QUESTIONS TO ASK BEFORE
TARE / Y-90 TREATMENT
The complete patient question checklist for your TARE consultation โ organised by category to ensure you leave your appointment with the information needed to make a confident, fully informed treatment decision.
analyticsAt a Glance
- check_circleInformed patients get better TARE outcomes โ asking the right questions identifies centres using personalised dosimetry
- check_circleQuestions about platform selection, PVTT management, and complications reveal the depth of a centre's TARE experience
- check_circleCost and logistics questions should be resolved before the mapping session โ not after treatment has started
- check_circleCancerFax prepares patients with specific questions relevant to their individual case before specialist consultations
Why Asking the Right Questions Matters for TARE
TARE is a technically demanding procedure where outcomes are significantly influenced by the expertise of the treating team, the dosimetric approach used, and the quality of the pre-treatment workup. A patient who asks informed questions identifies whether the centre uses personalised dosimetry, what their PVTT experience is, and how they manage REILD โ information that directly predicts the quality of care they will receive.
โThe question 'what Gy dose will you target to my tumour?' separates centres using personalised dosimetry from those using empirical methods. Informed patients ask it.โ
Questions Reveal Dosimetry Quality
Asking 'what is the estimated absorbed dose in Gray to my tumour?' reveals whether partition model dosimetry is being used. Centres that can answer in Gray are using personalised dosimetry. Centres that answer only in GBq (activity injected) without a Gray calculation are using simpler empirical methods with higher REILD risk.
Questions Reveal Centre Experience
Asking 'how many TARE procedures have you performed in the last 12 months?' and 'how many PVTT cases have you treated with TARE?' provides direct information about the volume and complexity experience of the team โ the strongest predictor of procedural safety and outcome quality.',
Category 1 โ Dosimetry and Technical Questions
These questions assess whether personalised dosimetry is being used and whether the centre applies the technical standards associated with optimal TARE outcomes.
| Question to Ask | What a Good Answer Looks Like | Red Flag Answer |
|---|---|---|
| What Y-90 dosimetry method do you use for dose calculation? | Partition model โ we calculate the absorbed dose in Gray to your tumour and normal liver separately | BSA method / empirical โ we calculate activity based on your body size or tumour category |
| What tumour dose in Gray are you targeting for my case? | For HCC: >200 Gy (ablative) or >120 Gy (palliative); stated as a specific Gy number | Unable to state a Gy figure โ only GBq activity mentioned |
| What is the planned dose to my non-tumorous liver? | We calculate this and keep it below 70 Gy (non-cirrhotic) / 50 Gy (cirrhotic) | Normal liver dose is not calculated separately |
| Which platform will you use โ TheraSphere or SIR-Spheres? Why? | Specific clinical rationale given (e.g. PVTT โ TheraSphere; CRLM โ SIR-Spheres) | We only use one platform regardless of indication |
| Will you perform post-treatment distribution imaging? | Yes โ Bremsstrahlung SPECT/CT or Y-90 PET same day to confirm distribution | No post-treatment imaging planned |
Category 2 โ Eligibility and Centre Experience Questions
These questions establish whether TARE is genuinely appropriate for your case and how experienced the team is in handling cases like yours.
| Question to Ask | What a Good Answer Looks Like | Red Flag Answer |
|---|---|---|
| Am I a good candidate for TARE and why? | Specific rationale โ BCLC stage, portal vein status, Child-Pugh, prior treatments; honest about limitations | Generic yes without clinical reasoning |
| How many TARE procedures has your team performed in the last year? | >30โ50 per year at a minimum for a specialist centre; higher is better | Fewer than 10โ15 annually without explanation of programme newness |
| Do you have experience treating HCC with portal vein tumour thrombus? | Yes โ with a specific number of cases and outcome data available | No specific PVTT TARE experience |
| What happens if the MAA scan shows high lung shunting? | We reassess eligibility, discuss alternative approaches, and may reduce activity โ we do not proceed if LSF >20% | We proceed regardless / unclear response |
| What is your REILD rate and how do you manage it? | Specific REILD rate <10%; protocol for early corticosteroid treatment at first sign of decompensation | No monitoring for REILD; no protocol |
Category 3 โ Response Assessment and Follow-Up Questions
These questions establish how response will be measured, what happens if the tumour does not respond, and how ongoing monitoring is organised.
| Question to Ask | What a Good Answer Looks Like | Red Flag Answer |
|---|---|---|
| How will you assess my response to TARE? | mRECIST criteria on multiphasic CT or MRI at 4โ6 weeks and 3 months; LI-RADS TR applied | Standard RECIST / tumour size measurement only |
| When will I have my first post-treatment scan? | 4โ6 weeks for safety; 3 months for formal response assessment | No defined imaging schedule |
| What happens if my tumour does not respond adequately? | Specific retreatment options discussed โ repeat TARE, TACE, systemic therapy escalation, or trial access | No clear plan for non-response |
| Who will communicate my results to my home oncologist? | CancerFax / the international patient office โ translated reports with clinical summary will be provided | Patient responsible for obtaining and translating their own records |
Category 4 โ Cost and Logistics Questions
These questions ensure there are no financial surprises and that travel and stay logistics are clearly planned before commitment.
| Question to Ask | What a Good Answer Looks Like | Red Flag Answer |
|---|---|---|
| What is the written total cost estimate for my treatment? | Detailed written breakdown covering microspheres, procedure, dosimetry, imaging, and any inpatient charge โ provided before travel | Verbal estimate only; costs confirmed only after mapping session |
| Is the mapping session cost included in the treatment estimate? | Clearly stated โ either included or a separate itemised cost provided | Mapping cost mentioned only after arrival |
| How long will I need to stay for the mapping session plus treatment? | Specific day count โ typically 10โ14 days for a single lobar TARE including mapping wait | Uncertain / flexible without explanation |
| What follow-up will I need to return to the hospital for? | Specific visits defined โ e.g. in-person 3-month scan vs remote follow-up with translated imaging results | No defined follow-up plan |
The Numbers That Should Appear in Good Answers
A quick reference of the specific numerical answers that distinguish expert TARE centres from less experienced providers.
- >200 GyTumour absorbed dose target in the answer to 'what dose will you deliver?'Any centre performing ablative-intent TARE should target โฅ200 Gy to the tumour using partition model dosimetry.
- <70 GyNormal liver dose limit that should appear in the dosimetry answerThe non-tumorous liver dose constraint that prevents radiation-induced liver disease โ should be explicitly stated.
- >30/yearMinimum TARE annual procedure volume at a specialist centreVolume is experience. Fewer than 30 TARE procedures annually suggests a developing rather than established programme.
You Have Reached the End of the TARE / Y-90 Resource Library
Explore the complete 20-page TARE resource library โ every aspect of Y-90 radioembolization covered for patients and families.
Frequently Asked Questions About TARE Consultations
What should I bring to my TARE consultation?
Bring: (1) All recent liver imaging โ CT or MRI as DICOM files on CD or USB (radiology reports alone are insufficient for proper assessment); (2) Liver function blood tests from within the past 4โ6 weeks (bilirubin, albumin, PT/INR, AFP); (3) Doppler ultrasound report if portal vein thrombosis is known or suspected; (4) All prior treatment summaries โ TACE sessions (date, lobe treated, response), ablation procedures, and current systemic therapy. (5) A written list of your questions. CancerFax prepares a structured clinical summary for you to bring to the consultation โ removing the risk of key information being missed during the appointment.
Should I get a second TARE opinion if my centre recommends against treatment?
Yes โ especially if the reason for ineligibility is portal vein thrombosis, Child-Pugh B, or advanced stage. These are exactly the scenarios where a specialist TARE centre's opinion may differ from a general oncology team's assessment. TARE eligibility in PVTT and borderline liver function is centre-expertise-dependent โ a team with high PVTT TARE volume may accept cases that a less experienced team declines. CancerFax can arrange a second opinion consultation with the interventional radiology teams at Zhongshan Hospital or EHBH for patients who have been told they are not TARE candidates.
Can I ask these questions during a video consultation before I travel to China or India?
Absolutely โ and this is precisely why CancerFax arranges a remote pre-consultation with the treating team before you commit to travel. The video consultation is the right time to ask all questions in Categories 1โ4. CancerFax provides a translated version of your questions to the Chinese team in advance and can participate in the call to help clarify answers. By the end of the remote consultation, you should have: a confirmed TARE indication and rationale, a stated Gy dose target, a written cost estimate, and a clear logistics plan โ before any flights are booked.
How CancerFax Helps
CancerFax is a specialist cancer access and patient-navigation platform. We help patients and families understand their options, organise medical records, coordinate hospital communication, and support cross-border treatment planning where appropriate.
We help collect and organise reports, scans, pathology, biomarker results, and treatment history for structured case review.
We communicate with hospitals or trial teams to assess whether a case may be suitable for further screening.
We support appointment coordination, document submission, translation, and direct communication with international departments.
For international patients, we help with practical coordination โ travel planning, hospital admission guidance, and local support.
If this option is not suitable, we help explore other relevant treatments, clinical trials, or advanced care pathways.
From inquiry through to follow-up, our coordinators provide a single point of contact for the family.
CancerFax does not guarantee treatment access, eligibility, or clinical outcome. Our role is to help patients access accurate information, structured review, and appropriate specialist pathways.
Preparing for a TARE Consultation? CancerFax Can Help.
CancerFax prepares a personalised consultation question list based on your specific case โ and can attend remote video consultations to help you understand the answers and advocate for evidence-based treatment decisions.
This content is for informational purposes only. The questions listed are suggested starting points โ adapt them to your specific clinical situation and follow your treating team's guidance.