All You Need to Know About Chemotherapy Port

A chemo port is a small device that consists of an implantable reservoir. Doctors place it under the skin below the collarbone; and connect the reservoir to a thin silicone catheter or tube. This vein-access device helps deliver chemotherapy medications directly into the vein, eliminating the need for multiple needle pricks at every chemotherapy cycle.

The doctors do the procedure for chemo port placement in the operation theatre under C-arm (portable X-ray) guidance. They clean the area where they are); this numbs the area. They perform the procedure under general anaesthesia under certain circumstances, like an apprehensive patient or a child.

Also Read: What is Chemotherapy?

A chemo port is very beneficial to a patient undergoing chemotherapy as they can get all the blood investigations, chemotherapy cycles and supportive intravenous medications through it. This decreases the anxiety of multiple pricks and reduces the chances of extravasation injuries and thrombophlebitis, leading to hassle-free treatments.

Usually, they centrally place a chemo port under the skin near a large vein in the upper chest. This can be an excellent alternative to an intravenous (IV) catheter peripherally placed in an arm or hand vein (a suitable IV site can sometimes be difficult to find). Easily accessible by a patients treatment team, a port can provide a safer and more efficient medication delivery process than an IV. And while a port will produce a visible, quarter-sized bump under the skin, regular clothing can easily cover it.

How to care for the chemo port?

It is important to follow precautions once a chemo port is in place. If cared as per the instructions, the chemo port can last for two years. It doesnt hamper daily activities like movements, bathing, etc. Following precautions will help the port to last longer.

Sanitation and hygiene are essential to prevent infections. Once there is an infection in the port, it is ideal to remove it.

They will flush the chemo port every 4th week with heparinized saline. A trained Onco-care nurse should do it under aseptic precautions to avoid complications.

Only professionals must attempt the medications/chemotherapy/sample withdrawal.

A chemo port is now a standard of care practice worldwide for chemotherapy patients. It helps cancer patients by bringing ease and comfort to taking chemotherapy, thereby increasing compliance with treatment.

Where do you implant a chemo port?

The doctors place a chemo port under the skin near a large vein in the upper chest. This can be an excellent alternative to an intravenous (IV) catheter peripherally placed in an arm or hand vein (a suitable IV site can sometimes be difficult to find). It can be easily accessible by a patients treatment team. A port can provide a safer and more efficient medication delivery process than an IV. And while a port will produce a visible, quarter-sized bump under the skin, regular clothing can easily cover it.

How long does a chemo port remain in place?

They insert an IV catheter for each treatment session whereas a port can remain in place as long as necessary. It can remain for several weeks, months or even years. They can remove the port through a relatively simple outpatient procedure when it is no longer necessary.

Advantages of a chemo port

There are advantages and disadvantages to having a chemo port like any surgical procedure. The advantages include:

-When a traditional IV is in use, chemodrugs 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.

-You can usually bathe and even swim without concern about infection because the port is completely encased under the skin.

-A port site is equipped with a sterile technique, which ensures that all surfaces are free of microorganisms and thus dramatically reduces the risk of infection.

-It can also deliver fluids and transfusions, draw blood for lab testing, and inject dye for CT and PET scans.

-A port decreases the chances of medications coming into contact with the skin.

-A port is in use to deliver treatments that extend several days.

Disadvantages of a chemo port

The disadvantages of chemotherapy include:

While the risk of infection inchemo portis comparatively low, it may occur. As per research, around 2% of chemo ports need to be exchanged due to an infection.

Many people with a chemo port may develop a blood clot (thrombosis) which can block the catheter. An injection of the blood-thinner heparin is used into the catheter to unblock this blockage. But sometimes, it does not work, and the port is exchanged.

Mechanical problems like the movement of the catheter or a separation of the port from the skin may occur sometimes. It stops the chemo port from functioning.

Activities like bathing and swimming can be performed with a chemo port, but oncologists recommend avoiding heavy workouts involving the chest until chemotherapy is done.

Some people find that having a permanent scar on their upper chest is an upsetting reminder of their cancer experience. They may also choose not to have a spot for cosmetic reasons.

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.

When undergoing a chemotherapy port placement procedure, there are a few things to keep in mind:

1. Consultation: Before the procedure, consult with your healthcare team to fully understand the purpose, benefits, and potential risks of having a chemo port.
2. Preparations: Follow any pre-operative instructions provided by your healthcare team, such as fasting requirements or medication adjustments.
3. Consent and Questions: Sign any necessary consent forms, and feel free to ask your healthcare provider any questions or concerns you may have regarding the procedure.
4. Medications: Inform your healthcare team about any medications or supplements you are taking to ensure there are no potential interactions during the procedure.
5. Fasting: Follow the fasting instructions given by your healthcare team, which typically involve refraining from eating or drinking for a certain period before the procedure.
6. Clothing: Wear comfortable clothing that allows easy access to the area where the port will be placed.
7. Anaesthesia: Discuss the type of anaesthesia to be used during the procedure and any potential side effects or risks associated with it.
8. Post-procedure care: Understand the necessary post-procedure care instructions, such as keeping the incision site clean and dry, and any limitations on activities or lifting heavy objects.
9. Follow-up appointments: Schedule any follow-up appointments recommended by your healthcare team to monitor the port and address any concerns or complications.

Remember to always consult your healthcare team for personalized advice and guidance specific to your situation.

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Reference:

1. Teichgrber UK, Pfitzmann R, Hofmann HA. Central venous port systems as an integral part of chemotherapy. Dtsch Arztebl Int. 2011 Mar;108(9):147-53; quiz 154. doi: 10.3238/arztebl.2011.0147. Epub 2011 Mar 4. PMID: 21442071; PMCID: PMC3063378.
2. Vinchurkar KM, Maste P, Togale MD, Pattanshetti VM. Chemoport-associated Complications and Its Management. Indian J Surg Oncol. 2020 Sep;11(3):394-397. doi: 10.1007/s13193-020-01067-w. Epub 2020 May 3. PMID: 33013116; PMCID: PMC7501323.