Portacath??

  1. I am an L&D nurse and not more than basically familiar with oncology. A very good friend of mine was dx with carcenoid cancer in her colon that had gone to her liver. This was last Oct. She had her colon resected 4 weeks ago and is doing wonderfully--no GI problems. Eating normally, etc. She looks good-no jaundice. She is now scheduled to have several chemo tx done to her liver to try and shrink the carcenoid to the point that they can try a resection there some time next summer. It is my understanding that carcenoid is very slow growing and time isn't as much a factor as with other cancers.

    The surgeon even told her that he doesn't like to refer to carcenoid as cancer because she is not as bad off as typical liver cancer patients and shouldn't feel it is a death sentence. This all sounds OK. She is dealing well, but is only 39 and has three young kids she would like to at least egt to adulthood. They put her on Zoloft and I encouraged her to feel good about it if it helps.

    To get to my question: they have told her that it may be best if she had a portacath put in for the liver chemo. She was asking me about it. She had some bad luck with her peripheral line during her surgical stay. After asking her more about it, it sounds like she was just uncomfortable with a k rider and the morphine didn't go in very smoothly either. Going back to what I knew from school. I told her the main drawback for portacaths was the possibility of infection. Am I correct? I think she will be having 3-4 round of chemo lasting 2-3 days each. What are your experiences with portacaths?? Do you have a high rate of infection? What are risks/benefits?

    Thanks so much for your time! It is nice to know you all are here. I applaud what you do.
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  2. 12 Comments

  3. by   RNPATL
    Certainly there are post procedureal risks of infection and also risks of infection each time the port is accessed and de-accessed. However, after the port site is healed and if proper procedure is used in accessing, the risks of infection are pretty low, at least in my experience.
  4. by   traumaRUs
    I would opt for a medi-port myself - self-contained and can be used or not used as the case may be.
  5. by   Stephanie in FL
    I'm an RN with ovarian cancer. I have had a port-a-cath since 11/2003 without any problems. My mom has had a port for 5 years with no problems.

    Stephanie
  6. by   JaneyW
    Thanks for all of the replies so far. I appreciate your help and will relay your comments to my friend!
  7. by   leslie :-D
    as with all iv catheters, infections are always a primary concern. but because of the location of the porta-cath, you are not dealing with just any iv related infection but cardiopulmonary. if the immune system stays intact and strict sterile technique is used religiously, then this type of system has many, many advantages. the only time i ever experienced a problem is when i had a pt. who was neutropenic....but i would never, ever use a peripheral line for chemo; never even heard of it. explore your options carefully and my prayers are with you.
  8. by   BernieO
    I am also an RN with a dx of ovarian ca. I have had my porta cath for 18 months.
    After post insertion healing your friend should not even feel or notice the port is there. My gyn/onc recommends that ovarian cancer patients keep their ports as long as they function. so he has had patients with ports for 10 years.

    Chemo and the many necessary blood draws are so much easier with a port.

    Cindy
  9. by   julieK
    I think that a PAC poses less risk of infection than a peripheral line. You only have to change the needle q week (depending on hospital policy) so there's less fussing with the site. Plus, you have the added advantage of not worrying about a vesicant or irritant causing tissue damage.

    -Julie in NYC
  10. by   PedsNurse1981
    I work with peds oncology so everythings on a slightly smaller scale, but I would have to think it would be the same.

    A lot of our kids have portacaths and we're anal about keeping everything sterile. From my experience, I've seen more infections in broviac catherters and PICC lines than in ports. She just needs to watch everything they do and make sure they use good technique.

    Best wishes to her!
  11. by   lisaloulou
    A PICC line would be another alternative- easy to place and easy to remove and can stay in place up to a year. The Bard Groshong PICC is saline only flush. If not in active use, can be flushed every 7 days.

    It is also an option to have an arm port placed.

    Ports in the chest have a long life usually and the majority of patients have no problems with them. They do make a low profile port which is tiny and not very noticeable.

    All in all, Id choose the PICC.
  12. by   CardioTrans
    My mother had a port for almost 4 yrs. She would have continuous chemo for 48hrs. There is no way that I would ever allow chemo to be given through a peripheral line, for any length of time. Chemo drugs are so damaging to the tissue. I have seen patients that had been given chemo through a peripheral line, the line went bad, the chemo went into the tissues, and the tissue became necrotic. HUGE mess. Once the port heals, then it is barely noticeable, and when it is accessed it is usually done with sterile procedure like a central line dressing.
  13. by   lisaloulou
    PICC= line which starts in the arm but whose tip is in the SVC= central line
    arm port= portacath placed in the arm with tip in SVC= central line
  14. by   JaneyW
    Quote from lisaloulou
    PICC= line which starts in the arm but whose tip is in the SVC= central line
    arm port= portacath placed in the arm with tip in SVC= central line

    OP here! She ended up with a PICC line which I think is a good choice for her situation. She had her first round of chemo this week and I haven't had the chance to talk to her yet. Her husband sent out an e-mail about the PICC.

    Thanks to you all for your responses!!! I really appreciate the time spent.

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