Cancer Realities

By Heather Millar

I have an acquaintance who’s about to start chemotherapy. Lately, she’s been obsessing about whether or not to have a port surgically implanted to make chemo easier.

A port is a semi-permanent device that doctors and nurses can hook up to deliver drugs during chemotherapy. As most cancer patients know, the vast majority of chemotherapy agents cannot be taken orally: They may be poorly absorbed by the digestive system, or stomach acids may rob them of their punch. So doctors must have access to veins, and the port makes this possible without subjecting a patient to endless needle sticks.

There are several different kinds of ports: Some are circular and placed under the skin; some are essentially long-term catheters. They’re most often implanted in an outpatient procedure using local anesthesia. Doctors site most ports near a large vein in the chest, but sometimes an arm is better. For chemotherapy that’s delivered into the abdominal cavity, the port may be placed on the belly. You can find an overview of chemo ports on WebMD and also here.

Sounds great, right?

Not to me.

I’m not a huge fan of needles and IVs, but I emphatically did not want a port when I was going through chemo. I had a completely emotional reaction to the idea. To me, getting a port was like having a nozzle installed in my body so that poison could be delivered more efficiently. I didn’t want some creepy device bulging under my skin near my collarbone that would remind me every minute that I was being treated for cancer. Of course, how could I forget that I was being treated for cancer, port or no port? But we’re talking unreasoning emotion here.

Hoping to help my acquaintance, I did some asking around: It turns out that many people who get ports, LOVE them. Fellow patients rave about how convenient they are for the nurses, how it’s one less thing to worry about during a chemo infusion, how nice it is not to deal with needles when you’re already dealing with chemo. I know one woman who still has her port three years after ending active treatment. She uses the port when she has to get follow-up scans. I know another woman who didn’t have a port when she was first diagnosed 12 years ago. Now, she’s dealing with a recurrence, has a port, and wonders why she didn’t get one the first time around.

Ports are not perfect, though. Sometimes they’re not placed properly. If that happens, they may clog or may never work properly. If a patient is overweight, they can get lost under folds of flesh. If you don’t think about where your seat belt or your bra strap hits you, the ports may get placed there, causing irritation every time you get in a car or put on your underwear. If you’re not using it, you have to go in to the clinic and have it flushed and cleaned about once a month. Sometimes they get infected anyway. When they’re removed, they leave a scar.

All that said, ports still creep me out. What about you?