I'm Not Doing It, The Port That Is

Just a quick update, folks. After much thought, and discussions with nurses and my husband, I have decided not to go ahead with the insertion of the Port-a-Cath on Thursday.

The key factor for me was that my current treatment is oral Tamoxifen daily and infusions of Herceptin and Pamidronate every three weeks . These drugs don't damage the veins like chemo does. So I don't really need the port now. At some point, I should expect that this treatment will fail. Eventually I will have to go back on chemo. At that point, I will need either a port or a PICC. But I will wait until then.

For those of you who are deciding whether to get a PICC or a Port-a-Cath, here are the pros and cons as I see it. Please check with Dr. Google to learn about other aspects that I didn't experience:

Note: as soon as I hit "publish" I thought of more items for the list. They are marked with a "*".

Port-a-Cath

Pros

• Protects veins from chemo.
• Once the incision heals, you can shower and swim normally.

Cons

• Both inserting and removing the port require minor surgery. Healing from the port insertion feels like you've been kicked by a mule. I was aching and taped awkwardly, which made me walk like Igor from the old horror movies.
• *The port site is exactly where your child's head cuddles you. Seat belts and bra straps will also irritate the site.
• The port may erode the skin above it. In my case, I had persistent bruising at the port site (not normal) and later an infection.
• I could feel where the wire looped up my neck. It was a little painful. Definitely icky.
• In Ottawa, an appointment with a nurse is required to use the port for a blood test. If you want to leave the Gripper needle attached between the blood test and treatment, sterile dressing is required. So much for showering normally.
• If your port isn't accessed every four weeks, you need a nurse to come to flush it.
• The incisions (there are two of them) and the port site could form keloid scars. At the suggestion of my dermatologist, my doctors injected Kenalog (a type of cortisone) at the incision site to reduce the chance of keloids forming. It worked, so far.

PICC

Pros

• Protects veins from chemo.
• Painless accessing of the PICC for blood tests and IV medication.
• Removing the PICC is easy. They slowly pull it out. I watched; it was cool.

Cons

• You walk around with a bit of tubing sticking out of your arm the whole time. This is covered with sterile dressing. It is annoying in the summer. I had a weird tan that year.
• A nurse must come weekly to change the sterile dressing and flush the PICC line.
• You can't swim.
• To shower you have to wear a plastic sleeve to keep the dressing dry. Your arm never gets a good scrubbing.
• In Ottawa, an appointment with a nurse is required to use the port for a blood test.
• If you are sensitive to adhesive, like I am, you may need to use Mepore (paper dressing) to avoid irritation. I later changed to IV3000. My skin was fine while I had the PICC, but I had some scabs form after the PICC was removed and the dressing taken off for good.

No PICC or Port

Pros

• No holes in your body.
• You can swim and shower normally.
• You can walk in for blood tests either at the hospital or a local blood lab. No appointment necessary.

Cons

• Chemo can damage your veins.
• Blood tests and treatment will require a poke in the arm. If your veins are hard to find, as mine sometimes are, maybe two pokes. You may bruise at the site of the poke.

That is all I can think of. I hope these pros and cons will be helpful to someone that's just starting out with cancer treatment. I know I will come back to the list when I have to start chemo again.

Please add a comment with your experience with PICC lines and ports.