Chemotherapy Ports Benefits and Risks

A chemotherapy port (also known as a chemo port) is a small device implanted under the skin that is attached to a vein in the chest to deliver chemotherapy drugs to the body. Without a port, a new intravenous (IV) needle would need to be placed each and every time you have chemo.

A chemo port differs from a peripherally inserted central catheter (also known as a PICC line), which is implanted into a vein in your arm and used for a shorter period of time.

This article explains why a chemotherapy port is needed and how the device is implanted. It also outlines the benefits and risks of a chemo port and how infection and other complications are avoided.

Port Use in Chemotherapy

Chemotherapy involves multiple intravenous infusions of medications over time. The drugs are generally given in courses of three to six months with infusions given every two to six weeks. You may be given one course or chemo or several. In advanced cases, treatment may be ongoing.

Chemo ports spare you the pain and aggravation of getting jabbed in the arm every session. But, they are about more than just convenience. Some chemotherapy medications can only be given through a port because they are too caustic for the veins in your arm. Instead, the drug is delivered to a larger, thicker vein in the chest.

Chemotherapy can also cause changes to veins that make them harder and more difficult to access with a traditional IV needle.

Cancer specialists called oncologists generally recommend a port if you will require more than four infusions. In some cases, a port may allow you to have some chemotherapy at home instead of in a hospital or clinic.

How a Chemo Port Is Implanted

Chemo ports are surgically placed under the skin near a large vein in the upper chest. They are typically implanted as a same-day procedure with a local anesthetic that numbs the skin rather than puts you to sleep. They are sometimes placed at the same time as the surgical resection (removal) of a tumor.

During the insertion, a small, round metal or plastic disc, called the drum or reservoir, is placed under the skin through a 1- to 2-inch incision. An attached tube, called a catheter, is then connected to either the internal jugular vein of the neck or the subclavian vein that runs from the shoulder to the neck.

After your port is placed, the surgeon will perform an X-ray to make sure the port is correctly connected and secured. The port will be visibly seen under the skin but is largely concealed with clothes.

After chemotherapy is completed, the device can be removed.

Advantages

As with any surgical procedure, there are advantages and disadvantages to having a chemo port. The benefits include:

• Increased comfort: With a chemo port, an IV needle is inserted into the reservoir through a thin rubbery membrane called the septum. You may feel initial pressure but little pain.
• Reduced risk of extravasation: When a traditional IV is used, chemo drugs may extravasate (leak) and damage surrounding tissues. A chemo port reduces the risk since the delivery vein is large. The leakage, if any, is usually limited to the reservoir.
• Bathing and swimming: You can usually bathe and even swim without concern about infection because the port is completely encased under the skin.

Disadvantages

Chemotherapy ports may seem like a "no-brainer," but they have their limitations and risks. They include:

• Risk of infection: While the risk is relatively low, it can occur. Research suggests that around 2% of chemo ports need to be replaced due to an infection.
• Risk of thrombosis: Many people with a chemo port will develop a blood clot (thrombosis) which can block the catheter. The blockage can often be unblocked with an injection of the blood-thinner heparin into the catheter. But sometimes the port will need 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 chemo port to stop working.
• Limitation of movement: Although activities like bathing and swimming are usually OK, your oncologist may recommend avoiding strenuous exercises involving the chest until chemotherapy is completed.
• Scarring: Some people find that having a permanent scar on their upper chest is an upsetting reminder of their cancer experience. They may also prefer not to have a scar for cosmetic reasons.
• Surgical risks: Any surgical procedure carries risks, including the risk of bleeding. A rare complication called pneumothorax (collapsed lung) can occur if the lung is accidentally punctured. Pneumothorax has been reported in 1% of cases.

Avoiding Complications

As infrequent as infections are with chemo pumps, they do occur. In severe cases, this can lead to a potentially life-threatening, whole-body infection known as septicemia.

Flushing the catheter with an antibiotic and heparin solution appears to significantly reduce the risk of infection. Cleansing the skin also does not appear to help. However, if there are signs of a local infection, dressings impregnated with antibiotics may be used along with oral or injected antibiotics.

Thrombosis is another common reason that ports are replaced. Routinely flushing a port with heparin does not seem to reduce the risk and may promote bleeding. Any minor clots that do develop can often be broken up with an injection of heparin into the catheter.

Summary

A chemotherapy port is a device implanted under the skin to deliver chemo drugs to a large vein in the upper chest. The port is usually implanted as a same-day surgical procedure under local anesthesia.

A chemo port reduces the need for repeated needle sticks during chemo. The port is largely invisible under clothes and can be submerged under water while bathing or swimming. Even so, chemo ports carry a risk of infection, thrombosis (blood clots), and mechanical failure. There is also a risk of surgical complications, including bleeding and pneumothorax.

The risk of infection can be reduced by flushing the catheter with an antibiotic and heparin solution prior to each chemo session. Minor blood clots can usually be broken up by injecting heparin into the catheter.

A Word From Verywell

Having a chemo port implanted is often the first step in chemotherapy. Since it involves minor surgery, there are risks you need to consider.

It is important to talk with your oncologist about the pros and cons of a chemo port—and how you'll need to care for it—before you make an informed decision about the procedure.