Chemo ports 101

Dr Daleen Geldenhuys gives us a rundown on chemo ports 101, explaining how they work, who should get them, and the insertion and removal process.

You can listen to this article below, or by using your favourite podcast player at pod.link/oncologybuddies

A chemotherapy port (chemo port) is a small device placed under the skin in the chest area that is usually hidden from sight but also not in the way of a seatbelt or a bra strap. It’s attached to a vein to deliver chemotherapy drugs to the body and can stay in for months to years. Removal is done when the chemo port is no longer needed.

Who needs a port?

It can be a personal choice regardless of the regimen or the number of chemotherapy sessions that you undergo.

It’s usually recommended for breast cancer patients whom, for the purpose of avoiding lymphoedema, can only receive chemotherapy in one arm.

It’s also indicated if you need a constant infusion of chemotherapy over two to five days. This can be a safe way to have the therapy at home rather than as an inpatient in hospital.

Some chemotherapeutic drugs can cause severe irritation of the veins and a port inserted into a bigger vein can prevent phlebitis (inflammation that causes a blood clot to form in a vein).

If you have small frail veins, the chemotherapy nurses may advise placement for easier administration of chemotherapy. This means less pricking and prodding.

The parts of chemo port

Reservoir: This is the body of the port. A general or vascular surgeon will surgically implant this under the skin, typically in the chest area. Local anaesthesia or conscious sedation will be used. After insertion, it will look like a little bump under the skin.

Septum: Covering the top of the reservoir is a septum, which is a self-sealing, rubber-like material. Healthcare professionals use a special needle, angled at 90 degrees, to access the port through the septum to deliver medications or draw blood. This rubber also keeps the needle stable and unlikely to dislodge whilst doing normal activities.

Catheter: This is a thin, flexible tube that is attached to the reservoir, extending from the port to a major vein near the heart. It’s what allows chemotherapy medications to get directly into the bloodstream.

Chemo port complications

The insertion and removal of a chemo port is a generally safe procedure. However, like any medical or surgical intervention, some complications are possible.

Infections may develop at the incision site or along the catheter, possibly leading to localised swelling, redness, pain, or fever. 

Doctors usually clean the surgical area thoroughly and may prescribe antibiotics before and after the procedure to reduce the likelihood of infections. 

Mild bleeding may occur at the incision site or the catheter insertion point. This is usually minor but may need a little extra care.

After insertion and while the area around the chemo port is healing, it’s important to keep the area clean and dry. Using a waterproof barrier or covering the port site during showers may help you reduce the risk of infection. After it’s healed, you can shower, bathe, and even swim without risking infection.

Catheter damage or dislodging of the port may occur if you participate in vigorous physical activity. But you are still able to exercise. Your healthcare team will advise what is safe and how you can adjust your daily activities to avoid putting excessive strain on the port area. 

Blood clots may occur as having a catheter in place increases the risk. Any swelling after insertion of a catheter should prompt immediate attention by a medical professional.

Ports are designed to be inconspicuous and comfortable, allowing you to go about your daily activities without noticing it’s there. If you experience issues with your port, speak to your healthcare team for advice.

Taking care of chemo ports

When the healthcare team decides to keep the port a while longer, without using it frequently, it’s advisable to flush the port at intervals. Different facilities have reported safe interval times between the flushes and may vary from centre to centre. Six to eight weekly intervals are acceptable.

Chemo port removal

Once the healthcare provider determines chemotherapy treatment is complete, you’ll no longer need the chemo port. To remove the chemo port, a surgeon will make a small incision in the skin directly over the port, allowing access for removal. They may use local anaesthesia or conscious sedation to keep you comfortable during the process. They will gently pull on the catheter to remove it, then close the incision with stitches.

After removal, it’s normal to experience mild discomfort with some swelling or bruising, which should subside in a few days.

Removal complications

Adhesions: If the port is left in for a long period of time, the potential for scar tissue formation may result in adhesions making it more difficult to remove but not impossible.

Incomplete removal: Sometimes a portion of the port or catheter may break off during removal, requiring additional surgeries to remove it.

Final thoughts

Always discuss any physical and other concerns with your healthcare team. Having a port may help with administration of therapy but it may also be a constant reminder of your disease. Speaking to patients in the treatment room or a support group may also help you to adjust.

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