Did you guys that had docetaxel get ports?

[Tua32427]

My dad is currently receiving docetaxel and I swear I'm ready to go off on the doctor. They didnt do a port or offer to. Hes had 3 veins blown and most recently an infection from a chemo burn. The nurse apparently did not put it in tight enough and the chemo meds came out on his skin and burned him badly. And is now infected. Anybody else with experiences like this or anybody know if theres a reason to not put a port in? Thanks and sorry about the rant it's hard watching a loved one go through this extra pain when they are already in so much.

[ctarleton]

I would certainly bring it to the attention of the prescribing oncologist that these mishaps with the "needle wranglers" at the infusion lab have happened. If it's just one technician who just can't seem to find and set IVs, do not hesitate to ask firmly for somebody else to do it. Most staffs usually have a "vein whisperer" whom everybody knows is the best at doing these things. It is often good to really hydrate for an hour or so before going into the IV session. Keeps the veins fuller and easier to find and "stick". Sometimes the technician can try putting a warm pad over the area to get veins to "stand up", too. And sometimes just "slapping them around a little" can help.

As with anything, the less invasive the better, as a general rule. Ports and PICC lines carry their own sets of benefits/risks profiles, too.

Hope it goes better next time.

[MontyB]

I agree with ctarleton's suggestions...especially the one to not hesitate to ask for somebody else to do it...somebody practiced, skillful, and knowledgeable with infusions. Not suggesting this, but as much as I hate sticks and especially failed sticks...big baby I am...if I couldn't be guaranteed to have a skillful tech for future sessions I would probably look for another place to administer the infusions...one which would provide a skillful tech.

I know techs need training and support that, but IMO they should not train on cancer patients.

I've been through docetaxel with no port and I was lucky to have someone who was very good with starting infusions. That's ??? terrible about the chemo getting on your dad's skin! (Shaking my head as I wrote that.)

Provenge was a different story for me as I lost one of my best veins during my first cell collection session. I had hydrated a lot to prepare for it. After that blown vein...a good skillful senior tech immediately took charge and I didn't have any more problems with the sticks.

I too hope that your dad's future sessions are better.

Take Care, Monty

[Canoehead]

The risks with installing a port are the usual risks of minor surgery, but the benefit is that you will have easy infusions after that. I think getting a port is a no brainer, and even though I don’t need mine now, I get it flushed every 2 months to keep it viable

[cesanon in reply to Canoehead]

Isn't the port removed after its use?

[wifeofvet in reply to cesanon]

no. that's the purpose of a port. it remains in until all treatments are finished. a friend of mine died from a hospital-borne infection that came with the installation of his port. my husband had no veins left and they managed to stick him each and every time. he bruised, but it healed.

[Reptale in reply to cesanon]

If you are lucky enough that the oncologist is certain you’ll never need a port again, it can be removed. Otherwise it stays in and is flushed about once a month. My flush coincides with my monthly blood draw, so it doesn’t require an extra visit.

[Godschild62 in reply to Canoehead]

Flushed every two months...protocol is at least once a, day.... At meat in Canada it is. Where are you from my friend?

[sgrama in reply to Godschild62]

Are you referring to the port in the chest that has to be flushed everyday? My husbands is only done once a month but now when he had the pics line in his arm with tubes hanging out it had to be flushed once a day but not the ports that's a big advantage of a port in the chest.

[Grumpyswife]

My brother in law had his chemo 6-7 years ago and still has the port. He gets it flushed regularly and said it’s too risky to have it removed.

BTW, he is cured and 81 years old.

[Daddysdaughter]

It was the best thing we did was ask for a port prior to any chemo. He now doesn’t have to be poked and prodded for blood draws.

[johngwilk]

I did a round of docetaxel several years ago. Though doing chemo isn't easy, the hardest part for me was having the IV inserted. I'm just coming to the end of a round of cabazitaxel. This time I insisted on having a port installed. Having the port has taken a lot of the fear and discomfort away. It was the right decision for me.

[cesanon]

What are the pros and cons of using or not using a port?

[Reptale]

I’m grateful that I had a port put in before beginning Taxotere the first time. I’m in another sequence of chemo and the port is a godsend. Between the first Taxotere 3 1/2 years ago and now, I’ve had a number of intravenous treatments in which the practitioners either could not or would not use the port, so I have a lot of experience with IVs in the arm hand and wrist. Port is far less painful and more reliable. In your shoes, I would confront your doc about this. Doesn’t seem like very caring treatment to me.

[cesanon]

How do you shower with a port?

It sounds dangerous to install, dangerous not to install, dangerous to remove, and dangerous not to remove.

[Litlerny in reply to cesanon]

You shower with a port just like you shower without it. There are no limitations other than to not get a direct blow to it. It is no more dangerous to install than any other implantable medical device, and the risk factor of implanting it and accessing it is far less that getting repeated venous pokes to draw blood and infuse chemo drugs. My wife had hers removed a few months ago. In and out of the procedure room in under 30 minutes. The actual removal procedure only took a few minutes. Spent an hour or so in post-op, then we went out and had lunch. Very few restrictions for several days, then unlimited. Very small residual scar at the port site.

Relatively speaking, the risks are pretty low.

[Ian2017]

I had what appeared to be burn from a docetaxel infusion although I don't recall anything being 'spilt' on me. A long red weal appeared about a week after an infusion. It ran from the point of infusion for about 10-12 cm across the top of my hand. It wasn't particularly uncomfortable, albeit unsightly, and disappeared mostly after 2-3 weeks. I used a generic antiseptic cream which solved the problem.

[Metungboy]

I had no port and only had one nurse who couldn't get a line in. She blamed the chemo but I had not had it in that arm before.

I said nothing because she was clearly flustered. She called a colleague who had no trouble.

They have a "2 goes only" rule per nurse.

I have had to put lines in when I was working and if you miss once the anxiety increase your chances of missing a second time.

I am glad I avoided the sepsis risk and trauma of insertion, associated with a port.

If I was having a long course of chemo or with vein wrecking chemo, I would have had a port.

Docetaxel isn't the most vein irritating so you can usually get away with out a port.

If you do you are glad not to have one.

If you don't you can't understand why you didn't get one.

Shit happens!

[Scruffybut1]

I had 8 months of chemo nil ports though many I know did.

[Godschild62]

Picc limesgo straight to the heart. They come with a lot of risks. People who get them are usually taking chemo weekly, not every three weeks, where you have time to heal. One major risk is blood clots, cancer patients are all ready high risk of blood clots, not to mention increased risk of injection. . Rule of thumb, try to do the least invasive procedure first. Any line whether it's a PICC line or an IV line, it needs to be flushed daily.

[sgrama in reply to Godschild62]

My husband had Picc line and he had chemo every 3 weeks but now he has a port in his chest for chemo this time around and he gets it also every 3 weeks.

[Godschild62 in reply to sgrama]

My husband is on his second IV chemo with the same regimen- everythree weeks. He still only receives his chemo via a fresh IV line each time he goes.

[EdBar]

Yes I had a port put in back in 2015 when I had chemo, I still have it in case I need it again. A friend of mine that I met through a support group recommended it, he had chemo prior to me and it burned the veins in his arms pretty bad after the first treatment, they then put a port in. It's a simple out patient procedure, just needs regular maintenance (flushing to prevent clots) if you leave it in. Sorry to hear about your dad, chemo is difficult enough without having to deal with that.

Ed

[Litlerny]

Saw the other posts. I can only address my personal experience. I had a chemo port installed for my docetaxel treatments at the Mayo Clinic in Jax, FL earlier this year, and it was a Godsend for me.

Using chemo ports is pretty much SOP for chemo at the Mayo unless the patient refuses it. But unless you are only going to get one or two cycles (pretty rare) I think it is worth it. it makes the process much easier. The port installation was a fairly uncomplicated procedure. Invasive? Yes, but not as much as when I had my first cardiac pacemaker installed in 1997. Risks? Yes. ALL surgical procedures have risks. Digging a sliver out of your finger is a surgical procedure that has risks.

Weigh the relative pros and cons for your individual situation.

For me, the benefits far outweighed the risks.

Having the port made the chemo infusions so much easier. No need for the phlebotomist to find and accurately place the needle each time. They just find the “target” nubs which you can see under your skin, and put the needle in the “bullseye.” It eliminates the chance for a “miss” and the resulting tissue damage and bruising. To me it was less painful than getting a new poke in a vein in your arm every time.

Also, the port is used for the blood draws that are done prior to each chemo infusion...one less painful vein stick each time, and those also are invasive and have risks.

The downside?

The need to go in monthly to have the port flushed was the only downside I have experienced. We live 140 miles (2 1/2-3 hour drive each way) to the Mayo and back. It makes it inconvenient to schedule port flushes. However, I was told by one of the ppl there that you can usually safely get by with less frequent flushing. I haven’t been able to find a reliable local source just for the flushing.

My wife Also had a chemo port put in at the Jax Mayo for chemo treatments she underwent for oral cancer two years ago. Her positive experience with it parallels mine. She recently had it removed, a 10 minute procedure under light sedation and topical xylocaine to deaden the area. Recovery was quick and complete with only very minor residual scarring.

That has been our experience. Hope it helps. Best wishes to your dad!

[Hidden]

I had a port for seven months during my six month chemo trial. It was standard in 2004, though I did know one person with a long line being treated at a another faculty.

The reason the port is used. Safer and cleaner and less chance of infection. One of the chemotherapy drugs I took was administered via 24 hour pump. There is just a too great of chance in accidentally pull the line out while sleeping.

Having both arms free and not worrying about pulling the line is much easier. And finally, why curtail those activities one might enjoy, especially if things go south. For example, fishing. No way if one has a long line with a much greater risk of infection. Same for cleaning a koi pond.

I saw a question of how to you shower with a port. No problem the port is closed. How do you shower with a long line? It can be done but with great preparation to keep the arm dry.

BTW, you commence with chemo the same day that the port is installed! I wondered how long the port would stay in. The Oncologist said as soon as I think that it is no longer needed. The port came out within 30 days. The installation and removing involves about four hours total time and it's a less than 15 minute procedure.

Gourd Dancer

[elainea53]

My husband does not have a port. He has blood taken before each chemo. The lab has a nurse put a port in a vein. They use it for labs and then the chemo and the chemo nurse takes it out. So one stick instead of two.

[Grumpyswife]

When my husband had his Provenge port we covered it with a gauze pad covered by that sticky Saran Wrap and worked great for showering.

[Chalkie42]

No issues with the port when I had 7 infusions over 21 weeks but it is no one told me to scrub my finger nails every day. i subsequently ended up with each finger nail being infected one by one as the treatment progressed. Nails do suffer but toe nails which were very ugly prior to chemo now appear much healthier - one year on. There may be some other treatment for nail infections which is available - I ended up taking antibiotics but the nails did suffer. I am OK now but after six months of Xtandi PSA is on the move again

[cesanon in reply to Chalkie42]

Chalkie42, Please explain. It doesn't make obvious sense to me that there is a relationship between the installation of a port and fingernail and toenail health?

I'm not doubting you... but I'm just not getting it.

[larry_dammit]

Sorry to hear about your dads problems, they offered me a port but I declined. After finishing chemo I am on a 30 day schedule, sounds like I am lucky as the nurses have never missed 😢😢😢

[Tua32427]

Thanks for all the responses. We talked with the doctor and from now on only the head nurse is to stick him. He has 2 more rounds left for now. His PSA is declining it went from 170 to 74. I'm still very hesitant of this info because he had an MRI of his back 2 weeks ago and while one spinal tumor shrunk, the cancer spread to many other places in his back. Has anyone had this result lower psa but cancer appears to spread? Thanks again for the responses I appreaciate any info

[j-o-h-n in reply to Tua32427]

Good, but hopefully the head nurse isn't nurse Ratchet from one flew over the cuckoo's nest. I guess a port in any storm is the favorite way to go. I usually ask the nurses to prick my ear lobe(s) so that I can get my ears pierced at the same time.

I do hope that your DAD will have better results after his 2 more rounds of chemo. God bless and

Good Luck and Good Health.

j-o-h-n Tuesday 07/17/2018 6:36 PM EDT

[cesanon in reply to Tua32427]

"Has anyone had this result lower psa but cancer appears to spread?"

That is not such a good sign. It may mean that the cancer has mutated to a more aggressive small cell type of prostate cancer.

[Tua32427 in reply to cesanon]

The only thing the doctor said was "well we still have two more rounds to go so we will see if that take cares of the spreading..." I'm very concerned because when he had the MRI done on his back he already had 4 rounds of chemo and like I said the dr said it shrank the tumor in one spot but spread in others. This mutation means it's harder to treat?

[cesanon]

I don't think you can rely on your provider personnel to self-identify who is the "vein whisperer". They all think they are. Yet some are clearly better (luckier?) than others.

And you can't rely on that person being there for you when you are there. Nor is it in their interest to bother to coordinate your scheduling with that of such person.

What has been your experience? (this question is open to everyone)

[Tua32427 in reply to cesanon]

I agree with this. The head nurse at his doctors is actually I believe ready to retire. Shes been there for years and doesnt work a full week so I guess I'll believe it when I see it that they have the head nurse stick him every time. I should mention we live in a small town and the only reason we havent gone to a big city or changed drs is the pain associated with travelling for my father. He has several tumors on the spine and is wheelchair bound. Painful for him to be in a car for very long.

[Stegosaurus37]

I had a port put in for my taxotere rounds. Made infusions a lot easier. One thing to watch for. They put it into your chest and this is something I didn't think about. Fortunately they put it into the right side. Well, I'm a left handed shooter, so that worked for me. But if they'd put it in the left side shooting a rifle or shotgun wouldn't have been possible. It's the details that get you. I've since had it taken out since I've made the decision not to go on chemo again and as a long time blood donor before I had cancer, I have no problem keeping my arm still for the 15 minutes it takes for Zometa infusions.

[eggraj8]

After the first two infusions my skin was stained with the chemo. The Dr. then said I should get the port. I have used the port for 23 more infusions and numerous blood tests and scans. Port is wonderful and makes it easier on me. The only problem is that a nurse needs to take blood while a nurse is not needed to take blood from the veins.

[Bob10]

No port here Just use IV