Ports and Other IV Catheters

Ports and other IV catheters are used to give treatment, including chemotherapy, through a vein in your body. Which one you have will depend on how long you need to get treatment. 

A port (common brands include Port-a-Cath and PowerPort) can seem intimidating to some people because it’s placed underneath the skin. But when you’re going through cancer treatments, it can actually save you from a lot of discomfort and extra needle pokes. 

If you and your doctor decide that you should get a port for treatment, you’ll need to have a short surgery to insert the port under your skin. The port is usually placed just below the collarbone on either the left or right, based on your preference, but usually opposite the side of the breast cancer. Some ports can be placed in the arm, but this is done less often. The port connects directly into a vein, so that your healthcare team can draw blood or give you IV (intravenous) medications or fluids.  

For example, if you go in for monthly chemotherapy treatment, a healthcare provider will insert a needle through the skin and into the port’s access point. The center of the port, called the septum, is made of rubber and lets the needle through — nothing else can get in. This is how medications and other fluids can flow into the big veins that lead to your heart. 

IV catheters usually fall into two categories: peripheral IVs and central lines (also called central venous catheters). A port is a type of central line. 

These are the ones you’re probably the most familiar with if you’ve ever been in the hospital for a surgery, labor and delivery, or have needed IV fluids or a blood transfusion. 

Peripheral IVs are most often placed in the arm or hand and are used for a few days before they need to be replaced. 

A port is one type of central line. Other types include PICCs (peripherally inserted central catheters) and tunneled catheters (also called Hickman catheters).

Unlike peripheral IVs, which go into smaller veins of your hand or arm, central lines can go directly into the big veins leading to your heart. Central lines allow for longer use and can handle medications that would be too damaging for the smaller veins in your arms or hands. Ports differ from the other central lines, because the entire device sits under the skin. 

“Anyone who will need treatment with IV medications or frequent lab draws lasting more than a couple months could consider getting a port, as this will be more likely to last throughout their whole treatment course,” says Anne Peled, MD, a breast cancer surgeon and co-director of the Breast Care Center of Excellence at Sutter Health California Pacific Medical Center. “While ports can be safely left in place for years, IVs and PICCs are limited to days or weeks.” 

Ports also need less care than other IV catheters since any outside tubing and needles are removed once your infusion is over. With PICCs and other IVs, you have to make sure they’re kept covered and the dressing stays dry. 

Once a port is placed, you can only see a bump under your skin where it sits.  

Getting a port placed is done as an outpatient or same-day surgery procedure. “Some patients receive [their] port and chemotherapy the same day,” says Aditya Bardia, MD, director of translational research integration at the UCLA Health Jonsson Comprehensive Cancer Center.

Most people get “twilight” sedation when having this surgery. This means you’re asleep for the procedure with medications given through an IV that relax you, but you’re breathing on your own, explains Dr. Peled. “Usually for twilight sedation, people are unaware of what’s happening and usually don’t remember any of it once they’ve gotten sedation.” Once the medications are stopped, you wake up quickly. 

During surgery, the doctor makes a small incision about an inch long on your chest that makes a pocket for the port to sit in and prevent it from moving. A second, even smaller cut under your collarbone helps the surgeon place the catheter into the vein. The entire process lasts less than an hour. 

You might have some soreness after your surgery that should only last a day or two. Afterward, your port shouldn’t hurt, and if it does, let your doctor know. 

Some of the things that can happen when you have an implanted port include:

• Sponsor Message

  blood clots form in the vein where the catheter sits

• Sponsor Message

  the catheter moves, or migrates, from its original place

• Sponsor Message

  the port becomes blocked

• Sponsor Message

  the port site can get infected

The most common reason a port is removed before a person is done with treatment is when there’s reason to believe the area may be infected. Signs you may have an infection include pain, swelling, and redness over the port site. 

Because the port is under your skin, you don’t have to care for it as often as an IV or a PICC, explains Dr. Bardia. However, he cautions that people with ports take it easy when exercising. Heavy lifting or strenuous exercise could cause the port to shift. This is especially important after you get your port, but also for the next few months, says Dr. Bardia.  

If you’re a swimmer, ask your provider how long you need to wait before hitting the water again. Dr. Peled says usually you should wait 3 to 4 weeks so the site can heal completely.

You don’t need to sleep any certain way with a port, but sleeping on your back puts the least amount of pressure on the port area. Sleeping on the opposite side where your port is can also help. 

If you have questions about anything after your port placement, contact your care team. It’s better to address any concerns before they become more serious. 

Your provider or surgeon will remove your port when it’s no longer needed. You’ll get a numbing medication to make you more comfortable. Ports are typically removed under twilight anesthesia (the same medication you had when you had the port placed). This is both for your comfort and to make sure you stay still during the removal, explains Dr. Peled. 

Then the provider makes a small cut in the skin. The whole port is taken out and the skin is stitched closed. Removal of the port takes less time than the initial placement.