What is a ChemoPORT?

Routes of giving chemotherapy

Is it necessary
to put in a ChemoPORT?

"A ChemoPORT is an 'Medical Appliance', which is implanted into the body by a surgery and is used to administer chemotherapy (instead of using an intra venous line on the hand)". Hmmm, sounds like a text book definition!

How is chemotherapy given?

Chemotherapy drugs are available as a 'powder'. They are dissolved in 'saline' and given through an 'intra venous line' in the veins on the hand. But once a vein is used to give chemotherapy, it becomes 'thrombosed' or 'hard' and is not possible to use again. So as chemo cycles go on, ultimately, veins become very difficult to find, and there is lot of pricking and pain for the patient. Apart from this, if a chemotherapy solution slides out of the vein, it causes a bad reaction on the hand and the skin becomes read and then black and hard, like leather. To avoid this, a chemoport is helpful.

So lets discuss a few things about this chemoport:
What is a port and when is it inserted?
What problems can come up with port?
When is the port removed?

What is a chemoport?

The Chemoport consists of two parts (Refer to the image to understand):
The chamber: This can be metallic or plastic and contains a central 'silicon' bubble. A needle can poke into this silicon. Below this silicon is an empty area which is connected with the tube.
The tube: Any thing injected in the chamber will come into this tube
By a surgery, the chamber is implanted in a pocket of skin created below the 'collar bone', and the tube is 'threaded' below the skin into the neck and passed into the major veins in the neck which carry the blood towards the heart. So, the bulge of the port is slightly visible below the collar bone. One can insert the special 'Huber' needle into the port and give intra venous solutions including chemo, through the port. To note, there are different places where a chemoport can be implanted, and each surgeon will have his own choice. By far, the most common place is below the collar bone, which is mentioned above.

When is the Chemoport surgery done?

In patient, where, from the reports and examination, we are very sure that she is going to need chemotherapy, we insist on inserting a chemoport during the main breast cancer surgery itself.
In patients, where we are not fully sure of the need for chemotherapy, or in cases where it has not been inserted, we can always do the surgery for chemoport insertion, a couple of days before starting chemotherapy. It's either a day care surgery or at most needs a full day admission.

A chemoport
X ray showing chemoport
Problems with port

Problems related to port

Chemoport, by far, is a very well tolerated appliance. We run ito problems very rarely, maybe 1 or 2 in a hundred. The two most common problems we face are:

Port infection: Chemotherapy is known to reduce the immunity. At these times, infection might settle down in the port. The patient tends to get a fever with 'chills', especially when something in injected into the port. Sometimes, antibiotics can settle this infection, but in most cases, the port will need to be removed and the tip of the tube is send for examination for infection (Culture and Antibiotic Sensitivity). In the meanwhile, the chemotherapy will have to be given by the hand.
Port block: This is indeed very rare. The port becomes blocked by a clot. The tube of the port is in the blood vessel and blood can enter it in reverse. To avoid this happening, an 'anti clotting' solution of Heparin is always injected after using the port. But in spite of these precautions, it can become blocked. In msot cases, we are able to manage that clot and re open, by using some solutions. But in some cases, it just doesn't work and we end up removing the port.
Apart from the above two problems, there are some other rare issues which can crop up. But, by far, for a vast majority, the port works very well and definitely helps to reduce issues and problems related to giving chemo through intra venous lines. We strongly urge patients, to undergo chemo through a chemoport.

So what can be done if such mild pain symptoms happen?

Chemoport Removal

Chemoport can be kept for almost 2 years or even more. The silicon of chemoport can withstand 2000 needle pricks! In any case, once the chemotherapy is over and port is no longer needed, once can plan it's removal. For patients with a higher chance of recurrence, many Oncologists prefer to keep it for six months, in which case, it should be flushed with an 'anti clotting' solution once every 6 weeks or so. For others, it can be removed once chemotherapy is over. Chemoport removal is an OPD based procedure (done under local anesthesia), and last 30 minutes and the patient can go home immediately or may be kept for a few hours observation and then sent home.

Our Approach at this Step

I strongly advise using a chemoport for chemotherapy. The benefits far outweight the risks. The quality of life becomes much better. There is no doubt, most patients, who take chemotherapy by an intra venous line, do have some or the other problems and it definitely affects quality of life. As it is, there are problems related to chemo, so a Chemoport does make life much better.

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Journey of BC: Diagnosis

1. I feel a lump! - The first visit to doctor
2. Is it really cancer? - Confirmatory tests
3. What is the stage? - Staging and fitness tests
4. Will it be surgery first? or chemo first? - Treatment planning and sequence

Journey of BC: Surgery

5. Should I conserve or remove breast? - Choice of Surgeries for breast cancer
6. How long will be the surgery? - Admission and Surgery
7. Care after surgery - Precautions and guidelines
8. What next? - The Pathology Report

Journey of BC: Further Treatment

9. How many chemo cycles? - Chemotherapy Consultation
10. Is a PORT necessary? - ChemoPORT insertion - You are presently on this page
11. Will I be normal during chemo? - The Chemotherapy time
12. Is Radiation painful? - Radiation Therapy
13. Yes!! I did it! - Treatment is over
14. How frequently do I meet doc? - Follow up guidelines

Other Topics

Risk Factors - The Risk Factors for Breast Cancer
Symptoms of Breast Cancer - Know the Symptoms of Breast Cancer
Early Detection of Breast Cancer - The Guidelines

Neo Adjuvant Chemotherapy (NACT) - For LABC
Sentinel Node Biopsy - How is it done?
Targeted Therapy - Trastuzumab
Hormone Therapy - Who gets it?