Chemotherapy Ports Benefits and Risks

If your doctor has recommended a port for chemotherapy, you may wonder what this means. What is a port exactly, 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 exactly what having a port (sometimes called a port-a-cath) entails—the pluses and minuses, and ways you may be able to prevent complications such as infection or obstruction of the port.

Surgeon preparing a surgical instrument
Cultura Science / KaPe Schmidt / Riser / Getty Images

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 also be used if you need transfusions of red blood cells or platelets.

Without a port or a PICC line, a new intravenous needle (IV) will need to be placed each time you have chemotherapy, and separate IV lines will need to be placed 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, for access that will be needed for one to six weeks only). PICC lines are placed in your arm closer to your skin (subcutaneous) and do not reach as close to your heart as a port catheter.

Port Use in Chemotherapy

Whether or not your doctor recommends a port may depend on several things. Some chemotherapy medications can only be given through a port, as they are too caustic to be delivered into a peripheral vein.

If you will be having several infusions of chemotherapy (some oncologists recommend a port if you will require more than four treatments), a port is often easier than inserting an IV each time. 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. This makes a port a better option than placing an IV.

In order to make the best decision for you personally, let your doctor know if technicians have found it easy or difficult to draw blood or place an IV in your hand or arm in the past. (You may have heard a tech remark that you are an "easy stick" or a "hard stick").

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 have a general anesthetic in place. During insertion, a small round metal or plastic disc is placed under your skin through an incision that is an inch or two long.

Where Is a Port for Chemo Placed?

The port may be located on your upper chest, or occasionally your upper arm.

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

After your port is placed, 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

  • Less risk of infection when bathing or swimming

Disadvantages
  • Surgical procedure needed to place the port

  • Can become infected

  • Can develop a clot in the catheter

  • Could stop working due to mechanical problem

  • Might limit some activities

  • Scar from port

Benefits and Advantages

As with any surgical procedure, there are both advantages and disadvantages to having a chemotherapy port placed. It's estimated that over 5 million ports are placed in the United States each year, so physicians are very familiar with the procedure and it has been well studied.

The benefits of having a chemotherapy port over using a traditional IV include the following:

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 can cause changes that make veins very difficult to puncture.)

Avoiding Delays

Not only do you avoid the delay of having your nurse attempt to find a good vein to draw blood or infuse chemotherapy, but having a port can reduce the time needed to prepare your hand or arm for the procedure.

Lowering the Risk of Extravasation

When an IV is used, medications are more likely to leak (extravasate) into the tissues surrounding your hand or arm. Since many chemotherapy medications are caustic to tissue, a port can reduce the risk of inflammation-related to leakage of these medications.

Easier Bathing and Swimming

Since a port is completely under the skin, you can usually bathe and even swim without being concerned about the risk of infection.

Possible Disadvantages

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

Risk of Installing the Port

Any surgical procedure can carry the risk of infection. Complications of insertion can include bleeding (such as if the subclavian vein is punctured) and a pneumothorax (collapse of the lung) if your lung is accidentally punctured during the procedure. These occur in less than 1% of 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. Research is evaluating methods of reducing this risk, so it is important to talk to your oncologist about how to properly manage your port.

Thrombosis

A clot may form in the port or catheter, causing it to stop working. Many people who have a port placed for chemotherapy will develop a thrombosis (clot) in the catheter (often causing a need for the port to be replaced).

Mechanical Problems

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

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

Several studies in recent years have looked at methods of reducing the risk of bacterial colonization on a port and the subsequent risk of infection (sepsis). Sepsis is a "body-wide" infection in which bacteria are present in the blood. It can be very serious.

While routinely using antibiotics has not been found helpful, flushing the catheter with an antibiotic/heparin solution appears to reduce the risk. Cleansing of the skin has not proven to be very beneficial 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 Doctor

Since infection is the most common complication of having a port, contact your doctor 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 a frequent reason for which a port needs to be removed and often replaced. Routinely flushing a port with heparin and saline does not seem to make much difference, nor has a reduction been noted with using low dose heparin (though it did increase bleeding).

Overall, the risk of thrombosis in a port is significantly less than that in a peripherally inserted central catheter (PICC) line.

Frequently Asked Questions

  • What does a chemo port look like?

    Chemo ports are around the size of a nickel or a quarter 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 flexible plastic tube called the catheter.


    There are two types of chemo ports: a single lumen port, which has one access point, and a double lumen port, which has two access points. Most people get a single lumen port.

  • 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. During periods 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. You and your doctor should decide when exactly your port should be removed.

  • 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, which can usually be removed in 24 hours.


    It typically takes around six to eight weeks for the incision site to heal completely. Tell your healthcare provider if you develop a fever; have swelling, bleeding, or discharge at the incision site; or are experiencing pain that is not relieved by a pain reliever.

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 doctor about the pros and cons of a port (and how you'll need to care for it) before you decide to have one implanted.

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Article Sources
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