When I was diagnosed with breast cancer, I had to make a lot of quick decisions about unfamiliar things. One of these decisions was whether or not to get a port for chemotherapy treatment. Most of the women I’ve met on this journey opted for a port, but I didn’t. If you are struggling with this decision and need a different perspective, here is my take on not getting a port for chemotherapy treatment.
What is a port and why would you need one?
Chemotherapy and other medications are often administered intravenously as infusions. They can last hours and, depending on your chemotherapy regimen, you may need an infusion daily, several times a week, or every few weeks. Each time you get an infusion, a nurse will need to access your veins, and using a port is one way to do this. Another way is to use an IV line. Those are the two options I was given for receiving intravenous infusions. Here is a basic description of each method:
- IV line: A nurse uses a needle to insert a thin, plastic tube (catheter) into one of your veins. The medication is delivered through a line connected to this catheter. Using an IV line requires that a vein be found and punctured each time you get an infusion.
- Port: Also known as a port-a-cath, this is a device which is surgically implanted in your chest or arm. It consists of a small silicone drum with a catheter on one end. The catheter remains inserted into a large vein. The silicone drum, called a septum, is where the nurse inserts the needle each time you get an infusion. Blood can also be drawn from the port, and the device can be punctured 900-1,000 times before it has to be replaced. When you no longer need the port, it is removed through another minor surgery. It is difficult to visualize a port if you’ve never seen one. This is what it looks like:
Pros and cons of a port for chemotherapy treatment
There are at least two main benefits to getting a port for chemotherapy treatment. First, it will spare your veins. Initially, I didn’t understand what the nurses meant by “saving my veins.” Now I know that when you get chemotherapy your veins could be damaged through scarring and from contact with the toxic chemo drugs.
Your veins will develop scar tissue from being continuously pricked, and it will be harder for nurses to find your veins in the future. If you are getting chemotherapy, you will be pricked a lot. Not only for infusions, but also for blood work. I had my infusions every three weeks, but at times I was having blood drawn on a weekly basis. When I was hospitalized for an infection, they drew blood several times a day!
Your veins may also be damaged at the IV site by the chemo drugs. My veins began to darken with my second infusion. Slowly, the skin covering those veins began to chafe and peel. It looked like a burn at the time. Today, fifteen months after my last chemo infusion, these veins are still darkened. To see what I mean, see the pictures below.
The other benefit to getting a port is convenience. As I stated above, you will get pricked many times for infusions and blood work. Add to that all the times the nurse struggles to find a vein and has to puncture you repeatedly before succeeding. The port provides quick and easy access to your veins, so you will definitely get less needle pokes.
In my opinion, the biggest drawback of getting a port is that it requires a surgical procedure. While it is a minor, outpatient procedure, it is surgery nonetheless. It requires local anesthesia, and you will most likely be sedated during the procedure. Under a best case scenario, it takes about a week for the site to heal after surgery.
The port also carries a chance of infection, not only immediately after the implant surgery but also throughout its use. Nurses will disinfect the area before using the port, but an infection is still possible. Blood clots are also a risk with ports. To lower this risk, the port should be flushed each time it is used or at least once a month.
Another downside is that not all nurses know how to use a port. I’ve met some women who say that they have still had to use their veins for blood work if the person drawing the blood is not familiar with accessing a port. I would be disappointed to go through an additional surgical procedure for a port implant to turn around and not be able to use it whenever possible.
Finally, from an aesthetic point of view, ports are discreet but still noticeable. Aside from the scarring that will remain at the surgical site, the port itself appears as a small lump on your chest or arm.
Thoughts on not getting a port
At first, I had planned on getting a port, but then I decided to use the IV line for as long as possible. I would get a port only if my veins couldn’t hold up anymore.
Several factors influenced this decision. First, I don’t like surgical procedures, even if they are minor. Second, some information I read said that you could resume normal activity after the port site heals while other sources said that you should avoid repetitive movements like swimming, golfing, weight lifting, etc. I naively believed that I would have enough energy to continue working out throughout all of my chemo treatments, and I didn’t want the port to interfere with that. Finally, I didn’t want additional scars on my body. From my point of view, the benefits of a port did not outweigh the costs.
Luckily, most of the chemo nurses who treated me were able to find my veins effortlessly. I remember three instances when that wasn’t the case, and searching for a vein was very painful. Blood work was also painful when I was hospitalized for an infection and had blood drawn every few hours. Aside from this, having an IV line inserted for each chemo treatment wasn’t so bad. As the pictures above show, some of my veins did darken and the skin at the IV site was temporarily damaged, but none of that was painful.
In the end, I don’t regret choosing IV lines over a port. However, I haven’t met anybody with a port who has regretted getting it either. I think this is one of those decisions where you are likely to be happy no matter what you pick (barring any complications). You just need to choose whatever will suit your personality best. If you prefer convenience, then go for the port. If you want less procedures, then don’t get a port. You can always get one later if you change your mind or if it is too difficult to access your veins.
What are your thoughts on getting a port for chemotherapy treatment? Share your ideas in the comments below!