Portacath or Hickman line?

[chinateapot]

Hello all
Just wondering if anyone has experience of the above?
My 6 year old has just had a new diagnosis of cancer and will be needing one of these in the next week or so so she can start chemotherapy. I think Portacath will probably be better for her so she can swim - but any personal experience very much appreciated.
Also thoughts on how I support my two lovely girls through this (older one is 12)
We are likely to have a good outcome but obviously it is still kind of scary

Hi,
It depends really on the treatment protocol . What are the oncology team advising?
Regarding swimming I will be honest. How intensive is her treatment going to be? How often immunosuppressed and do you really want her swimming whilst on treatment?

Portacaths don’t have the obvious line the whole time but do have to be accessed by a needle and it’s not always as easy as you think.
Hickman’s obviously always visible more difficult with baths/ showers and risk of pulling etc. but no needles to access it also can have double or even triple lines if needed.
It is difficult but talk to your team.

Both have risk of infection.
As a nurse I personally prefer using Hickman lines.
As a child with cancer ( I will whisper this) i refused point blank to have either. It became the biggest battle ever but I got through chemotherapy on peripheral. Very much not ideal. ( I was a nightmare patient)
Whatever you do, do not give your daughter any opportunity to do what I did).

Good luck, stay strong I hope it goes well for you all. Take Advice from the Paediatric oncology nurses not the Internet though, every center is a little different and they have preferences also they will know which treatment protocol and how intensive it really is. X

Hi Chinateapot

My daughter was diagnosed with cancer aged 4. We opted for a portacath. It was brilliant for us; she could go to school and get changed for PE on the days she felt well enough, without the line getting in the way, and she could wear her dancing leotard without any problem. It also never got infected. The only issues we had was with the numbing cream, and towards the end of treatment. DD became sensitised to the standard cream, so had to use a less effective cream which too longer to work, and that did mean that she disliked accessing and de-accessing her port. With the second issue, it started to become difficult to draw blood out of the port before starting the infusion because the end of the tube started getting blocked, which was a concern as it would have meant an op to clear it. Now aged 9, she has been left with a small scar under her arm.

With regards to your children, I would take full advantage of the family support teams. Candlelighters were brilliant for us, and run events for siblings as well as the patient.

Huge amounts of luck to you all xx

Oncologist today was leaning towards Portacath - but did say it was our choice.
Even if swimming doesn’t happen she does also like to completely submerge herself in the bath.
I think I need to see what she thinks too xx

Sorry to hear about the diagnosis.

My son was 8 when he was diagnosed and had a portacath. He was very resistant to having it accessed the first couple of times, but soon got used to it and barely noticed the needle after a while.

You might want to think about the treatment protocol and how frequently access will be needed. My son's only needed access once a week for chemo and/or bloods so a Hickman line would have been restrictive the rest of the time (he was still in school through most of his treatment). When he was having chemo over a couple days in hospital, they would just leave the line in for those days and take it out when we went home.

He did go swimming several times while he had the portacath, so it is possible, but will depend on how your daughter responds to and tolerates her treatment.

Have you been given a nurse specialist - ours was very helpful with this sort of decision making. Also the play therapists if they are available to you, they often have more time to support you and your child in understanding and getting used to whichever option you choose.

Good luck, and sending you strength for the journey ahead.

Very sorry to hear what you and your little girl are going through.

My son had a portacath at 3/4 years old and it was totally fine. He had 30 rounds of radiation under anaesthetic (weekdays for 6 weeks), so would have the port accessed on a monday morning, then would it removed on a Friday after treatment.

That said - a friend's little one got an infection in her port & needed it removed. Very unlucky. She is a keen swimmer - though not sure how she contracted the infection.

Thanks all
We are also looking at once weekly treatment I think with 2 inpatient nights every 3 weeks
Leaning towards Portacath and she has said she’d prefer that too