on the kidneys.
• Chemotherapy reaching nearby tissue through shared vessels.

The prostate series involved embolisation, which TACP does not, so their complications may not apply directly. One series reported bladder wall ischaemia (reduced blood supply) needing surgery in one man, temporary urinary retention and urinary urgency in one man each, and sexual dysfunction in two men that resolved within 12 months. Another series saw a small ischaemic area at the urethral opening that resolved within 2 weeks, and rectal wall ischaemia on MRI without clinical consequences. Across the German pelvic TACP series of 24 patients, no grade III or IV toxicity was reported. These findings should be attributed to the specific study and should not be presented as established complications or expected outcomes of TACP [3] [4] [6].

After the procedure, tell the treating team without delay about bleeding at the puncture site, a pale or cold leg, fever, new or worsening pelvic pain, blood in the urine or difficulty passing urine.

Chemotherapy Related Side Effects

Regional delivery is meant to limit exposure elsewhere in the body, but some drug still reaches the bloodstream. Possible effects depend on the drug and dose, and common ones are listed below:

• Lower blood counts, with a higher risk of infection and anaemia.
• Nausea, vomiting and loss of appetite.
• Fatigue.
• Mouth sores and inflammation.
• Hair loss with some drugs.

TACP Results and Evidence in Prostate Cancer

Evidence for TACP in prostate cancer is very limited, and most reports describe related techniques that also block the arteries.

The chart above shows how few men with prostate cancer appear in these reports, and that only one had TACP without embolisation. The main findings of each report are listed below [3] [4] [6]:

• German pelvic TACP series, 2007: 24 patients with recurrent tumours, one with prostate cancer, had 128 sessions of mitomycin C and gemcitabine.
• The authors reported no grade III or IV toxicity and described a palliative role.
• Prostatic artery chemoembolisation, 2018: 20 men with localised disease received docetaxel with microspheres. Both arteries could be treated in 16 of the 20 men, and a PSA-based response held at 12 to 18 months in 10 of those 16. Adverse events were reported in 31 per cent of the 16 men.
• Prostatic artery chemoembolisation, 2022: 8 men with advanced prostate cancer, all with complete urinary retention and two also with bleeding, were analysed after treatment with epirubicin beads (12 were treated, and 4 lacked follow-up data). All men started hormone therapy three days later, so changes in PSA and prostate volume cannot be credited to chemoembolisation alone. PSA fell into the normal range in 5 of 8 men at 3 months, and prostate volume fell by about 54 per cent. Follow-up averaged under 7 months, and only 2 men had PSA values at 12 months. The study was retrospective, uncontrolled and small.
• Prostatic artery chemoembolisation with docetaxel infusion, 2023: 32 men with advanced prostate cancer and bleeding that had not responded to other treatment, 22 of them also with urinary retention, received epirubicin-eluting beads plus a docetaxel infusion into the arteries. Technical success was reported in all men with no major adverse events, and bleeding stopped within 5 days. Good bleeding control was reported in 26 men (86.7 per cent) at a mean follow-up of 24 months. The authors suggested it could be considered when no other therapy is available. The study was uncontrolled, and embolisation was part of the procedure.

Results from other cancers do not carry over. A 2024 series of 75 women with gynaecological tumours treated with TACP or TACE cannot be applied to prostate cancer, because the tumours differ in biology and treatment context [1].

TACP Treatment in Germany and Specialist Assessment

In Germany, a specialist assessment of the prostate cancer comes first and typically covers scan findings, previous therapies, laboratory results and artery anatomy, to judge whether TACP is worth discussing for that patient.

Is TACP for Prostate Cancer Available in Germany?

Whether a German centre offers TACP for prostate cancer differs and cannot be assumed. It is not among the standard options described in the German S3 guideline [2], and it has been reported only in small case series.

To prepare for a first assessment, international patients can gather:

• Pathology reports, including the grade.
• Recent MRI, CT or PSMA PET images, not only the written reports.
• A full treatment history.
• PSA values over time and recent kidney function results.

Questions to ask the specialist:

• Does my pattern of disease match what has been reported for TACP?
• Which other options do I still have, including clinical trials?
• Does your centre offer TACP, and what would the risks be in my case?

The cost depends on the number of sessions, imaging, sedation or anaesthesia, drugs, hospital stay and follow-up, so no fixed price can be given. International patients can ask the German centre for a written cost estimate before travelling.

TIG GmbH (Treatment in Germany) can review available medical records and imaging, identify relevant German specialists or centres for assessment, and coordinate consultations and next steps where appropriate. A review does not guarantee eligibility, treatment availability or benefit. The German medical team determines suitability and treatment recommendations and provides clinical care. Patients who would like their records reviewed can contact TIG through and ask which documents to send first.

References

1. Vogl TJ, Nica AI, Booz C, et al. Therapy Response and Survival among Patients with Gynecologic Tumors Treated with Transarterial Chemoperfusion and Transarterial Chemoembolization. Medicina. 2024;60(10):1585.

2. Leitlinienprogramm Onkologie. S3 guideline Prostate Cancer (Prostatakarzinom), Kurzversion, version 8.1, August 2025 (in German).

3. Vogl TJ, Zangos S, Eichler K, et al. Transarterielle Chemoperfusion des Beckens: Ergebnisse bei symptomatischen lokal rezidivierten Tumoren und Lymphknotenmetastasen. Rofo. 2007;179(11):1174-1180 (in German).

4. Guan Y, Wang W, Zhang T, et al. Epirubicin-loaded beads transarterial prostatic arterial chemoembolization for advanced prostate cancer with lower urinary tract obstruction or hematuria: a case series. Transl Androl Urol. 2022;11(4):480-494.

5. Wang MQ, Zhang JL, Duan F, et al. Prostate arterial chemoembolization for treatment of refractory hematuria and urinary retention in patients with localized advanced prostate cancer. Prostate Cancer Prostatic Dis. 2023;26:88-95.

6. Pisco J, Bilhim T, Costa NV, et al. Safety and Efficacy of Prostatic Artery Chemoembolization for Prostate Cancer: Initial Experience. J Vasc Interv Radiol. 2018;29(3):298-305.

7. Krebsinformationsdienst. Chemotherapie: Substanzen und Nebenwirkungen bei Krebs (in German).

Why Patients Worldwide Prefer Our Medical Services in Germany – Key Benefits Explained

International patients planning prostate cancer treatment in Germany may need support with hospital consultations, medical documentation, translations, and travel arrangements. TIG GmbH helps coordinate these practical steps and communication with healthcare providers according to each patient's needs and the services agreed.

The table above compares the support and coordination services offered through TIG GmbH with the arrangements patients may need to manage when booking directly with a clinic.