Chemotherapy remains one of the primary forms of cancer treatment. The chemical nature of many chemotherapy medicines necessitates administering the drugs directly into the bloodstream. Cancer care professionals use different types of tubes, or catheters, placed into a blood vessel to administer chemotherapy medications. The various types of chemotherapy catheters can remain in place for different time periods.
Peripheral Intravenous Catheter
A peripheral intravenous catheter is a short tube inserted into an arm or hand vein, providing short-term access to the bloodstream. This type of catheter generally works well for patients receiving chemotherapy once every few weeks. A nurse typically inserts the peripheral intravenous catheter when the patient arrives for treatment and removes it at the end of the chemotherapy session. A peripheral intravenous catheter can remain in place for a few days, if needed.
Midline Intravenous Catheter
A midline intravenous catheter is a 6 to 8-inch tube threaded into a vein near the elbow. The open end of the catheter rests within a vein at approximately shoulder level, explains Ohio State University Medical Center. A midline catheter can remain in place for several weeks and works well for patients receiving frequent chemotherapy or requiring intravenous fluids or transfusions. Patients with a midline intravenous catheter must avoid heavy lifting and take precautions to keep the site clean and dry.
Peripherally-Inserted Central Catheter
A peripherally-inserted central catheter, also known as a PICC line, is a longer version of a midline catheter. The end of the catheter opens into a large vein near the heart, notes the American Cancer Society. The daily care and precautions associated with a PICC line are similar to those for a midline catheter. A functioning PICC line can remain in place for several weeks to months.
Tunneled Central Catheter
A tunneled central catheter provides long-term access to the large veins of the chest, potentially remaining in place for months to years. The doctor places the catheter into the chest wall through two small skin incisions. The device is tunneled through the tissue beneath the skin surface and threaded into a large chest vein near the heart, explains the National Institutes of Health. A tunneled catheter has external tubing for delivering chemotherapy medications, drawing blood or receiving intravenous fluids or other medications. A central catheter requires daily care, and the entry site must remain clean and dry.
Implanted Venous Access Port
An implanted venous access port consists of catheter tubing and a small, round reservoir surgically placed under the skin. The catheter attached to the reservoir is threaded into a large vein during implantation, explains the Society for Vascular Surgery. The chest is the most common site for an implanted venous access port. A needle inserted through the skin into the port reservoir allows chemotherapy medication to flow into the bloodstream.
Since the device has no external parts, an implanted venous access port does not require a bandage or special site care after the implantation incision heals. An implanted venous access port can remain in place indefinitely.
References
- Ohio State University Medical Center: Midline Catheter
- American Cancer Society: What are the Different Ways to take Chemotherapy?
- National Institutes of Health Clinical Center: Managing Your Tunneled Catheter: Hickman, Neostar, Broviac, Leonard
- Vascular Web: Venous Access
- The Leukemia & Lymphoma Society: Understanding Drug Therapy and Managing Side Effects
