What to Know About Chemo Ports

If your cancer treatment will be given into a vein (intravenous or IV infusion), your doctor may recommend an implanted port. Often called a “chemo port,” this device can be used to make the process of giving IV treatments and other medicines easier. You and your care team will decide whether a port is right for you.

“This is your journey, and we’re here as your advisors. We will walk through this with you, hand in hand,” said Elizabeth McGrath, DNP, APRN, an oncology clinical nurse specialist at Huggins Hospital and an American Society of Clinical Oncology (ASCO) expert.

Understanding how a port works and how it might fit into your daily life can help you make an informed choice about getting one.

What is a chemo port?

A chemo port is a small device implanted just under the skin, usually on the upper chest, but sometimes in the arm, groin, or abdomen. It provides safe access for long-term treatment infusions given through an IV, such as chemotherapy (chemo), targeted therapy, and immunotherapy. It can also be used for giving fluids, nutrition, and other IV medicines, as well as for drawing blood. A port can be very helpful for people with veins that are small or hard to find.

The device consists of 2 main parts:

• Reservoir (port body): A small, quarter-size chamber with a rubbery, self-sealing center called the septum. This part of the port sits just under the skin.
• Catheter: A thin, flexible tube that connects the reservoir to a large vein. The tip of the tube will be near your heart. When a treatment or infusion is given, it travels through the catheter to the bloodstream so it can circulate through the body.

The 2 types of ports are:

• Single-lumen: The port has 1 reservoir and 1 access point. This is the most common type.
• Double-lumen: The port has 2 separate reservoirs and access points, side by side, so you can get 2 different treatments or fluids at the same time.

Ports can remain safely under the skin for weeks, months, or even years. When the port is needed, a nurse or other healthcare provider accesses it by inserting a special needle through your skin and into the septum.

A prescription numbing cream can help prevent or decrease discomfort. You apply the cream to the skin around the reservoir a few minutes before the needle is put in.

What are the benefits and risks of a chemo port?

A port helps avoid several risks associated with other types of IV lines used to deliver cancer treatments into the bloodstream.

For example, a standard peripheral IV uses a needle that’s inserted into a vein in the hand or arm when treatment or other infusions are needed. Repeated peripheral IV pokes can scar and wear out smaller veins, making them more fragile. In addition, some cancer treatment drugs can damage nearby tissue if they leak from a vein while being infused. Because a port bypasses these smaller veins entirely, it helps protect hands and arms from irritation and tissue damage due to infusions. With a port, the strong medicines enter a larger vein with rapid blood flow, where they are diluted quickly.

Ports used for chemo do carry some risks, including blood clots, blockages, or infection. They can also malfunction, split, or break, which can cause infusions to leak out of the catheter. But these complications are less common with ports than with other long-term IV treatment delivery methods, like peripherally inserted central catheters (PICCs) or tunneled central venous catheters (CVCs or Hickmans). “Ports have a very, very low infection rate,” said Dr. McGrath.

What happens when a port for chemo is placed?

Inserting an implanted port is a minor outpatient surgery that takes about an hour. The port can often be used the same day it’s put in.

The 3 main steps to the insertion procedure are:

• Anesthesia: The process may vary depending on the clinic. Many people receive a local topical anesthesia to numb the area. This is usually combined with mild sedation to help the person relax. General anesthesia, which creates a deep sleeplike state, is only occasionally used for port insertions.
• Placement: Typically, a surgeon or radiologist makes 2 small cuts (incisions) in the skin. One incision is just below the collarbone and creates a pocket under the skin where the reservoir is placed. The other incision is made in the neck area where the catheter is connected to the reservoir, then threaded through the vein and guided toward the heart. The incisions are then closed.
• X-ray: A chest x-ray confirms the port is safely in the right position and ready to use.

When is it safe to shower after getting a chemo port?

You’ll need to keep the incision sites dry. You can typically shower 1 to 2 days after port placement if the area is covered with a waterproof bandage. After 7 to 14 days, when you’ve healed from the procedure, you can shower, bathe, and swim normally.

Is it safe to exercise with a chemo port?

You can be active with a chemo port. Your care team can even select the area for port placement that best fits your lifestyle. Once the surgical area heals, you can return to the activities you love.

“We’ll ask which hand is dominant, what activities you enjoy, and whether you’re usually a driver or passenger,” said Dr. McGrath. Your answers to these questions can help your care team figure out how to keep the port as out of the way as possible.

For people who may be concerned about the port being bumped or exposing others to treatment or medicine given through the port, Dr. McGrath offers reassurance. “Your kids and grandkids can sit on your lap. That’s not a problem,” she said. “The port is secure under your skin, and there’s no risk of exposing anyone.”

What happens if a chemo port isn’t used or flushed?

To keep the port working its best, it must be flushed regularly with saline solution. Otherwise, a natural protein called fibrin can build up, causing a clot to form and clog the tube. When your port is used regularly, such as during active treatment, it is flushed after each use. When the port is not used regularly, such as during treatment breaks, you’ll need to visit the clinic every 4 to 12 weeks to have it accessed and flushed.

If the tube does become clogged, your care team may be able to clear it with a special medicine.

What else is important to know about ports for chemo?

Remember that your oncology team is there for you. “We want you to ask questions, and we want you to understand the process,” said Dr. McGrath.

While recommended for many patients and certain treatments, a port is not the only option. Depending on a person’s diagnosis and treatment plan, they may be able to get treatment using a different type of IV therapy or as an oral pill. Talk with your care team about the pros and cons of each option.

If you do choose a port, highly trained oncology professionals will manage it. Their goal is to keep you comfortable and safe throughout the treatment process.

Learn more from the American Cancer Society:

• Chemotherapy
• What to Expect on Your First Day of Chemo
• Getting Chemo Infusions or Injections
• IV Lines and Ports Used in Cancer Treatment

Dr. McGrath is an ASCO member.