Port-A-Cath Placement

What is a Port?

A Port-a-Cath (also called a port) is a device that allows easy access to veins. It can be used to administer treatments such as chemotherapy, IV fluids, or blood transfusions, as well as obtain blood draws for labs. It is implanted under the skin and is placed in a larger vein than a typical IV. This allows the port-a-cath to be used for extended periods of time. Ports are not necessary for every type of cancer treatment or every patient. Talk with your oncologist to see if you are a candidate for this procedure.

How is a Port Procedure Done?

Most implanted ports are placed in the upper chest near either the left or right collar bone. In some cases, a port may need to be placed in the arm or abdomen. The procedure is typically done under a moderate sedation; you would be aware of the process, however you would not feel or remember the procedure.

For ports located in the upper chest, two small openings or incisions will be made, one in the lower neck and the other in the upper chest. The chest incision is where the port will be placed and secured just below a thin layer of skin. The tubing (catheter) of the port is positioned into a vein that leads to the heart (either the superior vena cava, the jugular, or the subclavian). The neck incision is used to secure the tubing to the vein.

An x-ray will be done to check that the port is in the correct place before the end of the procedure. The chest port incision and the neck incision will then be closed.

What Will It Look Like?

After surgery, the port will be entirely beneath the skin. You may be able to see or feel a slight bulge where the port or tubing is located. You will see both incisions, but these should fade as you heal.

How is It Used?

Prior to the port being used, you may apply a numbing cream to the skin (typically 45-60 minutes before use). This is a prescription cream that your oncologist will need to prescribe for you. Once ready for use, the skin over and around the port will be cleaned. Your nurse will wear a mask and sterile gloves during this procedure. You may also be asked to wear a mask and/or turn your head in the opposite direction while the port is accessed or prepared for use. This is done to keep the area clean or sterile while placing the needle into the port. These steps are very important to help prevent infection in the port.

When the area is sterile and prepped, a needle will be inserted through the skin into the center port. The needle will be secured with a sterile adhesive bandage, flushed with saline, and a “blood return” check performed. This is done to make sure the port is working correctly and is ready for use. After your treatment or blood draw is finished, the needle will be removed until the port is used again.

What are the Benefits of a Port?

An implanted port allows for quick access to a large reliable vein. Some medications given during cancer treatment can cause scarring of smaller veins in the arms and can be dangerous to other areas of the body if the drug were to leak outside of the vein. Using a port for cancer treatment infusions helps reduce this risk.

Small fragile veins and veins that are hard to stick are not ideal for receiving cancer treatments. Your oncology team can perform a vein assessment and let you know if a port should be considered for your treatment. A port allows multiple blood draws and infusions with a single needle stick and less pain for the patient.

What are the Risks of a Port?

There are risks with any treatment or procedure. However, if your provider is suggesting a port, they feel the benefits outweigh the risks.

Risks that can be associated with port placement and use include:

  • Infection (most common risk)

  • Blockage to the port/catheter

  • Blood clot or air embolism in the catheter/vein

  • Damage to the port

  • Surgical complications

How Do I Take Care of My Port?

Ports require little care since they are completely under the skin. The most important thing for you to do is keep the skin around the port clean and dry. When the port is being used on a regular basis, the nurse will flush it with saline, and this maintains the tubing inside the port. If the port is not used frequently, it should be flushed every 4-6 weeks or as recommended by your provider.

When Can the Port Come Out?

After the incisions have healed, and you have received the okay from your oncologist, there is no restriction in activity with having a port. For that reason, ports are typically left in for the duration of your cancer treatment and sometimes beyond that point depending on patient preference. Ports can stay in for years before a replacement is necessary.

When Should I Call My Doctor?

  • Signs of infection such as fever, redness, warmth, or swelling

  • Bleeding or fluid at the port site

  • Swelling to the arm that is on the same side as the port

  • New onset of dizziness or shortness of breath