This past Thursday in preparation for the start of chemotherapy on Monday, my surgeon implanted a port-catheter (sometimes called a portacath) just under the skin right below my left collarbone. (Note: He really undersold the discomfort and pain I would feel for a few days.)
Once treatment begins my oncologist and his staff will use this port-catheter to draw blood for the complete blood count (CBC) test and to administer the chemo. From my personal perspective, the big advantage of the portacath is the repeated avoidance of IV insertion into the veins of my arms and the top of my hands. Medically, there are some more sound reasons we’ll get to shortly. Below is a picture of the actual port I received … (does it come in any other colors?)
This explanation is straight from Wikipedia and does a good job of describing the above picture, “A port consists of a reservoir compartment (the portal) that has a silicone bubble for needle insertion (the septum), with an attached plastic tube (the catheter) … The septum is made of a special self-sealing silicone rubber; it can be punctured hundreds of times before it weakens significantly.” The septum is that black circle you see in the middle of the port above. I know the whole thing actually looks like a little mouse. Well, the tail in the picture above is rigid. But basically they attach a flexible tube to it (the catheter – see picture below) which they then insert it into one of the central veins that delivers blood to your heart.
Apparently some main medical advantages of using a portacath under such a set-up is that administering medications via the port puts them directly into the large central veins instead of the smaller peripheral veins of most IVs and so the medications … in this chemotherapy … mixes more thoroughly in the blood … also diluting them so they are less harmful to your vascular system. So there are indeed some valid medical benefits beyond just avoiding the multiple needle pokes into your arms and hands …
So my clinician … or chemo nurse/technician … will access the port by inserting a special needle into the soft top … the port septum … for blood work and/or chemotherapy infusion. Later when the needle is extracted, the hope is that the silicone rubber of the septum will self-seal. This is very similar to what occurred when they took a needle biopsy from inside my lung … as they pulled the needle out, the lung immediately sealed up and healed … amazing!!!
Note: Most of the medical details above came out of the ‘Dignity Patient Guide’ I received with the port-catheter.
From what I have been able to learn, most folks go to the chemotherapy lab and have their entire injection done there with it lasting 5 -6 hours. They then on some predefined schedule return to the doctor to repeat the process. This continues for a number of months and then they redo the test that initially revealed the cancer to see if there is any reduction.
My process is going to be slightly different … I will go in the office for a 3-4 hour injection but then I will leave with come sort of pump (CADD pump possibly) that will continue to inject chemotherapy into my system for the next 48 hours. Then I will return to the doctor to have it removed. Initially we will repeat this process every two weeks for two months … then we will do some more CT scans to see what impact the chemotherapy … AND MORE IMPORTANTLY GOD … is having on the cancer. My understanding is that on average if the chemo is working the treatment runs 6-8 months … but that is simply an average.
So chemo starts on Monday for me … at this point my greatest apprehension is what side effects (if any as my encouraging wife Sheryl points out) I might encounter … and will it help slow down the cancer.
If you enjoyed some of the details and specifics of this post, you might enjoy some of the details and specifics of cancer and chemotherapy I shared earlier this week in the post ‘first insights into the cancer-chemo puzzle’.
Prayers appreciated … and watch for the updates.
Also – if anyone reading here has more insights, knowledge and experience regarding cathaports, chemotherapy and pump, please share what you know.