Different Ways to Receive IV Chemotherapy

Short-Term IV Catheters

If only a few chemotherapy infusions are needed, a short-term IV catheter is usually the best option. These intravenous lines consist of a needle and a short length of tubing that connects to an IV bag.

How It's Done

A nurse will insert the needle into a vein in your hand or arm, and tape it in place with the tube. When the procedure is over, the needle and catheter are removed.

This method is often used even when up to eight infusions are needed in a treatment series. It doesn;t have the risk of scarring that can occur as a result of port insertion.

Midterm IV Catheters

If you need a catheter in place for one to six weeks, a midterm catheter, such as a peripherally inserted central catheter (PICC) line, may be used. Unlike short-term IV catheters, most of the tubing will be situated inside an arm vein, with only a short length extending outside of the skin.

How It's Done

For this procedure, a doctor, nurse, or technician will insert the catheter line into your arm and secure it in place. Since PICC lines are usually placed in deeper veins, a numbing agent and local anesthetic may be used during the placement to reduce pain.

Whenever you need infusions, the nurse can access the catheter portal rather than sticking a needle into your skin with every visit. Another advantage is that PICC lines can also be used to draw blood.

PICC lines are more reliable and durable than peripheral IV lines. They allow for larger amounts of fluid to be delivered and have a lower risk of leaking.

Side effects include localized infection, clogging of the PICC line, and abnormal heartbeats if the end of the catheter is placed too close to the heart.

PICC lines are commonly used when people need to continue IV antibiotic therapy at home following discharge from the hospital.

Long-Term IV Catheters and Ports

If you will have many chemotherapy infusions, a long-term IV vascular access device (VAD) may be recommended.

How It's Done

Similar to midterm IV catheters, you'll have a length of tubing placed inside an arm or chest vein. However, this one will go almost all the way to your heart, ending at a large vein. Long-term VADs are either tunneled catheters with external injection caps or implanted vascular access devices (called ports).

Ports work well for people who have fragile veins, and they can be used to take blood samples and deliver other types of medications.

Examples of long-term IV devices include:

• Implanted VADs placed just beneath the skin by a surgeon or interventional radiologist
• Central venous catheters (CVC), which have tunneled lines with external injection caps

Ports are often placed at the time of surgery when a tumor is removed, and they can be used as soon as the day after being placed.

Some chemotherapy drugs can cause damage to veins, so the medical team will recommend a port in the chest to reduce that risk.

The advantage of a port over IV lines is that you are protecting the veins, and the port can also be used to collect blood and deliver other medications.

Disadvantages include the risk of clogging the port and infection. Infections can sometimes be serious, especially because many people have a low white blood count after chemotherapy.