What should I expect for port placement???

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KatDaz
Posts: 16
Joined: Mon Jun 18, 2018 7:54 pm

What should I expect for port placement???

Postby KatDaz » Mon Jun 18, 2018 8:14 pm

I am new here and I don’t know how to list my stats, sorry.

I was diagnosed with stage 2 colon cancer on April 5 2018 which also is the day I had surgery which removed the cancer and now I’m faced with having a port inserted this Thursday to start chemo on Monday!!! I’m very nervous as I read that people are awake for this surgical procedure and I’m really scared of that thought alone!!!

I don’t know what else to write at this point because my mind is racing to learn more on how others have gotten through the port placement. I’m trying to take one procedure at a time, I’m thinking I can get through the first chemo treatment but we will see.

Thank you in advance for putting my mind at ease or maybe not :cry:
Kathie
Via ER had CT scan on 4/4/2018 that showed mass in colon that nearly broke through
Date of diagnosis: 4/5/2018 with surgery performed this day to remove 3.2 cm tumor - stage 2A
Colonoscopy on 6/15/2018 - all clear, he asked how does normal sound!!! :D
Power Port placed on 6/21/2018
Chemo started 6/25/2018 Folfox
Started with Neulasta now given Neupogen

weisssoccermom
Posts: 5988
Joined: Thu May 10, 2007 2:32 pm
Location: Pacific NW

Re: What should I expect for port placement???

Postby weisssoccermom » Mon Jun 18, 2018 9:10 pm

Hi Kathie,
Welcome to the club. Others will certainly chime in but I will give you my take on it. Most people aren't technically put out but rather given a light sedation for the port placement. For me, I felt nothing so I truly wouldn't worry about it. On a side note, I was wide awake when they took mine out.

I do want to give you some advice, however, for figuring out the exact placement of the port. First of all, as a female, make sure that when they mark you for the port, you are wearing a bra AND you are sitting up. There is a reason for each of these. You don't want the port to be placed where your bra straps would hit so for the initial marking for placement (which they do right before the placement), INSIST/DEMAND that you be wearing your bra (obviously take it off afterwards) AND be sitting up. You want to sit up because if they decide on placement when you are laying flat, your breasts won't be in the same position as if you were sitting or standing. In some women (and this has come directly from the surgeon and/or interventional radiologist ....they also place the ports) the port was placed too low and when the woman would sit up/stand, the weight of her breasts would pull downward and made the port placement very uncomfortable. DO NOT let the doctor/nurse talk you out of having your bra on/sitting up for the marking.....it will only insure that, in the long run, you are more comfortable.

Secondly, think about which side you would prefer that the port be placed on. IF you do a lot of driving then you may want to have the port in the left hand side so that the seat belt doesn't rub against it. If you are more of a passenger, then you might want to consider having it placed on the left hand side. Your preferred sleeping habits can also play a role in which side you would prefer. I've only heard of port placements being restricted to a particular side in the case of a medical condition such as breast cancer.

I know it's not fun to be thinking about all of this but truly you will get through it and be surprised at how easy it is to have it done. Personally, I would have liked them to have waited a week or two after my placement before starting chemo. You are a little sore and don't be at all surprised if you bruise around the port and in that side's breast. I know that some people get their port placed on one day and start chemo the next and I couldn't imagine doing that. It is sensitive for a week and to have the area accessed when it is still so tender would not have been a pleasant experience.

You will do fine. Talk to your doctor about your concerns with respect to sedation, etc. and go from there. Good luck and come back and tell us how you did.
Dx 6/22/2006 IIA rectal cancer
6 wks rad/Xeloda -finished 9/06
1st attempt transanal excision 11/06
11/17/06 XELOX 1 cycle
5 months Xeloda only Dec '06 - April '07
10+ blood clots, 1 DVT 1/07
transanal excision 4/20/07 path-NO CANCER CELLS!
NED now and forever!
Perform random acts of kindness

Capri
Posts: 80
Joined: Thu Apr 19, 2018 5:59 pm

Re: What should I expect for port placement???

Postby Capri » Tue Jun 19, 2018 8:11 am

Hi KatDaz,

First, I wish you all the best for your port placement. weisssoccermom wrote some good advice.

My late husband had lung CA and his port was placed on the right side; my son's port is on the left. Both had conscious sedation for the procedure. No problems other than muscle soreness for a few days at the insertion site.

I was told radiologists tend to place ports on the right, surgeons on the left, which mirrors how my husband and son had theirs inserted. Anyway, both ports worked for chemo. My son had a port scan because it intermittently would permit blood draws--no problem putting chemo IN, sometimes a problem pulling OUT like for blood draws, flushes. Scan showed the distal end of the catheter was up against the vein. He gets blood draws from his arm, chemo via port.

Let us know how you do; I'm sure you'll be fine!
Last edited by Capri on Tue Jun 19, 2018 8:47 am, edited 1 time in total.
Mom to son 46 yo at Dx (2017)
1/18 Robotic resection, sigmoid adenocarcinoma, Stg. IIIA T3 N1 MX, mod. differentiated, margins clear
2/18 - 7/30/18 Port placed; completed 12 cycles of FOLFOX
6/18 Put on Early surveillance CT,PET scan-normal. Neuropathy has started.
11/18 Clean colonoscopy; 11/20 CT normal.
2019 to 7/22 colonoscopies, CTs neck to groin have been normal.

NHMike
Posts: 2555
Joined: Fri Jul 21, 2017 3:43 am

Re: What should I expect for port placement???

Postby NHMike » Tue Jun 19, 2018 8:11 am

Hello Kathie,

I had this done last December. The doctor asked me a bunch of questions and explained what I could and couldn't do (or suggested) with the port and how the procedure would go. They gave me something which was something like a sedative - it made me tired though I didn't fall asleep, and they gave me what I think was a powerful but local painkiller. He did the procedure and I had a ride home. It hurt moderately for about three days and then pain declined. It felt like it was all gone after a week.

Afterwards, they give you instructions on caring for it for the first either three days or a week and a number to call if you have a problem.

I was somewhat anxious but it was a much simpler and smaller surgery than the one I had to remove the tumor and I walked out on my own power.
6/17: ER rectal bleeding; Colonoscopy
7/17: 3B rectal. T3N1bM0. 5.2 4.5 4.3 cm. Lymphs: 6 x 4 mm, 8 x 6, 5 x 5
7/17-9/17: Xeloda radiation
7/5: CEA 2.7; 8/16: 1.9; 11/30: 0.6; 12/20 1.4; 1/10 1.8; 1/31 2.2; 2/28 2.6; 4/10 2.8; 5/1 2.8; 5/29 3.2; 7/13 4.5; 8/9 2.8, 2/12 1.2
MSS, KRAS G12D
10/17: 2.7 2.2 1.6 cm (-90%). Lymphs: 3 x 3 mm (-62.5%), 4 x 3 (-75%), 5 x 3 (-40%). 5.1 CM from AV
10/17: LAR, Temp Ileostomy, Path Complete Response
CapeOx (8) 12/17-6/18
7/18: Reversal, Port Removal
2/19: Clean CT

boxhill
Posts: 789
Joined: Fri Apr 06, 2018 11:40 am

Re: What should I expect for port placement???

Postby boxhill » Tue Jun 19, 2018 11:40 am

I had a port installed on the right side a couple of weeks before chemo started. Unlike the others here, I was out for the procedure, although the anesthesia was apparently on the light side so that they could use some kind of device to maintain the airway that didn't involve being intubated again, which as a singer I hoped to avoid. I had minor pain/discomfort for well over a week, and a lot of "bruising"--ie, blood drainage--into the breast on that side, which looked horrible but didn't hurt. I also had some intermittent pain in my shoulder. It's perfectly fine now, though.
F, 64 at DX CRC Stage IV
3/17/18 blockage, r hemi
11 of 25 LN,5 mesentery nodes
5mm liver met
pT3 pN2b pM1
BRAF wild, KRAS G12D
dMMR, MSI-H
5/18 FOLFOX
7/18 and 11/18 CT NED
12/18 MRI 5mm liver mass, 2 LNs in porta hepatis
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LPL
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Location: Europe

Re: What should I expect for port placement???

Postby LPL » Tue Jun 19, 2018 1:32 pm

weissockermom wrote:
Secondly, think about which side you would prefer that the port be placed on. IF you do a lot of driving then you may want to have the port in the left hand side so that the seat belt doesn't rub against it. If you are more of a passenger, then you might want to consider having it placed on the left hand side.

KatDaz, it sure depends on where you live. We live in France and hubby (who does the most driving, and on the right side of the road :wink:) has his port on the right side - for the same reason.
DH @ 65 DX 4/11/16 CC recto-sigmoid junction
Adenocarcenoma 35x15x9mm G3(biopsi) G1(surgical)
Mets 3 Liver resectable
T4aN1bM1a IVa 2/9 LN
MSS, KRAS-mut G13D
CEA & CA19-9: 5/18 2.5 78 8/17 1.4 48 2/14/17 1.8 29
4 Folfox 6/15-7/30 (b4 liver surgery) 8 after
CT: 8/8 no change 3/27/17 NED->Jan-19 mets to lung NED again Oct-19 :)
:!: Steroid induced hyperglycemia dx after 3chemo
Surgeries 2016: 3/18 Emergency colostomy
5/23 Primary+gallbl+stoma reversal+port 9/1 Liver mets
RFA 2019: Feb & Oct lung mets

KatDaz
Posts: 16
Joined: Mon Jun 18, 2018 7:54 pm

Re: What should I expect for port placement???

Postby KatDaz » Tue Jun 19, 2018 1:41 pm

Thank you for all of your comments and helpful tips. So im not a person to seek out something that is painful hence making the choice to go through with chemo and all which is a no brainer but still you get the point i hope. So the amount of pain is like a slam to the chest??? a bad deep wound ???... any thoughts on this part???

Thanks so much, i appreciate you taking the time for me, im feeling somewhat better regarding the port implant.
Via ER had CT scan on 4/4/2018 that showed mass in colon that nearly broke through
Date of diagnosis: 4/5/2018 with surgery performed this day to remove 3.2 cm tumor - stage 2A
Colonoscopy on 6/15/2018 - all clear, he asked how does normal sound!!! :D
Power Port placed on 6/21/2018
Chemo started 6/25/2018 Folfox
Started with Neulasta now given Neupogen

weisssoccermom
Posts: 5988
Joined: Thu May 10, 2007 2:32 pm
Location: Pacific NW

Re: What should I expect for port placement???

Postby weisssoccermom » Tue Jun 19, 2018 2:35 pm

Oh my goodness NO....the pain is not that bad. My breast was bruised (looked icky but didn't really hurt). Mostly you're just sore.....more like a bad bruise. Now, I'll be realistic....I was told that I wouldn't even feel it and yes, to go ahead and go on vacation the next day. Would I do that again? Absolutely NOT. I did hurt for a couple of days and honestly, the 4+ hour drive was NOT pleasant....I just couldn't get comfortable in a car. Sleeping was a tad bit uncomfortable for the first few days but it wasn't as though I had gotten hit in the chest or anything that severe. I was analogous to waking up with a stiff neck and having that uncomfortable feeling last for a few days (obviously not in your neck.....but in your chest area).

It's a few days of mild/moderate discomfort.....some tylenol helps and its nothing that honestly looks worse than it feels (IMO).

Before you rush into this and if you are this concerned, postpone the procedure and talk to your onc about taking Xeloda instead. I'm NOT saying that this is the route you should go.....only that with a stage II diagnosis (correct me if I am remembering incorrectly about your staging), you may just want to take Xeloda (oral form) and skip the oxi. Unless you have one or more negative prognostic factors, the administration of oxi for an uncomplicated stage II patient hasn't been shown to offer a significant benefit. That way, you would still get the chemo (Xeloda vs infused 5FU) but wouldn't need the port. It's something to think about. I'm NOT saying you should forgo chemo entirely but if this is an option that you want to pursue, you should talk with your onc BEFORE you get the port placed.
Dx 6/22/2006 IIA rectal cancer
6 wks rad/Xeloda -finished 9/06
1st attempt transanal excision 11/06
11/17/06 XELOX 1 cycle
5 months Xeloda only Dec '06 - April '07
10+ blood clots, 1 DVT 1/07
transanal excision 4/20/07 path-NO CANCER CELLS!
NED now and forever!
Perform random acts of kindness

weisssoccermom
Posts: 5988
Joined: Thu May 10, 2007 2:32 pm
Location: Pacific NW

Re: What should I expect for port placement???

Postby weisssoccermom » Tue Jun 19, 2018 2:40 pm

I guess I should clarify my last post.

The normal chemo protocol is one of the following:

FOLFOX (infused 5FU....go home with a pump for 48 hours + infusion at center of oxaliplatin).....necessary to have a port
XELOX (oral 'form' of infused 5FU.....still have infusion of oxi at center) possible to get oxi without the port but not recommended

Xeloda only.......pills only.....no need for port

As I stated in my prior post, the studies for stage IIA cancer patients (not necessarily stage IIB) don't show a significant benefit when adding the oxaliplatin (oxi).

You need to read your pathology report, find out if you have any negative prognostic factors and sit down and talk with your oncologist about the chemo protocol he/she is recommending. Oxi does have some serious side effects that can be long term and you need to weigh both the side effects and the benefits with respect to YOUR cancer treatment.
Dx 6/22/2006 IIA rectal cancer
6 wks rad/Xeloda -finished 9/06
1st attempt transanal excision 11/06
11/17/06 XELOX 1 cycle
5 months Xeloda only Dec '06 - April '07
10+ blood clots, 1 DVT 1/07
transanal excision 4/20/07 path-NO CANCER CELLS!
NED now and forever!
Perform random acts of kindness

NHMike
Posts: 2555
Joined: Fri Jul 21, 2017 3:43 am

Re: What should I expect for port placement???

Postby NHMike » Tue Jun 19, 2018 2:41 pm

I didn’t use any painkillers at all after surgery so that should give you some idea as to the level of pain. I’m sure that I could have gotten something fairly strong if I asked for it.
6/17: ER rectal bleeding; Colonoscopy
7/17: 3B rectal. T3N1bM0. 5.2 4.5 4.3 cm. Lymphs: 6 x 4 mm, 8 x 6, 5 x 5
7/17-9/17: Xeloda radiation
7/5: CEA 2.7; 8/16: 1.9; 11/30: 0.6; 12/20 1.4; 1/10 1.8; 1/31 2.2; 2/28 2.6; 4/10 2.8; 5/1 2.8; 5/29 3.2; 7/13 4.5; 8/9 2.8, 2/12 1.2
MSS, KRAS G12D
10/17: 2.7 2.2 1.6 cm (-90%). Lymphs: 3 x 3 mm (-62.5%), 4 x 3 (-75%), 5 x 3 (-40%). 5.1 CM from AV
10/17: LAR, Temp Ileostomy, Path Complete Response
CapeOx (8) 12/17-6/18
7/18: Reversal, Port Removal
2/19: Clean CT

margiej
Posts: 109
Joined: Sat Apr 14, 2018 8:46 am

Re: What should I expect for port placement???

Postby margiej » Tue Jun 19, 2018 3:09 pm

weisssoccermom wrote:
FOLFOX (infused 5FU....go home with a pump for 48 hours + infusion at center of oxaliplatin).....necessary to have a port
XELOX (oral 'form' of infused 5FU.....still have infusion of oxi at center) possible to get oxi without the port but not recommended

Xeloda only.......pills only.....no need for port


I did the Xelox route and and didn't have the port. I completed 6 rounds of the Oxi and was infused through the vein in my arm. It wasn't easy but we got through it and I didn't have to have a port for a year..something I was trying to avoid. I wanted to get my life back to normal as quickly as I could. I'm not going to lie...there were a few times I almost wished I had a port when the nurses were trying to get my infusion started.
Margie
Dx CC 12/2015, age 57 at Dx
Stage IIIb: T3N1b
Adenocarcinoma, sigmoid colon, 2.5 cm - low grade, moderately differentiated
3/6 positive lymph nodes
laparoscopic colectomy 1/20/2016
Capox started 3/4/16 - Six rounds
CT-suspicious lymph 2/22/16
PET scan 2/24/16 clear
CT 6/8/16 clear
Clear Colonoscopy 3/2017 and 1/2020
CT 10/3/17 clear
CT 10/17/18 clear
CT 10/17/19 clear
CEA 12/17 1.7
5/16 3.8
7/16 1.9
3/17 1.3
10/17 1.2
4/18 1.6
11/18 1.2

KatDaz
Posts: 16
Joined: Mon Jun 18, 2018 7:54 pm

Re: What should I expect for port placement???

Postby KatDaz » Tue Jun 19, 2018 3:26 pm

Thank you weisssoccermom, I am going to ask for them to knock me out as i dont want to be awake at all or feel anything and the docs seem to be ok with that as i had a colonoscopy this past Friday and i asked for it then and it was not a problem to get. I will just ask for some meds for pain and if i need them then il have them especially going into the weekend. I will take everyones kind words of support to sleep with me and get through it. I have to work on Friday the day after as well so i may need meds for that.

I have been given the names of my chemo meds and there are three: leucovorin,oxaliplatin and fluorouracil.

I will go forward with this because i dont want to regret having the option and not taking it and i get this crud again. I have four kids and i want to be around for them to get married and have grandbabies for me to love on :D

My onc is on vacation as well and its been longer than they said is recommended for starting chemo after having surgery, so to postpone id be afraid that that would be a reason that id get it back.
Via ER had CT scan on 4/4/2018 that showed mass in colon that nearly broke through
Date of diagnosis: 4/5/2018 with surgery performed this day to remove 3.2 cm tumor - stage 2A
Colonoscopy on 6/15/2018 - all clear, he asked how does normal sound!!! :D
Power Port placed on 6/21/2018
Chemo started 6/25/2018 Folfox
Started with Neulasta now given Neupogen

weisssoccermom
Posts: 5988
Joined: Thu May 10, 2007 2:32 pm
Location: Pacific NW

Re: What should I expect for port placement???

Postby weisssoccermom » Tue Jun 19, 2018 3:37 pm

The combo you are given is FOLFOX and you will need a port. You may want to ask for XELOX instead. That way, you wouldn't have a pump for 48 hours. EVERY study has shown that Xelox is just as effective as Folfox and even if you have a port, you wouldn't need the pump for 48 hours and then wouldn't need to return for pump removal.

The leucovorin is a derivative of folic acid and is used with infused 5FU to help it remain in your system longer. Without it, the infused 5FU basically runs through your body.

Honestly, you may not want to go to work on Friday. You'll be groggy from the anesthesia and you will be in some pain...
Dx 6/22/2006 IIA rectal cancer
6 wks rad/Xeloda -finished 9/06
1st attempt transanal excision 11/06
11/17/06 XELOX 1 cycle
5 months Xeloda only Dec '06 - April '07
10+ blood clots, 1 DVT 1/07
transanal excision 4/20/07 path-NO CANCER CELLS!
NED now and forever!
Perform random acts of kindness

KatDaz
Posts: 16
Joined: Mon Jun 18, 2018 7:54 pm

Re: What should I expect for port placement???

Postby KatDaz » Tue Jun 19, 2018 3:42 pm

I just dont understand all of the different meds and parts of treatmemts - this has hit me like a ton of bricks - it was a Thursday and i was told the results of a test they did on my tumor and in the next sentence told that chemo is recommended. My onc was there only the next day, Friday, and then on vacation for three weeks and she said that they like to start chemo about a month after surgery so waiting wasnt advised. It had been the length of time it was in order to get the results back from the teat they did on the tumor - 3 weeks - and just getting the couple of appointments for the different things - PET scan and blood work - and get those results back in order to get to the decidimg if treatments were even needed or not point took time. They have been great at the cancer care i just dont know what to ask and when i do ask a question it doesnt seem to answer what im tryimg to learn. I have chemo education on Thursday morning before port placement Thursday afternoon. I am a bit concerned how some have said havimg chemo right away or before a week has passed that that is painful, again the unknown drives my mind into a whirlwind!
Via ER had CT scan on 4/4/2018 that showed mass in colon that nearly broke through
Date of diagnosis: 4/5/2018 with surgery performed this day to remove 3.2 cm tumor - stage 2A
Colonoscopy on 6/15/2018 - all clear, he asked how does normal sound!!! :D
Power Port placed on 6/21/2018
Chemo started 6/25/2018 Folfox
Started with Neulasta now given Neupogen

KatDaz
Posts: 16
Joined: Mon Jun 18, 2018 7:54 pm

Re: What should I expect for port placement???

Postby KatDaz » Tue Jun 19, 2018 3:44 pm

Thank you i will ask about this on Thursday morning then as the chemo is set to begin on monday!
Via ER had CT scan on 4/4/2018 that showed mass in colon that nearly broke through
Date of diagnosis: 4/5/2018 with surgery performed this day to remove 3.2 cm tumor - stage 2A
Colonoscopy on 6/15/2018 - all clear, he asked how does normal sound!!! :D
Power Port placed on 6/21/2018
Chemo started 6/25/2018 Folfox
Started with Neulasta now given Neupogen


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