Key points
- A port or a PICC gives lasting access to a large vein, so chemotherapy, other medicines and blood tests can all go through it [1]; in a study, patients preferred them to having needles put into the veins of the arm [3].
- A port lies completely under the skin and, when not in use, usually needs flushing once a month; a PICC comes out of the arm and needs flushing and a dressing change every week [3].
- Do not put the line under water; showering with a waterproof cover is fine [2].
- A temperature of 38 °C or higher, chills, or redness and discharge around the line may be signs of infection; call straight away [1, 7].
- Swelling or pain in the arm on the side of the line may be a sign of a blood clot; tell your doctor the same day [6].
What are a port and a PICC?
Most chemotherapy is given into a vein. When treatment is long, the doctor may put in a catheter: a soft, thin tube with one end in a large vein. Chemotherapy, other medicines and blood tests can all go through it [1].
- Port: a small, round disc placed under the skin, usually in the upper chest, with a thin tube connecting it to a large vein [1]. To use it, the nurse pushes a special needle through the skin into the port [3]. If a treatment lasts several days, the needle can stay in place [1]. When there is no needle in it, nothing is outside the skin [3].
- PICC (peripherally inserted central catheter): a long, thin tube that goes in through a vein in the arm, with its tip in a large vein near the heart [2]. Part of it stays outside the arm, under a dressing [3].
In a large study, ports usually stayed in for about a year or longer and PICCs for about four months [3].
| Feature | Port | PICC |
|---|---|---|
| Where does it go? | Under the skin of the chest, with a tube leading to a large vein [1] | In through a vein in the arm, with its tip in a large vein near the heart [2] |
| Outside the skin | Nothing, when there is no needle in it [3] | Part of the tube and its cap, under a dressing [3] |
| Care when not in use | Usually flushed once a month; no permanent dressing needed [3] | Weekly flushing and regular dressing changes [3] |
| Bathing | No dressing once the wound has healed; ask when you can bathe and swim [3] | Shower with a waterproof cover; no baths or swimming pools [2] |
| Putting in and taking out | Takes more [3] | Simpler [3] |
| In studies | Fewer complications [3] | Blood clots in the arm far more often than with a port [4] |
The choice between a port and a PICC depends on how long treatment will last, the medicines and your situation, and is made with your doctor.
Daily life with a port or PICC
- 1
Clean your hands before touching it
Before touching the line or the dressing, clean your hands with soap and water or an alcohol hand rub. Ask nurses, too, to clean their hands before and after handling the line [2].
- 2
- 3
Bathing: shower yes, under water no
Do not put the line or its site under water; with a PICC, or while a needle is in your port, avoid baths and swimming pools. Showering is fine if the line and its connections are covered with a waterproof cover [2]. A port without a needle lies under the skin and has no permanent dressing [3]; ask when you can bathe and swim after the port has been put in.
- 4
Do not miss flushing appointments
The line needs regular flushing with saline so that it does not block [9]. A PICC is usually flushed and redressed every week, and a port that is not in use usually once a month [3]. In one study, flushing ports every 3 months was safe in people who had finished chemotherapy [8]. Ask about your treatment centre's schedule and write the dates in your calendar.
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- 6
Exercise and work
Ask your team about heavy exercise, lifting heavy loads with the arm that has the PICC, and sports that involve knocks to the chest or arm.
The three main problems and their signs
Infection
Blood clot
Swelling, pain or tenderness, warmth or redness of the arm on the side of the line [6]. A clot that reaches the lungs causes shortness of breath, a fast heartbeat, coughing up blood or chest pain that gets worse with a deep breath or a cough; this is an emergency [6]. Clots are seen more often with a PICC than with a port [4].
When should I contact a doctor?
Call your treatment team straight away or go to the emergency department if:
- You have a temperature of 38 °C or higher or chills; do not take fever medicines before you call [7].
- The area around the line is red, swollen or painful, or there is discharge [1, 7].
- The arm or hand on the side of the line is swollen, painful, warm or red [6].
- The dressing is wet, loose or dirty [2].
Call your local emergency number if you suddenly have shortness of breath, chest pain, a fast heartbeat or cough up blood [6].
Frequently asked questions
Is a port or a PICC better?
Both are used for long courses of chemotherapy. In a large study of people having chemotherapy, ports had fewer complications than PICCs [3], and in another study blood clots in the arm were far more common with a PICC [4]. The international guideline on treating blood clots in cancer also prefers a port to a PICC [5]. On the other hand, a PICC is simpler to put in and take out [3]. Make the choice with your doctor.
Can I bathe or swim with a port?
How often does a port need flushing?
If a clot forms, will the line be taken out?
Not always. A blood thinner is given for at least 3 months and for as long as the line is in place. If the line works, is in the right position and is not infected, it can stay in under your doctor's supervision [5].
Do I need a blood thinner to prevent clots?
Is the line flushed with heparin or with saline?
Related pages
Central venous catheter care (for doctors)
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- CDC 2011 (prevention of catheter-related infection): hand hygiene before and after palpating, accessing, repairing or dressing a catheter; skin preparation with more than 0.5% chlorhexidine in alcohol at central line insertion and dressing changes (IA); transparent dressings on short-term central lines changed at least every 7 days and gauze dressings every 2 days; transparent dressings on tunnelled or implanted catheters no more than once a week until the site has healed (unless soiled or loose); replace damp, loosened or soiled dressings (IB); no topical antibiotic ointment or cream on insertion sites, except dialysis catheters (IB); do not submerge the catheter, showering allowed with an impermeable cover (IB); scrub the access port with an antiseptic before each use (IA); no routine systemic antibiotic prophylaxis (IB); promptly remove any catheter that is no longer essential (IA) [2].
- ASCO 2013: routine flushing with saline; prophylactic warfarin or LMWH not recommended; t-PA to restore patency of occluded catheters; most infections can be treated with the catheter in place, but some life-threatening infections require immediate removal; cultures before antibiotics; remove the catheter when no longer needed or if a radiologically confirmed thrombosis worsens despite anticoagulation [9].
- Heparin or saline (Cochrane 2022): 12 trials with 2422 participants; occlusion may be less frequent with heparin but this is uncertain (RR 0.70; 95% CI 0.51 to 0.95; low-certainty evidence); no clear difference in duration of patency, bloodstream infection, haemorrhage or mortality [10].
- Port flushing interval: in a phase 2 trial of 87 patients after completion of chemotherapy, flushing every 3 months: 10 port-related complications (11.49%; 95% CI 4.85 to 18.14%), with no infection or symptomatic thrombosis and no port failure while on protocol [8].
- CAVA (Lancet 2021; 1061 patients on systemic anticancer therapy for 12 weeks or longer): complication rate port vs PICC 32% vs 47% (OR 0.52; 0.33 to 0.83); port vs Hickman 29% vs 43% (OR 0.54; 0.37 to 0.77); PICC vs Hickman 52% vs 49% (non-inferiority not confirmed) [3].
- PICCPORT (399 patients with solid tumours): catheter-related deep vein thrombosis 8% with PICC vs 1% with port (HR 10.2; 95% CI 2.3 to 44.6); composite adverse events also more frequent with PICC (HR 2.7) [4].
- ITAC 2022: anticoagulation is not recommended for routine prophylaxis of catheter-related thrombosis (grade 1A); insert catheters on the right side, in the jugular vein, with the tip at the junction of the superior vena cava and right atrium (1B); implanted ports are suggested over PICCs (guidance). Treat symptomatic catheter-related thrombosis for at least 3 months and as long as the catheter is in place, with LMWH suggested; a functional, well-positioned, non-infected catheter can stay in place with good resolution of symptoms under close surveillance [5]. Details: Venous thromboembolism in cancer.
References
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Numbers in the text, such as [1], refer to these sources. Sources with a “Study card” button are summarised in the site’s evidence library.
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This page is based on reputable scientific sources and was last updated on 28 October 2026. The content of this website is for educational and informational purposes only and does not replace consultation, diagnosis or treatment by a specialist physician. Consult your treating physician about any treatment decision.
Printed from the website; the full and up-to-date version: https://drdabiri.com/en/guides/port-and-picc-care/