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Surgery

Ports and catheters

Ports and catheters for cancer treatment

This page was reviewed under our medical and editorial policy by

Maurie Markman, MD, President, Medicine & Science

This page was updated on September 21, 2021.

Ports and catheters are used in a number of medical treatments. For cancer patients, they may be used during surgery, for fluid removal, to give food or administer chemotherapy medicine.

What is a catheter?

Catheters are flexible, thin tubes inserted through the skin to provide direct access to a patient’s vein. Sometimes there’s an access point taped down to the outside of the skin, and other times the catheter goes completely under the skin.

What is a port?

When a catheter is located under the skin, a port is inserted to access it. While a catheter is typically used temporarily, a port is surgically implanted under the skin and may be used for long periods of time.

How does a chemo port work?

When a patient has a port inserted for chemotherapy administration, providers are able to deliver medication through that chemo port by inserting a needle directly into the center of the port, known as the septum. The medication then flows through the catheter and into the patient’s vein.

How ports and catheters are used for cancer patients

Together, catheters and ports are helpful when a care team needs to deliver medications via intravenous (IV) access for an extended period of time (for example, for patients undergoing treatment regularly over many months). Anyone who’s had blood drawn knows that sometimes it’s painful and difficult to find the vein with a syringe. If a patient gets pricked over and over, scar tissue may form, making it trickier to get to the vein. Catheters and ports provide clean, semi-permanent access points to use for weeks, months or even years. This means fewer needle pricks. Once the patient no longer needs such a device, the care team removes it.

Types of ports and catheters

Different types of devices may be used, depending on the length of the patient's treatment, his or her ability to care for the catheter, and the treatment plan.

Peripheral IV catheter

Also known as a peripheral IV, this is commonly inserted on the back of the patient's hand by a nurse or other medical professional. An IV is for the short term, staying in for a maximum of two to three days. It’s removed upon leaving the care facility.

Peripherally inserted central catheter (PICC line)

A PICC line (pronounced “pick” line) is for more long-term use and is placed at the inner elbow, where a blood draw would typically occur. A local anesthetic—or numbing agent—may be used so the patient doesn't feel pain while a nurse or other provider inserts the catheter tube into the vein with a needle. Once the needle is removed, the tube stays in the vein. The rest of the catheter is on the outside of the body. The PICC may be left in for weeks to months.

Central venous catheter (Hickman catheter)

Similar to a PICC, a central venous catheter (CVC) provides longer-term access to blood vessels, but it’s inserted under the collarbone. “Central” means the catheter goes in a wider blood vessel much closer to the main blood supplier—the heart. A light sedation or local anesthetic is used during the insertion. The CVC may be left in for weeks to months. It’s also known as a central line or Hickman catheter.

Port-a-cath

Unlike catheters, the body of an implantable port, or port-a-cath, goes under the skin, leaving a small visible bulge that the skin grows over. A surgeon inserts this into the patient's arm or chest using conscious sedation (a light form of sedation), or a local anesthetic.

What are some benefits of catheters?

The care team may recommend a catheter because:

  • With an already established access point, the patient may avoid getting needle-pricked each time he or she has chemotherapy.
  • Multiple treatments may be administered at the same time.
  • A secure and lasting access route prevents bleeding or bruising.
  • Drugs are less likely to leak out of the vein.
  • Sometimes having a catheter allows the patient to administer treatment at home through a wearable or portable pump.

What are some benefits of ports?

A port may be a good idea because:

  • Ports are useful if the patient requires frequent treatment given over several days.
  • There’s extended access to a “good vein” for administering medications.
  • Ports allow the care team to also take blood for blood testing.
  • Double ports allow two different medications or drugs to be given at once.
  • Bathing and swimming are still possible with no extra caretaking.

What are the risks of getting a catheter or port?

As with any medical procedure, there are risks associated with getting a catheter or port.

For all catheters, it’s possible that these problems may happen during insertion:

  • Sometimes other blood vessels near the site are punctured. This may lead to additional bleeding or bruising around the site of insertion.
  • Very rarely, the catheter may be mistakenly placed in an artery (where blood flows away from the heart) instead of a vein (where blood flows to the heart). If that happens, it’s removed and placed correctly.

For central line catheters that are threaded toward the heart:

  • The lung may be punctured and deflated, a condition called a pneumothorax. Ultrasound imaging may be used to guide the tube through the blood vessels and prevent this from occurring.
  • The heart’s natural rhythm is sometimes disrupted for a moment. The heart rebounds to normal after the care team repositions the central line.

Problems that may potentially develop after insertion of a catheter or port are infections, blood clots or blockages, and movement or leakage of the catheter or port. Specifically:

  • Skin infection around the site
  • More serious infections
  • Leaking from the catheter
  • Blood clots
  • Twist in the catheter tube

How to care for ports and catheters

Ports and catheters, though accomplishing similar things, require different care. The cancer care team may guide the patient through how to take proper care of the catheter or port.

Catheter care

An IV (peripheral) catheter may be cared for by the nurse in the clinic. For central line catheters, some specialized care is required. The outside of the catheter is typically dressed with bandages to ensure that it stays in place and is comfortable. This dressing cannot get wet and should be covered when showering or bathing. The skin needs to be regularly flushed around the site of insertion to prevent infection.

The care team may explain general care for central line catheters. Typically:

  • Wash both hands before touching the catheter.
  • Don’t touch the catheter if the tip cover is off.
  • Clean skin around the catheter and change bandages when instructed.
  • Keep the clamps and/or caps tight to ensure no air gets in. Extra clamps may be provided in case they are necessary to seal off the catheter. The care team may show the patient how to properly seal his or her specific catheter type.
  • Don’t submerge the catheter in water. If the bandage gets wet, it should be replaced.
  • Be aware of the catheter so it doesn’t get cut or broken. Sometimes it helps to tape the catheter down to the skin (with skin-safe tape) to prevent pulling and tugging.

Caring for medical ports

Since the port is entirely under the skin, the site of insertion heals over. The implanted port should be flushed out about once a month when not in use, but otherwise doesn’t require any special attention. The patient may be able to bathe, shower and swim as usual. The care team may provide specific instructions, so the patient knows when he or she can return to normal activities after its placement. A special needle is used to access the port when medication delivery or a flushing procedure is needed. This feels the same as any needle going into the skin, so it may be a little uncomfortable.

The care team may provide specific instructions about how often to flush the area with fluids, when and how to change the bandage, and other recommended care for the catheter or port.

Make sure to examine the site of insertion for anything out of the ordinary. Call the care team if any of the following occur:

  • Redness, swelling, pain or bruising around the catheter port
  • Significant bleeding around the catheter port
  • Fever
  • Fluids leaking from the catheter
  • Shortness of breath or dizziness
  • Changes in heartbeat
  • The tube sliding out
  • A blockage preventing liquid to go through the catheter or port—don’t attempt to force fluid into the catheter

Catheter and port removal

Catheters are removed by a medical professional. The tube is lightly tugged on until it loosens and then carefully pulled out. Usually, this is painless, and no numbing medication is necessary.

Ports are inside of the body, so removal requires a small cut in the skin. Central catheters in the chest have a larger entry site, so they also may need more careful removal. A local anesthetic or conscious sedation may be used.

Questions to ask about ports and catheters

Below are a few questions to consider asking when discussing options with the care team:

  • What will my catheter or port be used for?
  • What type of catheter do I need, and why do you recommend this one for me?
  • Will it hurt to get the catheter or port inserted?
  • How long will the procedure take to place the catheter or port?
  • How long will I keep the catheter or port in?
  • How much will the catheter or port cost me? What will insurance cover?
  • What are the risks of this specific catheter or port?
  • Will I be able to feel or see the catheter or port after it’s put in? Will it be uncomfortable?
  • What lifestyle changes do I have to make to care for my catheter or port? Can I wear normal clothes, swim or bathe?
  • Will the catheter or port affect future scans or medical imaging, such as X-rays?
  • What are possible problems that would necessitate immediate medical attention?
  • Whom do I call if I have a problem with the catheter or port? Whom may I call if it’s after working hours?
  • How should I care for my catheter or port? How often should I replace bandages, or rinse the area?

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