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Macmillan and Cancerbackup merged in 2008. Together we provide free, high quality information for people affected by cancer through our publications, website and phone service. Find out more| .
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This information is about implantable ports (sometimes called portacaths or subcutaneous ports). Implantable ports are often used to give chemotherapy| treatment and/or other medicines to both adults and children with cancer.
An implantable port is a thin, soft, plastic tube that is put into a vein in your chest or arm and has an opening (port) just under the skin. This allows medicines to be given into the vein or blood to be taken from the vein.
The tube is long, thin and hollow, and is known as a catheter. The port is a disc about 2.5–4cm (1–1½ in) in diameter. The catheter is usually inserted (tunnelled) under the skin of your chest. The tip of the catheter lies in a large vein just above your heart and the other end connects with the port which sits under the skin on your upper chest. The port will show as a small bump underneath your skin, which can be felt but is not visible on the outside of your body.
A port can be used to give you treatments such as chemotherapy|, blood transfusions| or antibiotics. Ports can also be used when it is necessary to take samples of your blood for testing. This makes it possible for you to have your treatment without the need to frequently put needles into veins in your arms.
You can go home with the port in and it can be left in place for weeks, months or, for some people, years. A port may be very useful if doctors or nurses find it difficult to get needles into your veins, or if the walls of your veins have been hardened by previous treatment. A port is more discreet than a central line| or PICC line| because it lies completely under the skin and has no external parts.
Your port will be put in at the hospital by a surgeon or a radiologist. It is usually done in the operating theatre or an area called the vascular radiology unit. It can be put in either under a general anaesthetic or a local anaesthetic.
Before your surgery you may find it helpful to discuss the position of the port on your chest with the surgeon.
You will have a small needle put into a vein in your arm or hand and you will be given medicine to help you to relax. The doctor will inject a local anaesthetic into your skin to numb a couple of small areas on your chest and neck. After this you may be aware of activity around you and may feel some pressure on your chest (or arm) during the procedure, but you should not feel any pain.
You will have one or two small incisions (cuts in your skin). If the port is put into your chest vein the incision on your upper chest will be about 3–4 cm long and is where the port is placed. There will be a smaller incision above this, which is usually less than 1–2 cm (½–1 in) long. The catheter will be put into a vein in your chest. It will then be tunnelled under the skin from the lower chest incision to the incision above. The catheter is then attached to the port, which is fitted into a space created under the skin. The incisions are then stitched. If the stitches are not dissolvable they will be removed after about 7–10 days, when the wound has healed.
If the port is put into a vein in your arm the wound will be on the inner side of your arm.
You may also have a chest x-ray to make sure the port is in the right place.
A small dressing may be used to cover the wounds for a day or so after the procedure. The nursing team will teach you how to look after this.
You may feel a bit sore and bruised for a few days after the port is put in. A mild painkiller such as paracetamol will help with this.
Immediately after the port has been put in, and for a few days afterwards, check for any redness, swelling, bleeding, bruising, pain or heat around the wounds. Let your hospital doctor know straight away if you have any of these signs as you could have an infection, which may need to be treated.
The port can be used soon after it has been put in, if necessary. When you are about to have treatment or have a blood sample taken, the skin over the port will be numbed with an anaesthetic cream which will be put on about half an hour beforehand. The skin will then be cleaned.
A special needle, known as a Huber needle, is used to push through the skin and into the port (see diagram, above). This should not be painful but you may feel a pushing sensation.
The Huber needle connects with the catheter, allowing treatment to be given directly into the bloodstream. Blood samples can also be taken in this way if needed. If you are having a short treatment, the needle will then be withdrawn. For longer treatments, a dressing will be taped over the needle to hold it in place until the end of the treatment, when it will be removed.
After each treatment a small amount of fluid is ‘flushed’ into the catheter so that it does not become blocked. The port will need to be flushed every four weeks if it is not being used regularly. The nurses at the hospital may teach you (or a friend or relative) to do this for yourself if you feel able to, or a district nurse can do it for you at home. Apart from this, your port will not need any care at all.
It is possible for an infection to develop either inside the catheter or around the port. You should tell your hospital if:
You will be given antibiotics, but occasionally, if the infection is serious, the port may have to be removed.
It is possible for a clot (thrombosis) to form in the line in which the catheter sits. If this happens, the port may have to be removed. You will also be given some medication (anti-coagulant) to dissolve the clot. Signs of a clot include swelling and tenderness or redness in the neck or the arm (on the same side of the body as the port – depending on where exactly the catheter is).
When you no longer need the implantable port it will be taken out. This is usually done by a doctor who will use a local anaesthetic to numb the area. Sometimes the port will be removed under a general anaesthetic.
The doctor will make a small incision over the site of the port and remove it. The catheter will be pulled out of the vein. The wound is then stitched and covered with a small dressing.
You may feel a bit sore and bruised after your port is removed. A mild painkiller such as paracetamol will help with this.
This section has been compiled using information from a number of reliable sources including:
For further references, please see the general bibliography|.
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