Access to Chemo Port Information

Your doctor just told you that you need to get a chemo port. You have many questions about a port and why you need one. I will explain what a port is and give you some insight into my personal experience with a chemo port.

What is a chemo port?

An implantable port, a chemo port, a power port, or port-a-cath, is a special type of IV that is inserted into your chest under the skin. It is different from a “regular” IV for a few reasons:

•   It can be left in place for months to years

• It is placed completely under the skin

•   It has a “well” or port that sits under the skin and is accessed by a special kind of needle, and it has a “tail” or catheter which is inserted into the very large vein in your chest

(Note: This image is a representation of where a port sits in the chest and how it inserts into the large vein in your chest. It is not to scale nor is it intended to be.)

Why do I need a chemo port?

You will get a port for a few different reasons:

Where a “regular” IV receives fluid under low pressure, fluids can be injected into a port under higher pressure.

Another reason is that some chemotherapy medicine is very toxic to the surrounding tissues. If your nurse put chemo medicine in a vein in your arm and your vein collapsed, the chemo could damage the tissue in your arm. On the other hand, a port goes into a large vein in your chest. By the time the medicine mixes with the blood in the vein the chemo begins to dilute and is not so toxic to the tissue.

One more reason you may need to get a port is that a port is not fragile like the veins in your arm or hand. For that reason, you can keep the port in for a long time and it won’t collapse. And the next time you go for your chemotherapy, and they don’t have to fish around to find a good vein, you will be grateful you have a port in.

A port can be used for things other than giving you chemotherapy though.

Your port can be used for:

·         Parenteral nutrition – this is a special IV mixture that has vital nutrients in it. If you are not able to eat, like due to severe nausea, or if you had surgery on your throat or stomach and you are not able to swallow or keep food down, your doctor may order parenteral IV nutrition to be infused.

If your nurse is allowed to, they might draw your labs from your port. Be aware that not all nurses are trained in how to use a port. Also, your doctor must write an order for your port to be used to draw blood.

How do I get a chemo port?

You will have a minor surgical procedure to get the port put in. The procedure can be done in interventional radiology in the radiology department, or in a regular operating room. The surgery can be done by an interventional radiologist or by a surgeon.

You will be given some type of anesthesia to make you sleepy. Also, your doctor will numb the area where your port goes in so you will not feel any pain.

How do I prepare to get a chemo port?

A minor surgical procedure is done to insert the port into your chest. You will need to follow some routine pre-surgical instructions to prepare for this surgery including:

v  Nothing to eat or drink after midnight or according to your surgeon’s instructions

v  Wash the area carefully as instructed by your surgeon’s office

v  Because you will receive sedation or anesthesia, you will need to have someone drive you home and stay with you until the sedation wears off

v  Bring your insurance card and photo ID with you

v  You may be asked to stop blood thinners or other medications before your surgery. Be sure to ask your surgeon’s office for personalized instructions

v  Notify your surgeon if you are allergic to heparin

Where does the port go?

There are two different ways your surgeon can put a port in. One way is to make a single small incision in the chest just under the collarbone and insert the port into the large vein in your chest.

Another way is to make a small incision in the internal jugular vein on the side of the neck to insert the catheter into. The other incision is made on the chest just below the clavicle where the port will be inserted. The catheter is then connected to the port and both incisions are stitched shut.

The port can be placed on either the right or left side of the chest. The location will be determined by a few different considerations including:

v  If the catheter is inserted into your neck vein, the surgeon will check to see if you have any blockage in the vessel before inserting the catheter

v  Another consideration is if you have a pacemaker/defibrillator in your chest, the opposite side may need to be used

v  Will you need to have radiation therapy to your chest?

v  Have you had previous surgery or trauma to your chest?

v  There are more factors to consider. Be sure to bring up any concerns you may have to your surgeon

How is a port used?

The nurse uses a special needle to insert into the port. Instead of a straight, slender needle that is usually used for IVs, this needle comes out of the catheter at a 45-degree angle, it is thicker than a regular IV needle therefore it allows more fluid to be infused.

Before inserting the needle, your nurse will thoroughly clean the area.

After inserting the needle, your nurse will put a dressing over the needle while it is inserted.

Before inserting the needle, they may use a numbing spray over your port to make inserting the needle less painful.

The needle can remain in the port longer than a traditional IV. Let your nurse know if you experience any discomfort once the needle has been inserted.

The needle has a small catheter attached to it. Your nurse will connect IV tubing to the catheter to infuse the medication like with a normal IV.

How do I take care of an implantable port?

Immediately after your port is inserted, you may feel some soreness or pain at the insertion site or sites. Be sure to follow your surgeon’s recommendation regarding what medication you should take to relieve the discomfort.

Remove any dressing according to your discharge instructions.

Observe the incision for any sign of infection such as:

v  redness

v  drainage

v  if you run a fever which is a temperature over 100.4 degrees F (38 degrees C) or according to your instructions from your surgeon

v  chills

v  unexplained aches or tiredness

v  Also, watch for unusual swelling or bruising

Report any concerns to your surgeon immediately.

Your port needs to be flushed every four weeks if you are not using it to make sure it doesn’t become clogged. This may be done by a nurse, or they may teach you how to do it yourself.

You should avoid putting pressure on the port:

v  When wearing a seatbelt, put a small pillow between your chest and the belt, or use a padded seatbelt attachment

v  Do not engage in any contact sports

v  Be careful not to allow small children to bang their heads against your chest when they give you a hug

How long will I keep an implantable port in?

First, it depends on why you have the port. You can keep your implanted port in for months or even longer. Your doctor can remove the port with another minor surgery when your treatments are completed, and you no longer need to use the port.

What does it feel like to get a chemo port?

Immediately after getting the port put in, the area around the incision site will be sore. Over-the-counter pain medication should be strong enough to relieve the pain, no narcotic pain med should be needed.

As the area around the port is healing it will be tender for several days. You should avoid vigorous exercise and carrying heavy items until you are cleared to do so by your surgeon. This includes if you carry a heavy purse or backpack.

It also may be uncomfortable to lie on the side where the port is inserted. Consider a different sleeping position while the incision is healing.

You may notice a small bump under the skin where the port sits, but maybe not depending on the shape and thickness of your chest.

What does it feel like to have a port removed?

Again, the area will be sore where the incision is made. After the port is removed, the area will be tender where the port was as the tissue goes back into its normal position.

Once again, you will need to watch for any signs of infection at the incision site.

Follow the same instructions you did when the port was put in until the area heals.

My personal experience with a port-a-cath

(Read: The Day I Met Cancer in the Mirror)

My chest was sore when to chemo port was inserted due to:

The incision in my chest where the chemo port was inserted was tender initially.

The port was a foreign object in my chest and my body had to get used to it being there.

Occasionally I felt soreness from the port while it was in, but not always.

I had chest soreness when the port was removed due to:

Again, I had an incision in my chest.

The tissue inside my chest was now returning to its normal position and my chest was sore during this adjusting period.

Accessing the chemo port:

Used numbing spray: Pro = less discomfort when inserting the needle into the port

                                          Con = the spray smelled bad (was it just me because I was sensitive to smells due to chemo or did it really smell that bad?)

                                                   = the numbing spray makes the skin over the port tougher over time

Best sleeping position with a chemo port in:

My port was inserted into the left side of my chest, which is the side I normally sleep on. Therefore, I slept on my back or right side until the discomfort from the port subsided.

To make this position more comfortable I also propped my left arm on a pillow to prevent my arm from tugging on my chest.

My cancer was in my right breast, so the port was inserted into the left side of my chest. This was to prevent future radiation treatments from interfering with my port.

Some general information about chemo ports:

My port came with a rubber bracelet that had the name of the brand of port on it. I was instructed to wear the bracelet on the same side as the port which was my left arm. That way if something happened to me where I was unable to speak for myself, the bracelet should alert emergency personnel that I had a port and where it was located.

I either put a small pillow under my seatbelt or put a padded protector on my seatbelt to prevent it from putting excess pressure against my port. This made the pressure from the seatbelt less painful.

All three of us, my mother, myself, and my friend, had power ports inserted. (Read: Who is MAB?)

A power port can be inserted in two different ways. Mine and my mom’s ports were inserted through one incision in our chests.

Amanda’s port was inserted via two incisions, one in her neck and one in her chest. (Read: The Day Cancer Turned Pink…Again)

This article has presented some common facts to consider when getting your port. Of course, your situation may present some factors not presented here. Be sure to talk with your care team about any concerns you have before and after getting your port put in.

 Here are some additional resources to give you more information on chemo ports:

https://www.cancer.net/navigating-cancer-care/how-cancer-treated/chemotherapy/catheters-and-ports-cancer-treatment

https://www.mskcc.org/cancer-care/patient-education/your-implanted-port

 After reading this article, what questions do you have to ask your doctor?

Wishing you all the best,

Kelly

 Are your cancer screenings up to date?

Yes, I am a nurse. No, I am not your nurse. The medical topics discussed in this, or any article on this site, are intended to be issues for you to discuss with your medical team if you feel they apply to you. None of the information you are about to read in this article is treatment advice for you from me. I do not have that authority.