Catheters and ports in cancer treatment

People with cancer often receive treatment through a vein. The medical term for this is intravenous (IV) treatment. This way, your healthcare team can give you chemotherapy, other medications, blood transfusions, and fluids. Medical devices called catheters and ports make IV treatments easier. They can also make it easier to draw blood samples for the healthcare team.

What are catheters and ports?

A catheter is a thin, soft plastic tube that goes into a vein. Your healthcare team uses the catheter to deliver treatment through that vein.

A part of the catheter may remain outside your body to make it easy to insert the medicine into the catheter. When you are not receiving treatment, the catheter is clamped or capped to keep it closed. Some catheters split into 2 or 3 separate ends. They are double or triple-lumen catheters. This type of catheter allows you to receive more than 1 treatment at a time.

Sometimes a catheter is placed completely under the skin. If so, it is connected to a small plastic or metal disk called a port, which is also inserted under the skin. You may see or feel a small bulge on the side of the port, but you will not see the tip of the catheter.

What are the types of catheters used in cancer treatment?

There are many types of catheters and they all work in a similar way. Which one you have will depend on factors such as:

How long do you need cancer treatment
The type of treatment you receive
How easy it is to care for the catheter
The cost of the catheter and its insertion

Where the catheter is inserted and how it is placed in your body will depend on the type of catheter. The different types of catheters are as follows:

IV Catheter Treatments given into a vein are usually given through a catheter with a small needle. This is called an “iv catheter” or simply an “iv line.” The nursing staff puts the needle in your forearm or on the top of your hand. In addition to chemotherapy, you can receive other drugs this way. For example, you might get medicine to help with nausea through an IV.

Usually, a member of the nursing staff removes the IV catheter when the day’s treatment is finished. A new IV line will be started each time you receive treatment. Sometimes you can keep the catheter in place for 2 or 3 days if it is secure in the vein and not painful.

Peripherally Inserted Central Catheter (PICC). This is usually called the PICC route (sounds like the pic). A nurse or doctor with special training places it in a large vein near your elbow. They will use a local anesthetic to numb the skin and tissue when the PICC line is inserted. Anesthetics are drugs that block the awareness of pain. Once the tip of the catheter is in the vein, a few more inches of the catheter are inserted into the vein. This is to ensure that the catheter does not come out. The last part of the catheter is left outside the body where the catheter was inserted.

Central catheter, tunneled venous catheter, or Hickman catheter. A specially trained healthcare professional places this catheter into a large vein below your collarbone or into a vein in your neck. As with the PICC line, the tip of the catheter goes into the vein and a few inches of the tube goes into the body. The rest of the catheter tube will stay outside your body, in your chest or neck. You will receive local anesthesia or conscious sedation when the catheter is placed. Conscious sedation is a medicine that helps you relax and makes you sleepy.

Implantable port or port-a-cath. A surgeon or radiologist places this port. This is usually done under local anesthesia or conscious sedation. The entire catheter is placed under the skin of the chest or upper arm. To administer treatment with a port, a nursing staff member first numbers the skin with cream. The nurse then cleans the skin and puts a needle into the port. Treatment or blood samples pass through the needle.

What are the benefits of using catheters for cancer treatment?

A catheter in the upper arm or neck can stay in place for weeks or months. Healthcare teams can use it for the following:

Reduce the number of times a nursing or team member needs to insert a needle into a vein to administer treatment or take a blood sample for testing. Members of the health care team call this a needle stick. The catheter helps if you will need a lot of needle sticks, if you have small or damaged veins, or if you have a fear of needles (trypanophobia).
Perform blood transfusions or administer more than 1 treatment at a time.
Reduces the risk of drugs leaking out of the vein.
Prevent bruising or bleeding if you have bleeding problems, such as a low platelet count.
Allow you to receive chemotherapy treatment at home instead of the hospital or clinic for certain treatment plans. In this way, you can receive continuous infusion therapy. During this type of therapy, you receive treatment drugs through a small pump that you wear or carry.

What are the benefits of using ports for cancer treatment?

Ports can stay in place for weeks, months, or years. Your computer can use a port for the following:

Reduce the number of needle sticks.
Administer treatments that last more than 1 day. The needle may stay in the port for several days.
Deliver more than 1 drug at a time through a dual port.
Do blood tests and give chemotherapy on the same day through 1 needle stick.

What are the risks of using catheters and ports during cancer treatment?

Each type of catheter can have side effects and risks. These include possible infections, blockages, and clots. Less common problems are the catheter kinking under the skin or the catheter or port moving.

Relieving side effects is an important aspect of cancer treatment in general. This type of care is called palliative care or supportive care. Talk to your healthcare team about the side effects you’re experiencing and ways to manage and treat them. It is important that signs, symptoms, or problems that you or your caregiver need to report immediately are addressed in this discussion.

How do I care for my catheter or port?

Taking good care of your catheter or port reduces the risk of problems. It is very important to take special care with the part of the catheter that is outside the skin and with the area that surrounds it.

You must flush the catheter with sterile fluid every day; this prevents it from clogging. A member of the nursing staff will show you how to do this. An IV services staff member may also help you until you feel comfortable doing so. You can get a demonstration in the doctor’s office or during a home visit.

Your healthcare team will tell you how to care for the catheter or port. Frequent instructions are as follows:

Always wash your hands before touching the catheter. This helps prevent infections.
Never touch the tip of the catheter when the cap is off.
Follow the instructions on how to frequently clean the area and change the dressing while holding the catheter in place.
Keep air out of the catheter. Make sure the top is closed or clamped securely, except during treatment.
Prevent the catheter from breaking or cutting.
Avoid submerging the catheter underwater.

The ports go under the skin, so they need less care. After a port is placed, the skin has to heal. Ask your healthcare team how you should care for the area, and follow their instructions. Sometimes the port is not used frequently. A nursing staff member may need to wash it out so it doesn’t get clogged.

When should I call my healthcare team?

Contact your health care team immediately if any of the following occur:

The area around the catheter or port becomes red, swollen, painful, bruised, or hot.
The arm on the same side as the catheter swells.
There is a lot of bleeding around the catheter or port.
He has fever.
There are fluids leaking through the catheter.
You have trouble breathing or dizziness.
The catheter tube outside the body lengthens.
You cannot flush the catheter or port with fluid and it seems blocked. Never force liquid into the catheter.
You have symptoms or problems that your oncology care team advised you to report right away.

How are catheters and ports removed?

Your doctor or a nurse will remove the catheter or port when you no longer need it.

If you have a PICC line, your doctor or nurse will gently tug on the tube until you feel it come loose, and then remove it. This is usually painless and anesthesia is not usually needed.

If you have a port, or a catheter in your neck or chest, your doctor or a radiologist will make a small cut in your skin. Then they will gently remove the port or catheter. You may need local anesthesia or conscious sedation.

Questions to ask your health care team

Why do you recommend that I have a catheter or port placed?
What type of catheter or port do I need?
What are the risks of this type of catheter or port? What issues should I report right away?
Who do I call if I have problems with the catheter or port? And outside of business hours?
How much of the cost of placing this catheter or port will my health insurance cover?
Will I feel pain or discomfort when the catheter or port is placed?
How long does it take to place a catheter or port?
How long will I have the catheter or port?
How do I care for the catheter or port? How often?
Will I be able to see or feel the catheter or port?
How will a catheter or port affect my daily life? Will I be able to wear my usual clothes, bathe, swim, and exercise?
Are catheters or ports a problem if I have radiation therapy or imaging scans?