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Irritant drug can lead to short-lived and limited irritation to the vein. Examples of Irritant chemotherapy drugs: |
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Vesicant drug - can lead to extravasation (infiltration of drug into tissue) |
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IV (intravenous) chemotherapy is administered by a healthcare professional directly into blood. It can be administered through a vein (a temporary IV), or into a vein through a fixed port. "Sometimes the chemotherapy needs to be given through an IV placed Factors which determine the preferred access type - temporary or fixed port:
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A temporary IV (or peripheral IV)
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Irritation to the vein |
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extravasation (infiltration of drug into tissue) leading to chemical cellulitis: See Injection Site Reactions above. |
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Access to veins (easily to locate and in good condition?) |
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Edema (swelling) of extremities |
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Sensations in extremities, such as numbness |
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History of:
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Access port - also called central venous catheters:
A fixed port allows your health care providers to give medications and fluids on a frequent basis.
"When chemotherapy needs to be given regularly over a period of time - several weeks or months, you may be given a special IV called a central venous catheter a thin tube that is inserted into a large vein with access to your central blood supply.
An implanted access port might be required when a temporary access cannot be done safely or easily as described above, or when receiving irritant or vesicant drugs (described above)
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Tunneled Central Venous Catheter (TCVC) |
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Peripherally inserted central catheter (PICC line)" |
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Midline catheter ((Per-Q-Cath Midline, Groshong Midline) |
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Implantable Venous Access Port |
Adapted from: http://www.cancer.org
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Infection may occur, at or below the insertion point of the line |
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Clots can form in the catheter |
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The catheter might leak or break |
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hypersensitivity reactions |
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phlebitis (inflammation of veins) |
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You cannot flush the catheter |
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You experience itching, rash, hives, wheezing, trouble breathing, or chest pain |
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Temperature of 101.0°F or higher |
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Redness, pain, or swelling at or near the catheter site |
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Drainage from the skin around the catheter |
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The catheter comes out or breaks |
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NYT:
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About Ports: radiologyinfo.org | emedicinehealth.com |
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Essentials: Complications of peripheral I.V. therapy http://www.nursingcenter.com/library/JournalArticle.asp?Article_ID=765665 PDF |
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Central Venous Catheters wikipedia.org |
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IV and Injection site reactions chemocare.com |
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Oral Chemotherapy - What do you need to know cancer.org |
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What Are the Different Ways To Take Chemotherapy? Cancer.gov |
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PICC lines wikipedia.org/ |
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Port Guidelines BCCancer.bc.ca | ACS |
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Preventing and managing peripheral extravasation (infiltration of drug into tissue) findarticles.com |
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PAL: Tips for Subcutaneous Injections |
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PAL: Tips for Blood Draws and IVs |
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PAL: Tips for Treatment Support: About Treatment |
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PAL: What's a Drug? |
I'll be starting chemo pretty soon, so I'm trying to figure out whether to have a port installed. I'm interested in hearing the pro's/con's from people who have been through this.
Dan
I have a port and I wouldn't do it any other way. Of course my veins are hard to access so a port was the only option. It goes in your upper chest and after the initial surgery and recovery I've had no trouble with it. I've had mine since October of 2008. If you are not getting chemotherapy you have to have it flushed once a month but that takes only about a half hour. You do that so that it doesn't clog up. Mine is plastic. As I said I haven't had any trouble with it.
Good luck, Joyce
I think it's a call based on your body. The younger you are and the better shape you're in enable the person administering the drug to find a vein. I donated many pints of blood, and was an aphaeresis donor, so I knew nobody ever had problems finding a vein to poke. I never got a port, but did get a central line catheter for my stem cell transplant chemo. The port, as I understand, is implanted under the skin, so it's really easy for someone to stick a needle into it, and it doesn't require all the cleaning that a catheter does. I guess the drawback is whether you can see and feel them (I think so) and it's another surgery.
Mark
It depends on the chemo you have. I had CVP, mostly in pill form. The Vincristine was administered by IV on the first day of treatment each three weeks - took about twenty minutes. This was before Rituxan and maybe a port is necessary for that tho I have heard others on this list say they had oral chemo also. It was a breeze.Sally
Dan, I went 8 rounds CVP without a port. It really depends how good your veins are. At your age they are probably okay. Every three weeks we alternated arms. A port comes with a lot of maintenance. It must be continually cleaned to keep from infection. Ned
Hello Dan,
I did 6 weeks of Rituxan IV in 2005, and just finished 4 weeks of a clinical trial of a newer "humanized" version of Rituxan. Each infusion took approx. 5-6 hours. Never had a port. Hope this helps some. ps: this is a journey, keep your chin up, ask questions, get multiple opinions from qualified hematologist oncologist, and do basic research. In the end, it is still your decision what to do. No one knows your body better than yourself. "Keep The Faith"....post as often as you need, we are all here to help, or
at the very least , support,.....God Bless, Roger
I have had a port since September 2008 also due to poor vein access. I have had no problem with it. I am about to begin Rituxan maintenance for 2 years and wonder if anyone has info on keeping the port in for another 2 years. I know I will have to have the port flushed every 4 to 6 weeks when not receiving the Rituxan, but I am a little worried about effects of having the double port in for so long. Any thoughts or experience with this?Thanks, Nadine
Dan, I have a Power Port, which I was told allows them to infuse the chemo drugs faster than they would through an IV. Accessing the port is still a poke, so it's no less pain. I didn't like the idea of having something implanted into my body initially, but as chemo weakened me, I decided that the port was a reliable way to access veins that might be hard to find if one was sick. Now that my chemo is done, the port doesn't bother me much at all. I have it flushed every 2-3 months when I see the doctor anyway. If I had it to do over again, I would still get the port.
JonniAnna, you will get better as you become active again and work out. I did, and I definitely improved, but I never got back to the level I had before. Of course, each year takes its toll regardless of whether we're taking chemo or whatever, so I can't say how much I lost. I can say the adria messed up my heart slightly, so besides having the damage from the Cytoxan (scarring my vessels), my heart is slightly impaired too. I was also at least a dozen pounds heavier when I completed my ten rounds of chemo, but I lost some before and after my stem cell transplant. I've always been on the thin-side, so having extra pounds may have contributed to my huffing and puffing. But now I'm back below my weight of twenty three years ago, and I'm still not in what I call good shape. Still, life is good. My lumbar discs are the focus of my attention right now, as my lover back has been much more troublesome than my nhl recently. Nice to be able to write that.
MarkMore on WebMagic: Port or No Port?