Chemoport In Cancer Treatment
Chemoport is a medical device that is implanted into the patient’s body (just under the skin of the chest, most commonly), primarily for chemotherapy. It has a small chamber with a thin tube (catheter) attached to it. This tube enters the vein. The entire device is under your skin and no part of the port is outside.
You have been advised to get a Chemoport inserted for administration of your chemotherapy.
Chemoport provides a long term and safe access to one of the large veins (blood vessels).
This avoids multiple needle pricks while you are undergoing chemotherapy, which is one of the most important advantages of a Chemoport.
During chemotherapy, you need to undergo blood tests before and after chemotherapy. Occasionally you may need transfusions, antibiotics and other medicines between your chemotherapy sessions. This means average 3-5 needle pricks in each chemotherapy session.
Many people are averse to needle pricks and some are truly scared of them.
The pain of needle prick may also induce a negative feeling towards chemotherapy which is not desirable.
In the absence of a Chemoport, chemotherapy is given via one of the small veins in your arms.
In some individuals, the blood vessels are too thin to accept an IV cannula.
Multiple Chemotherapy sessions via these small blood vessels have the risk of burning these vessels. This means with each cycle there are less numbers of vessels available for chemotherapy.
There is also a risk of drug spillage outside these vessels which can cause adverse skin reactions.
Both these things leave unsightly scars on the skin.
With Chemoport, all these adverse events can be avoided.
Chemoport can also be used for
- Drawing blood samples
- Giving blood transfusions
- Giving antibiotics and other medications
So, with a Chemoport in place you will essentially avoid all needle pricks.
The Chemoport has a chamber that is connected to a catheter
This chamber is placed underneath your skin at a suitable site (usually just below your collar bone). The catheter travels the skin and goes into a large blood vessel. The chamber receives the chemotherapy drug and pushes it into the catheter and the catheter takes it to the blood stream.
To administer chemotherapy a special needle is inserted into the port chamber through which chemotherapy is given.
Some amount of discomfort may be experienced when a needle is inserted but it is definitely not painful as a routine needle prick.
The Chemoport is inserted to gain access to one of the major veins in the neck (internal jugular vein) or in the upper chest (subclavian vein). These are some of the largest veins in the body that are easily accessible and can hold port catheters for a long time, without problems.
Hence the Chemoport chamber is usually placed in the upper chest, just below the clavicle (the site may vary depending on the surgeon’s preference). And the catheter travels some distance under the skin to reach the vein in the neck or in the upper chest.
Chemoport insertion is a surgical procedure. The procedure can be done either in local anesthesia or general anesthesia.
Your neck and chest area is prepped and draped. Under ultrasound guidance one of the chosen veins are punctured and a guide wire is inserted. The position of the guide wire is confirmed on x-ray. This wire guide gives access to the vein.
A pocket is created under the skin of your upper chest (site may vary) to make space for the port chamber.
From this site the catheter end of the port is threaded to the neck or upper chest where we have inserted the guide wire. And the free end of the catheter is inserted into the vein with the help of another peelable sheath.
You can watch a surgical video of Chemoport insertion here.
Chemoport insertion is a day care procedure.
It requires 6-8 hours of in hospital stay (The duration may vary depending on the time taken for admission and discharge process).
The procedure is done under x-ray and sono guidance with close ECG monitoring to ensure safety. Hence this procedure can be considered to have minimum risk.
However, the possible risks of the procedure include
- Clot formation
- Pneumothorax (air leak into the chest)
- Hemothorax (blood seepage into the chest)
- Arrhythmias (changes in the rhythm of the heart beat)
- Infection at the site
- Blockage of the port
An x ray is taken to confirm the position of the Chemoport and keep an official documentation
It depends on your body habitus.
In a thin individual the bulge of the chamber and the catheter coursing the skin may be fairly visible, while in a person with more skin fat it may be practically not visible.
You can carry out your daily activities as before after the procedure.
However, we advise you not to do any strenuous physical activities in the first 2 weeks after the procedure.
You will have a waterproof dressing covering the wound. So you don’t need to pay any special attention to the surgical site.
Avoid direct pressure on the site (e.g. wearing a shoulder bag, sleeping on your tummy).
We advise not to bathe for the first 2 days after the procedure.
Your wound will be checked on day 2, when you will undergo a change of the dressing.
After confirming that the wound is healing well, we advise you to start bathing or sponging depending on your preference. Since we are using waterproof dressing for the second dressing as well, there is no risk of wetting the operated area.
If there are any stitches that need to be removed, it is usually done between 9-10 days after the surgery. Till that time we usually advise patients to retain the waterproof dressing.
We also advise you to avoid carrying shoulder bags which put direct pressure on the port.
Chemoport can be retained for 1-2 years or more.
We generally advise to retain the Chemoport for at least 1 year after the completion of the treatment.
Not all medical personnel can access Chemoport.
Only trained nurses and doctors should access your Chemoport.
The Chemoport needs flushing every 4-6 weeks. Flushing is necessary to keep the port patent. The port is flushed using a heparin solution and it is done by a trained professional.
Removal of Chemoport is a minor surgical procedure that takes around 15-20minutes.
It is an outpatient procedure and you do not have to get admitted for the same.
The Chemoport is removed under local anesthesia.
You will typically spend around 2-3 hours in hospital for the same.