What To Know About Chemo Ports

A chemotherapy port (also known as a chemo port) is a small device placed under the skin that is attached to a vein in the chest to deliver chemotherapy drugs to the body. Without a port, a new intravenous (IV) needle would need to be placed each and every time you have chemo.

A chemo port differs from a peripherally inserted central catheter (also known as a PICC line), which is implanted into a vein in your arm and used for a shorter period of time.

This article explains why a chemotherapy port is needed and how the device is implanted. It also outlines the benefits and risks of a chemo port and how infection and other complications are avoided.

Nurse cleaning out chemotherapy infusion port
Mark Harmel/Photographer's Choice/Getty Images

What Are Chemo Ports Used For?

Chemotherapy involves multiple intravenous infusions of medications over time. The drugs are generally given in courses of three to six months with infusions given every two to six weeks. You may be given one course or chemo or several. In advanced cases, treatment may be ongoing.

Chemo ports spare you the pain and aggravation of getting jabbed in the arm every session. But, they are about more than just convenience. Some chemotherapy medications can only be given through a port because they are too caustic for the veins in your arm. Instead, the drug is delivered to a larger, thicker vein in the chest.

Chemotherapy can also cause veins changes, making them harder and more difficult to access with a traditional IV needle.

Cancer specialists called oncologists generally recommend a port if you will require more than four infusions. In some cases, a port may allow you to have some chemotherapy at home instead of in a hospital or clinic.

What Does a Chemo Port Look Like?

Chemo ports are about the size of a silver dollar and can be circular, oval, or triangular. The port has a raised center made of a self-sealing rubber material (called the septum) through which a needle is inserted to deliver chemotherapy and other drugs or solutions. The port itself is called a lumen.

There are two types of chemo ports:

  • Single-lumen port: This is a chemo port with one access point and one septum. It is the most common type that is circular in shape.
  • Double-lumen port: This port has two access points and two septums. They are either oval or triangular and can be used to deliver chemotherapy through one port and another drug or nutrition (called parenteral nutrition) through the other.

How Are Chemo Ports Placed?

Chemo ports are surgically placed under the skin near a large vein in the upper chest. This is usually done on an outpatient basis using a local anesthetic that numbs the skin rather than puts you to sleep. They are sometimes placed at the same time that the tumor is removed.

During the insertion, a small metal or plastic disc, called the drum or reservoir, is placed under the skin through a 1- to 2-inch incision. A tube, called a catheter, is then connected to either the internal jugular vein of the neck or the subclavian vein that runs from the shoulder to the neck.

After your port is placed, the surgeon will perform an X-ray to ensure the port is correctly connected and secured. The port will be visibly seen under the skin but is largely concealed with clothes.

Advantages of a Chemo Port

As with any surgical procedure, there are advantages and disadvantages to having a chemo port. The benefits include:

  • Increased comfort: With a chemo port, an IV needle is inserted into the reservoir through a thin rubbery membrane called the septum. You may feel initial pressure but little pain.
  • Reduced risk of extravasation: When a traditional IV is used, chemo drugs may extravasate (leak) and damage surrounding tissues. A chemo port reduces the risk since the delivery vein is large. The leakage, if any, is usually limited to the reservoir.
  • Bathing and swimming: You can usually bathe and even swim without concern about infection because the port is completely encased under the skin.

Disadvantages of a Chemo Port

Chemotherapy ports may seem like a "no-brainer," but they have their limitations and risks. They include:

  • Risk of infection: While the risk is relatively low, it can occur. Research suggests that around 2% of chemo ports need to be replaced due to an infection.
  • Risk of thrombosis: Many people with a chemo port will develop a blood clot (thrombosis) which can block the catheter. The blockage can often be unblocked with an injection of the blood-thinner heparin into the catheter. But sometimes the port will need to be replaced.
  • Mechanical problems: Mechanical problems, such as the movement of the catheter or a separation of the port from the skin, can cause a chemo port to stop working.
  • Limitation of movement: Although activities like bathing and swimming are usually OK, your oncologist may recommend avoiding strenuous exercises involving the chest until chemotherapy is completed.
  • Scarring: Some people find that having a permanent scar on their upper chest is an upsetting reminder of their cancer experience. They may also prefer not to have a scar for cosmetic reasons.
  • Surgical risks: Any surgical procedure carries risks, including the risk of bleeding. A rare complication called pneumothorax (collapsed lung) can occur if the lung is accidentally punctured. Pneumothorax has been reported in 1% of cases.
Benefits
  • Ease of use

  • Increased comfort

  • Largely invisible under clothes

  • Reduced risk of extravasation

Risks
  • Potential infection

  • Blood clots and catheter obstruction

  • Mechanical problems

  • Movement limitations

  • Scarring

  • Surgical complications

How to Sleep With a Chemo Port

In the first few days following the placement of a chemo port, you may feel pain and discomfort but this should gradually subside. The bigger issue may be your awareness of the port and concerns that you may somehow damage it if you sleep incorrectly.

While there are no sleeping positions considered "unsafe" for a chemo port, you can avoid discomfort and the unintended movement of the port by sleeping on your back. This is generally considered the optimal position as it places no pressure on the device.

If you have a hard time sleeping on your back, there are several things you can try:

  • Bolster your body on both sides with large pillows to keep you from rolling over.
  • Get supportive pillows that cradle your neck and shoulders so that you are less likely to turn over.
  • Consider switching mattresses if there are dips or sags that cause you to roll over.

If you simply cannot sleep on your back, there are a few things you can to do make yourself more comfortable while placing minimal pressure on the device:

  • Try sleeping on the shoulder opposite the chemo port. If you sleep on the same side, not only will your lower shoulder curl forward but your chin may tuck into your shoulder and onto the device.
  • Get a body pillow that you can wrap your legs and arms around. This prevents you from rolling face-down onto the mattress.
  • Placing pillows between your knees can also stop you from rolling onto your front.

Avoiding Complications

As infrequent as infections are with chemo pumps, they do occur. In severe cases, this can lead to a potentially life-threatening, whole-body infection known as septicemia.

When your port is in place, but you are not undergoing treatment, a nurse will need to flush it out every four weeks so it doesn't become blocked. Flushing the catheter with an antibiotic and heparin solution appears to significantly reduce the risk of infection.

Thrombosis is another common reason that ports are replaced. Routinely flushing a port with heparin does not seem to reduce the risk and may promote bleeding. Any minor clots that do develop can often be broken up with an injection of heparin into the catheter.

How Are Chemo Ports Removed?

A port can be left in place for weeks, months, or even years, but it is typically removed after chemotherapy treatment.

The removal of a chemo port is a relatively minor surgical procedure that often takes less than 30 minutes to perform. You will usually be given a local anesthetic before the chemo port is removed. A small incision will be made, after which the port and the catheter are removed.

The incision is then closed with sutures, surgical tape, or surgical glue, and covered with a bandage.

Summary

A chemo port is a device implanted under the skin to deliver chemo drugs to a large vein in the upper chest. The port is usually implanted as a same-day surgical procedure under local anesthesia.

A chemo port reduces the need for repeated needle sticks during chemo. The port is largely invisible under clothes and can be submerged under water while bathing or swimming. Even so, chemo ports carry a risk of infection, thrombosis (blood clots), and mechanical failure. There is also a risk of surgical complications, including bleeding and pneumothorax.

The risk of infection can be reduced by flushing the catheter prior to each chemo session. Minor blood clots can also be broken up by injecting heparin into the catheter.

8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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By Lynne Eldridge, MD
 Lynne Eldrige, MD, is a lung cancer physician, patient advocate, and award-winning author of "Avoiding Cancer One Day at a Time."