Web Exclusive: What Is a "Good Death?"
April 01, 2009 – Kathy LaTour
Web Exclusive: Resolving Your Own Death
March 25, 2009 – Kathy LaTour
Web Exclusive: Understanding Hospice
March 20, 2009 – The American Hospice Foundation
Web Exclusive: Find a Clinical Trial That's Right for You
March 18, 2009
Web Exclusive: Find a Clinical Trial That's Right for You
March 18, 2009
Web Exclusive: Eulogy for Dr. Phillip Berman
March 18, 2009
Web Exclusive: A Granddaughter's Eulogy
March 17, 2009 – Heather Venrick
Calming Cancer Pain
March 17, 2009 – Kathy LaTour
Excerpt: When Hormone Therapy Can Stress You Out
March 17, 2009 – Ed Weinsberg
Treatment Snapshot
March 17, 2009
Choosing the Right Plan
March 13, 2009 – Christy Schmidt
Lymphoma, Myeloma & Prostate Cancer
March 13, 2009 – Elizabeth Whittington
When Do I Tell Her?
March 13, 2009 – Jasan Zimmerman
Web Exclusive: Caregiving Resources
March 13, 2009
What Can Patients Do to Reduce a Spouse's Stress?
March 13, 2009 – Lacey Meyer
Web Exclusive: Childhood Survivors Face Increased Risks
March 13, 2009 – Teresa McUsic
Soy Story
March 13, 2009 – Lena Huang
Web Exclusive: An Amazing Journey with Remarkable Women
March 13, 2009 – Kathy LaTour
An Incredible Journey
March 13, 2009 – Kathy LaTour
Web Exclusive: Identifying Insurance Challenges (and Solutions)
March 13, 2009 – Elizabeth Whittington
Medicare Resources
March 13, 2009
New Legislation Focuses on Helping Patients
March 13, 2009 – Teresa McUsic
The Four Parts of Medicare
March 13, 2009
Should Breast Cancer Patients Make the Switch?
March 13, 2009 – Beverly A. Caley
Web Exclusive: Types of Non-Hodgkin Lymphoma
March 13, 2009 – The American Cancer Society
Web Exclusive: Cognitive Changes
March 13, 2009
Web Exclusive: Types of Thyroid Cancer
March 13, 2009 – The National Cancer Institute
My Extended Vacation
March 13, 2009 – Gary Grieger
Does Treatment Differ for Older Patients?
March 13, 2009 – Heather L. Van Epps, PhD
New Blood
March 13, 2009 – Susan Kreimer
For the Caregiver: Brain Nourishment
March 13, 2009 – Laura Beil
The Low-Iodine Diet
March 13, 2009 – Charlotte Huff
Conquer Prostate Cancer: How Medicine, Faith, Love and Sex Can Renew Your Life
March 13, 2009 – Kathy LaTour
Childhood Cancer Survivors Skip Needed Mammograms
March 13, 2009 – Elizabeth Whittington
Young Patients Make Their Mark in Art Exhibit
March 13, 2009 – Lacey Meyer
U.S. Surgeon General's Office Releases Updated Family Health History Program
March 13, 2009 – Lacey Meyer
Kathy Bates Reveals Her Survivorship Status
March 13, 2009 – Lacey Meyer
Q&A: KRAS Testing
March 13, 2009 – Len Lichtenfeld, MD
Supplements Offer No Prostate Cancer Protection
March 13, 2009 – Lena Huang
Crossing Gender Lines
March 13, 2009 – Kathy LaTour
CancerCare Telephone Education Workshop: Seventh Annual Cancer Survivorship Series
March 13, 2009 – Elizabeth Whittington
Ad Campaign Targets Health Care Reform
March 13, 2009 – Elizabeth Whittington
Message From the Editor
March 13, 2009 – Debu Tripathy, MD
Treatment Updates
February 18, 2009 – Susan R. Peck, PhD
The Ins and Outs of Ports
February 18, 2009 – Curtis Pesmen
Stressed Out
February 18, 2009 – Lacey Meyer
Battling Cancer Again
February 18, 2009 – Teresa McUsic
Warrior Survivors
February 18, 2009 – Kathy LaTour
Mind Games
February 18, 2009 – Laura Beil
Trying Something New
February 18, 2009 – Nicole LeBrasseur, PhD
The Good Cancer?
February 18, 2009 – Charlotte Huff
Letters from Our Readers
February 18, 2009
The Medicare Prognosis
February 18, 2009 – Teresa McUsic
The Final Journey: The Life and Death of Judy Abernathy
October 05, 2009 – Kathy LaTour
Web Exclusive: What Is a "Good Death?"
April 01, 2009 – Kathy LaTour
Web Exclusive: Resolving Your Own Death
March 25, 2009 – Kathy LaTour
Web Exclusive: Understanding Hospice
March 20, 2009 – The American Hospice Foundation
Web Exclusive: Find a Clinical Trial That's Right for You
March 18, 2009
Web Exclusive: Find a Clinical Trial That's Right for You
March 18, 2009
Web Exclusive: Eulogy for Dr. Phillip Berman
March 18, 2009
Web Exclusive: A Granddaughter's Eulogy
March 17, 2009 – Heather Venrick
Calming Cancer Pain
March 17, 2009 – Kathy LaTour
Excerpt: When Hormone Therapy Can Stress You Out
March 17, 2009 – Ed Weinsberg
Treatment Snapshot
March 17, 2009
Choosing the Right Plan
March 13, 2009 – Christy Schmidt
Lymphoma, Myeloma & Prostate Cancer
March 13, 2009 – Elizabeth Whittington
When Do I Tell Her?
March 13, 2009 – Jasan Zimmerman
Web Exclusive: Caregiving Resources
March 13, 2009
What Can Patients Do to Reduce a Spouse's Stress?
March 13, 2009 – Lacey Meyer
Web Exclusive: Childhood Survivors Face Increased Risks
March 13, 2009 – Teresa McUsic
Soy Story
March 13, 2009 – Lena Huang
Web Exclusive: An Amazing Journey with Remarkable Women
March 13, 2009 – Kathy LaTour
An Incredible Journey
March 13, 2009 – Kathy LaTour
Web Exclusive: Identifying Insurance Challenges (and Solutions)
March 13, 2009 – Elizabeth Whittington
Medicare Resources
March 13, 2009
New Legislation Focuses on Helping Patients
March 13, 2009 – Teresa McUsic
The Four Parts of Medicare
March 13, 2009
Should Breast Cancer Patients Make the Switch?
March 13, 2009 – Beverly A. Caley
Web Exclusive: Types of Non-Hodgkin Lymphoma
March 13, 2009 – The American Cancer Society
Web Exclusive: Cognitive Changes
March 13, 2009
Web Exclusive: Types of Thyroid Cancer
March 13, 2009 – The National Cancer Institute
My Extended Vacation
March 13, 2009 – Gary Grieger
Does Treatment Differ for Older Patients?
March 13, 2009 – Heather L. Van Epps, PhD
New Blood
March 13, 2009 – Susan Kreimer
For the Caregiver: Brain Nourishment
March 13, 2009 – Laura Beil
The Low-Iodine Diet
March 13, 2009 – Charlotte Huff
Conquer Prostate Cancer: How Medicine, Faith, Love and Sex Can Renew Your Life
March 13, 2009 – Kathy LaTour
Childhood Cancer Survivors Skip Needed Mammograms
March 13, 2009 – Elizabeth Whittington
Young Patients Make Their Mark in Art Exhibit
March 13, 2009 – Lacey Meyer
U.S. Surgeon General's Office Releases Updated Family Health History Program
March 13, 2009 – Lacey Meyer
Kathy Bates Reveals Her Survivorship Status
March 13, 2009 – Lacey Meyer
Q&A: KRAS Testing
March 13, 2009 – Len Lichtenfeld, MD
Supplements Offer No Prostate Cancer Protection
March 13, 2009 – Lena Huang
Crossing Gender Lines
March 13, 2009 – Kathy LaTour
CancerCare Telephone Education Workshop: Seventh Annual Cancer Survivorship Series
March 13, 2009 – Elizabeth Whittington
Ad Campaign Targets Health Care Reform
March 13, 2009 – Elizabeth Whittington
Message From the Editor
March 13, 2009 – Debu Tripathy, MD
Treatment Updates
February 18, 2009 – Susan R. Peck, PhD
Currently Viewing
The Ins and Outs of Ports
February 18, 2009 – Curtis Pesmen
Battling Cancer Again
February 18, 2009 – Teresa McUsic
Warrior Survivors
February 18, 2009 – Kathy LaTour
Mind Games
February 18, 2009 – Laura Beil
Trying Something New
February 18, 2009 – Nicole LeBrasseur, PhD
The Good Cancer?
February 18, 2009 – Charlotte Huff
Letters from Our Readers
February 18, 2009
The Medicare Prognosis
February 18, 2009 – Teresa McUsic
The Final Journey: The Life and Death of Judy Abernathy
October 05, 2009 – Kathy LaTour

The Ins and Outs of Ports

A port can make intravenous chemotherapy easier on patients. 

BY Curtis Pesmen
PUBLISHED February 18, 2009

Right after my stage 3 colon cancer diagnosis, something seemed odd: I was advised to have an immediate, voluntary surgery in order to get chemotherapy. But my port-a-cath implant surgery—also designed to help me avoid countless needle sticks—doesn’t seem odd today, looking back cancer-free, seven years after treatment. 

Basically, I consented to have a port-a-cath, a small, round (about 1.5 inches in diameter) intravenous drug reservoir and thin catheter tube placed into my chest to streamline both chemotherapy delivery and many blood draws over the course of nine months. Breast cancer patients who have mastectomies and lymph node removal also benefit from ports, as access to the inside of their arms on the operating side(s) may be limited.

The theory was that I’d have less pain and fewer vein-related complications. All proved true. Plus, unlike my planned tumor removal, it was outpatient surgery. The port stayed in me for one year post-treatment—shrouded by my chest hair—just in case of recurrence.

Today, port implants in the chest or along the inside arm seem almost routine following myriad cancer diagnoses. Both surgeons and interventional radiologists are now trained to perform the surgery. Radiologists are newer to the field, but their implants may be guided more precisely by pre-operative imaging.

Yet patients and their caregivers don’t always realize there’s more to the port story than easier access for oncology nurses and treatment efficiency. Older patients and survivors who face multiple rounds of intravenous therapy may over time suffer hardened veins, which complicates or even prevents traditional needle-catheter infusions of anti-cancer drugs, liquid nutrition, or antibiotics.

“Your [port] access is always there; without repeated needles, and without worrying about the nurse or CT tech not being able to ‘find’ a vein,’ ” says John Kaufman, MD, chief of vascular and interventional radiology at Dotter Interventional Institute at the Oregon Health & Science University in Portland.

Kaufman explains that many chemotherapy and targeted drug therapies follow a strict schedule; and if you return home after unsuccessful jabs one day—without a successful needle point-of-entry for treatment—that very schedule is jeopardized. “The port gives you tremendous security,” he says. “It’s meant to make a difficult time of your life easier.” Also, some chemotherapy agents can cause tissue damage if they leak around the vein from a regular I.V. line, so a port avoids that risk as well.

Still, ports aren’t perfect, nor are they maintenance-free. They typically require flushing every four to six weeks with heparin solution, a quick and relatively painless procedure that helps to prevent blood clots. The devices can break on rare occasions, or more often contribute to swelling, excessive pain, or infection. If the device does break, surgery may be needed—never a risk-free proposition for those who have compromised immune systems during chemotherapy— but other methods may be available. One recent European study looked at 30 patients whose ports required corrections, as they had migrated or were incorrectly implanted. One patient’s port corrected itself, while doctors used radiological imaging to help reposition 27 other patients’ ports without surgery.

Though rare, the ports can also “flip” over, rupture, or fracture, leading to risk of chemotherapy leakage. “I’ve been doing these for 17 years, into the thousands,” says Kaufman, “and I’ve only seen two flips.” Fractures and infections are more common. To avoid unnerving port malfunctions, experts say it pays to be vigilant about the device’s limitations and side effects.

Keeping Ports Healthy

So the key question remains: What can you do, if you opt for a port, to minimize your risk of complications? These tricks of the trade can help with maintenance—plus help you avoid port removals:

> To prevent pain, apply prescription EMLA cream (lidocaine-prilocaine) over the port site prior to infusions. Before intravenous therapy, a sturdy needle still needs to be inserted through the skin into the port receptacle, so remember to apply it one hour before your appointment. If you forget the advance prep, ask for numbing spray, such as Hurricane, at the infusion center.

> Ask what the center’s schedule or process is for port flushing for maintenance. If you travel for weeks at a time, can a significant other be trained to perform the flush while away?

> In case of infection, antibiotics may be able to successfully treat and cure the infection without having surgery for port removal. Ask your team what experience they have with both.

> In breast cancer cases, ports are usually not added during lumpectomy or other initial breast surgery. “You wouldn’t know the staging or prognosis until after the pathology report,” says Allen Cohn, MD, medical oncologist at Rocky Mountain Cancer Centers in Denver. It may turn out, he says, that a port isn’t needed after all.

Continue the conversation on CURE’s forum. >>
Talk about this article with other patients, caregivers, and advocates in the CURE discussion group.

Related Articles

1
×

Sign In

Not a member? Sign up now!
×

Sign Up

Are you a member? Please Log In