Home Medical Devices in Cancer Care

This page is for patients and caregivers looking after a medical device at home during cancer care. It covers central lines and ports, infusion pumps, drains and ostomies, and home oxygen.

A lot of cancer care has moved into people's homes. Pumps that used to hang from a pole in a hospital room now travel in a shoulder bag. Drains, ports and oxygen concentrators arrive with a handout and, if you are lucky, an unhurried nurse. Most people manage these devices well. Three things make the difference:

• Being taught properly.
• Knowing what normal looks like.
• Knowing who to call when something isn't normal.

Some people have a central line for treatment. It may be a port, a PICC line or a tunneled catheter. Ask your team which kind you have and why.

The main risk is infection, because the line is a direct path into the bloodstream. The CDC calls these central line-associated bloodstream infections. It advises patients to speak up and ask providers what they are doing to protect them. It also advises asking about the options and the pros and cons of a central line if one is needed, and touching the tubing and the place where it exits the skin as little as possible.

Practical habits that matter:

• Touch the tubing and the place where it exits the skin as little as possible.
• Ask your team what they are doing to protect you from infection. It is reasonable to ask them.
• Ask how to keep the dressing clean, dry and intact, and what to do if it lifts, gets wet or looks soiled.
• Know your flushing and dressing-change schedule, and who does it.
• Call right away, at any hour, about redness, swelling, pain, oozing, a bad smell at the site, or fever (CDC) — see cancer emergencies

Some people go home with a portable infusion pump. Ask your team to teach you how it works before you leave, including what each alarm means.

Before you go home, ask about:

• How to tell it is still running.
• What the alarms mean, and which ones you can reset yourself.
• What to do if it stops.
• Whether it can get wet.
• When and where it gets disconnected.
• What to do if the line leaks or comes apart.

If you are receiving chemotherapy, ask for the spill and body-fluid precautions in writing rather than guessing at them.

Surgical drains are usually temporary. You will be asked to empty the drain regularly, and to write down the amount of fluid, the date and the time. Keep the log even on days that feel routine, and bring it to your appointments.

Contact your surgeon if the drainage is cloudy or smells bad, if it stops suddenly after steady output, if it increases for more than 2 days in a row, if the tube comes out or the stitches come loose, or if you have signs of infection such as fever, spreading redness or pus (MedlinePlus).

Ostomies are a bigger adjustment. An ostomy is an opening made in the belly, called a stoma, that lets waste leave the body into a pouch. The most useful resource is a wound, ostomy and continence nurse, so ask for a referral if you have not been given one. A healthy stoma is pink or red, moist and a little shiny. Stool is irritating to skin, so a pouch that fits well matters. Redness, rash, raw areas or itching around the stoma are reasons to ask your team or ostomy nurse for help. With an ileostomy, very high output, ongoing diarrhea, a dry mouth or light-headedness can mean dehydration, so ask what output should prompt a call.

Call your team right away, at any hour, for:

• A stoma that turns purple, black or white, or pulls inward below the skin.
• Much less output than usual, or none at all with cramping and vomiting.

Call your team the same day for:

• A drain that suddenly stops draining or drains far more.
• Fluid that turns cloudy or smells bad.
• A wound that starts to open.

If an incision splits open, go to an emergency department. Do not drive yourself.

Oxygen is available only by prescription. If you feel more breathless, call your team before changing the flow.

The safety issues are mostly about fire. Oxygen makes things burn much faster. No one should smoke in a room where oxygen is in use, and a NO SMOKING sign helps. Keep oxygen at least 6 feet from stoves, candles, fireplaces, space heaters and electric blankets. Ask your team before using petroleum-based creams on your face or upper body. Secure the tubing so no one trips. Also ask your supplier about backup supply and what to do in a power cut.

Nobody absorbs device teaching well on discharge day. Ask for written instructions. Ask for the demonstration to be repeated with whoever will actually be doing it at home. Get the supplier's number as well as the clinic's, because equipment faults and clinical problems often go to different places.

Caring for someone with several devices is a real workload, and caregiver burnout is worth reading before you hit it. If something about a device feels wrong and you cannot say why, that is still a reason to call. Getting a nurse to look at a dressing costs very little. Waiting can cost far more.

• CDC — Central Line-associated Bloodstream Infections: Basics
• MedlinePlus — Closed suction drain with bulb
• MedlinePlus — Ileostomy: caring for your stoma
• MedlinePlus — Oxygen therapy
• CDC — Preventing infections in cancer patients: symptoms
• MedlinePlus — Oxygen safety