Cancer has been a disease responsible for deaths in the millions throughout our existence. For example, over 1.6 million new cancer cases were reported in 2020 in the U.S., with 602,347 reported deaths.
Over time, our capacity to tackle cancer has improved by leaps and bounds. Today, we have multiple forms of chemotherapy. Though they are not 100% successful, and scientists are still toiling away to find a cure, technology in the field has come a long way. Today, a number of ports and catheters are used to administer a slew of cancer treatments intravenously.
Apart from administering chemotherapy, catheters are also used for immunotherapy, giving IV fluids, electrolytes, and other antibiotics. They can even be used to collect blood samples.
Let’s take a look at the different types of ports and catheters, the use case scenarios for each, and the various benefits and drawbacks.
Peripheral catheters are one of the most common types of catheters, also colloquially referred to as ‘IVs’. You may have come across an IV catheter before if you have had to visit the hospital for treatment.
These catheters are connected to a vein, usually in the arm by a small needle. A nurse or healthcare provider secures the IV in place using a clear plastic dressing.
This type of catheter is best suited for short-term use. Generally functional for a few days, they are better suited for treatments with a limited duration, and will likely have to be switched out after being used for a couple of days.
Central Venous Catheters
Also known as central venous access devices (CVADs), a central venous catheter (CVC) is a type of catheter consisting of a flexible tube made of soft material. This tube is connected directly to, or near the superior vena cava, a large vein that flows into the heart.
Generally, healthcare providers will try to get the job done using an IV catheter. Due to a number of reasons, however, this is not always possible. Reasons include a patient having veins that are difficult to locate or fragile veins. Damaged veins can also be another reason.
Furthermore, if you require cancer treatment for an extended period of time, a CVC might be the catheter of choice.
A good way to understand the difference between an IV catheter and a CVC catheter is that a CVC catheter is connected to a major vein.
There are a few types of CVCs. Let’s take a look.
An implanted port is currently the cutting edge when it comes to catheter technology. Unlike IV or other types of CVC catheters, this catheter is placed under the skin (usually in the chest region).
Also unlike other forms of catheters, there are no external connections with an implanted port. Instead, every time treatment has to be administered, a needle is injected through the surface of the skin, into the catheter. Once treatments have been administered, the needle can be removed. Due to the injection port being built out of self-sealing material, injections can be repeatedly administered.
An implanted port can be used for the longest time among all the other types of catheters, and can sometimes be used for years.
As mentioned earlier, this technology is advanced. While it is harder to have the catheter ripped out, there are a few concerning drawbacks. Take the Bard Power Port lawsuit, for instance.
Bard PowerPort catheters, a type of implanted port, are built out of a material known as Chronoflex AL. Chronoflex AL is made of a mixture of polyurethane and barium sulfate. Barium Sulfate particles could break away from the Bard Powerport, increasing the risk of fracture and possible catheter migration.
A fractured catheter can cause a concerning amount of internal damage since there are pieces of the catheter wandering into your bloodstream. If the catheter were to get infected, on the other hand, it can overload our immune system which will struggle to fight pathogens from within the infected catheter.
Lawsuits in the case are currently ongoing, and TorHoerman Law points out that a motion intended to consolidate the lawsuits into multidistrict litigation (MDL) has been presented as well.
Also known as Hickman, Broviac, or Groshong catheters, this type of catheter is connected to a vein located in the chest via a small incision. A separate incision works as the exit site for the catheter, and the catheter tube that is left hanging out is stitched in place.
This method of installing a tunneled CVC is used to reduce the risk of infection, and the catheter being ripped out by mistake. A benefit of a tunneled CVC (and other CVCs) over IV catheters is that they have more than one line (usually up to 3) which allows doctors to administer more than one infusion at once.
A point to consider is that tunneled CVCs need to be thoroughly flushed before each use, and they cannot be exposed to water. However, they can be used for much longer; from a few weeks to a few months.
Peripherally Inserted Central Catheters (PICCs)
Another type of CVC catheter, a peripherally inserted central catheter (PICC) is started in the arm. A PICC line runs from the arm into the superior vena cava located near the heart. Like a tunneled CVC, a PICC also has a tube that sticks out. This tube is secured in place with a dressing being placed over the catheter.
Another similarity is that a PICC cannot get wet, and your healthcare provider will have to cover up a PICC before you go into the shower. Finally, PICCs can also be used for anywhere between a few weeks to a few months.
Generally, your healthcare provider is best equipped to decide what kind of catheter you need, as well as to install and remove it.
If you are going to need a catheter, however, it can be only beneficial to know the different types of catheters, and their subsequent pros and cons. This way, if you do not have a healthcare provider immediately available, you will know the do’s and don’ts for the catheter you have installed, and you can hold the fort down until a healthcare professional arrives on the scene.