Chemotherapy Ports Benefits and Risks

A man shows the chemo port on his chest

Willowpix / Getty Images

If your healthcare provider has recommended a port for chemotherapy, you may wonder what this means. What exactly is a port, and what are the pros and cons of a port when compared with other methods of access, such as an intravenous (IV) line or a PICC line?

Let's take a look at what having a port (sometimes called a port-a-cath) involves, and some ways you may be able to prevent complications such as infection or obstruction of the port.

Overview

A chemotherapy port is a small device that is implanted under your skin to allow easy access to your bloodstream. A port can be used to draw blood and infuse chemotherapy drugs. It can be used if you need transfusions of red blood cells or platelets.

Without a port or a PICC line, a new IV needle will need to be placed each time you have chemotherapy, and separate IV lines are needed if you require IV fluids or a blood transfusion.

How a Port Differs From a PICC Line

PICC stands for "peripherally inserted central catheter." A PICC line is usually placed in a vein for shorter-term treatment (for example, when access will be needed for one to six weeks only). PICC lines are placed in your arm subcutaneously, meaning under your skin surface, and do not reach as close to your heart as a port catheter.

Port Use in Chemotherapy

Your healthcare provider's decision to recommend a port may depend on several things. Some chemotherapy medications can only be given through a port because they are too caustic to be delivered into a peripheral vein.

Beyond that, using a port is often easier than inserting an IV each time if you will be having several infusions of chemotherapy. Some oncologists recommend a port if you will require more than four treatments. It can also allow you to have some chemotherapy at home instead of at the hospital or in a clinic.

Some people have veins that are very difficult to access and this makes a port a better option than an IV. Have you ever heard a technician remark that you are an "easy stick" or a "hard" one? Let your healthcare provider know if techs have found it easy or difficult to draw blood, or to place an IV in your hand or arm.

How Is a Port Inserted?

A port is most often inserted during a same-day surgical procedure that can be performed with a local anesthetic. If you are having a surgical procedure for your cancer, such as a lobectomy for lung cancer or a mastectomy for breast cancer, your surgeon may insert a port at the same time your other surgery is performed.

When a port is placed during surgery, you will already be under general anesthesia. During insertion, a small, round metal or plastic disc is placed under your skin through an incision that is 1 or 2 inches long.

Where Is a Port for Chemo Placed?

The port may be placed on your upper chest or occasionally your upper arm. It is then attached to a catheter tube that is threaded into one of the large veins near your neck, such as the subclavian vein or jugular vein, and ends near the top of your heart.

After your port is placed, your healthcare provider will perform an X-ray to make sure the end of your port is in the proper location.

You will notice a slight protrusion of your skin over the port. During blood draws or chemotherapy infusions, a nurse will insert a needle into an area called the "septum," a resealable rubber center on your port.

Advantages
  • Greater comfort

  • Less delay

  • Less risk of extravasation (leakage)

  • Less risk of infection when bathing or swimming

Disadvantages
  • Surgical procedure needed

  • May become infected or blocked

  • May stop working because of mechanical issue

  • May limit some activities

Benefits and Advantages

As with any surgical procedure, there are both advantages and disadvantages to having a chemotherapy port placed. Estimates suggest there are more than 5 million ports placed in the United States each year, so healthcare providers are very familiar with the procedure and it has been well studied.

The benefits of having a chemotherapy port compared with an IV access include:

Greater Comfort

A single needle stick is usually all that is needed to access your port. With IV therapy and traditional blood draws, sometimes many needle sticks are needed to find a good vein, especially if your veins have been damaged from repeated blood draws and infusions. Chemotherapy itself can cause changes that make veins very difficult to puncture.

Avoiding Delays

A port can reduce the time needed to prepare your hand or arm for the procedure. It also may help to avoid the discomfort or delay as a provider attempts to find a good vein.

Lowering the Risk of Extravasation

When an IV is used, medications are more likely to extravasate, or leak into and then damage tissue surrounding the site. Since many chemotherapy medications are caustic to tissue, a port may reduce the risk of inflammation and complications related to leakage of these medications.

Easier Bathing and Swimming

You can usually bathe and even swim without concern over the risk of infection because the port is completely under the skin.

Possible Disadvantages

Possible risks and problems related to a chemotherapy port include the following:

Risk of Installing the Port

Any surgical procedure carries risks. Complications of insertion can include bleeding, when the subclavian vein is punctured, for example. The complications may also include a pneumothorax (collapsed lung) if it is accidentally punctured during the procedure. This complication occurs between 1% and 6.6% of the time when ports and other CVCs are placed in people.

Infection

The risk of infection varies in studies but it isn’t uncommon. If a port becomes infected, it will often need to be removed and replaced. Researchers continue to evaluate methods for reducing this risk, so it is important to talk to your oncologist about how to properly manage your port.

Thrombosis

Many people who have a port placed for chemotherapy will develop a thrombosis, or blood clot, in the port or the catheter. This clot may cause the port to stop working, often creating the need for the port to be replaced.

Mechanical Problems

Mechanical problems, such as the movement of the catheter or a separation of the port from the skin, can cause a port to stop working in some cases.

Limitations in Activity

Although activities such as bathing and swimming are usually OK, your oncologist may recommend holding off on exercises to strengthen your upper body or arms until your port is removed.

Scarring

Some people may find having a permanent scar on their upper chest upsetting because it is a reminder of their cancer experience. They may also prefer not to have a scar for cosmetic reasons.

Preventing Infections

Researchers continually study ways to reduce the risk of bacteria that grows at the port site and then may cause infection. Septicemia is a systemic, or bodywide, infection in which bacteria are present in the blood. In the United States, a systemic infection occurs at the reported rate of 1.5 times for every 1,000 use-days that ports and other central venous catheters (CVCs) are placed in people living with cancer. These infections can be life-threatening and may prove fatal.

The routine use of antibiotics has not been found helpful but flushing the catheter with an antibiotic/heparin solution appears to reduce the risk. Cleansing the skin also has not proven to be very helpful at this time but using dressings impregnated with antibiotics may help.

It's also thought that securing the port with a method other than sutures (stitches) may reduce infection risk. As noted, this is an area of active research and you can ask your oncologist what is currently recommended.

When to Call Your Healthcare Provider

Infection is the most common complication of having a port, so contact your health care provider if you develop a fever or note any redness, swelling, pain, or drainage around your port.

Risk of Thrombosis

Clotting or thrombosis in a port is common and is frequently the reason ports are removed and replaced. Routinely flushing a port with heparin and saline does not seem to make much difference, nor has improvement been found with low-dose heparin use although it does increase bleeding.

Overall, the risk of thrombosis in a port is significantly less than that in a PICC line.

Frequently Asked Questions

What does a chemo port look like?

Chemo ports are around the size of a nickel or quarter coin, and can be circular, oval, or triangular. The port is implanted under the skin and has a raised center made of a self-sealing rubber material; this is called the septum, or the "access point" through which a needle enters the catheter.

How long is a port left in after chemo?

A port can be left in place for weeks, months, or even years, but is typically removed when you are finished with chemotherapy treatment. When your port is in place but you are not undergoing treatment, a nurse will need to flush it out every four weeks so it doesn't become blocked.

How is a chemo port removed?

You will be given a local anesthetic or conscious sedation before your port is removed. A small incision will be made and both the port and the catheter will be removed. The incision is then closed with sutures, surgical tape, or surgical glue, and covered with a bandage that usually can be removed in 24 hours.

A Word From Verywell

Having a port implanted is often the first step in chemotherapy treatment. Since this involves a minor surgical procedure and carries some risks, it's important to talk with your healthcare provider about the pros and cons of a port (and how you'll need to care for it) before you decide to have one implanted.

Was this page helpful?
10 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. American Society of Clinical Oncology. Catheters and ports in cancer treatment. Updated December 2020.

  2. Demarco C. Should you get a central line for chemotherapy? The University of Texas MD Anderson Cancer Center. Published June 20, 2018.

  3. University Health Network. What to expect when getting an implanted port. Updated July 2020.

  4. Kornbau C, Lee KC, Hughes GD, Firstenberg MS. Central line complications. Int J Crit Illn Inj Sci. 2015;5(3):170-8. doi:10.4103/2229-5151.164940

  5. Madabhavi I, Patel A, Sarkar M, Anand A, Panchal H, Parikh S. A study of use of "PORT" catheter in patients with cancer: a single-center experience. Clin Med Insights Oncol. 2017. doi: 10.1177/1179554917691031

  6. Tsotsolis N, Tsirgogianni K, Kioumis I, et al. Pneumothorax as a complication of central venous catheter insertion. Ann Transl Med. 2015;3(3):40. doi:10.3978/j.issn.2305-5839.2015.02.11

  7. Sousa B, Furlanetto J, Hutka M, et al. Central venous access in oncology: esmo clinical practice guidelines. Annals of Oncology. 2015;26:v152-v168. doi: 10.1093/annonc/mdv296

  8. Al-Asadi O, Almusarhed M, Eldeeb H. Predictive risk factors of venous thromboembolism (VTE) associated with peripherally inserted central catheters (PICC) in ambulant solid cancer patients: Retrospective single centre cohort study. Thromb J. 2019;17:2. doi:10.1186/s12959-019-0191-y

  9. Memorial Sloan Kettering Cancer Center. About your implanted port. Updated May 2021.

  10. Memorial Sloan Kettering Cancer Center. Instructions after your procedure to remove your implanted port or central venous catheter (CVC). Updated April 2021.