Port site symptoms that need an urgent call

Call 911 if you have a fever with shaking chills and feel suddenly and severely unwell, if you become confused or hard to rouse, or if you cannot get a breath. NCI is explicit that infections during cancer treatment can be life threatening and require urgent medical attention, so a rapid collapse in how you feel is an emergency, not something to sleep on.

A fever is a medical emergency while you are having chemotherapy. Ring your team at once, whatever the hour, and do not wait for morning. NCI's infection list uses a reading of 100.5 °F (38 °C) or higher; CDC's advice for people on chemotherapy uses 100.4 °F (38 °C). If your team has given you a number of their own, that is the one to use, and it may be lower again. If nobody picks up within a few minutes, get to an emergency department and tell them on arrival that you are on cancer treatment and have a port. Do not drive yourself if you feel very unwell — call 911 or have someone take you. NCI puts a fever at the top of its infection list and says these infections can be life threatening.

Call your care team the same day if the skin where your catheter enters your body becomes swollen or red. Also call the same day for chills, a cough or sore throat, diarrhoea, ear pain, headache or sinus pain, a stiff or sore neck, mouth sores, or a skin rash.

Do not take aspirin or ibuprofen to bring a temperature down before you speak to someone. NCI advises checking with your team first, because these medicines can mask a serious problem.

A port is a small device sitting under the skin, joined to a catheter that runs into a large vein. It saves your arm veins and makes treatment days shorter. It also creates a permanent doorway between the outside world and your bloodstream.

NCI's guidance on infection during cancer treatment reflects that. Among the signs it lists is swelling or redness, especially where a catheter enters your body.

The site is the one part of your treatment you can inspect yourself, every day, for free.

Give the area a proper look once a day in decent light, and take note of anything that has changed since yesterday.

• Redness that is new, or that is spreading outwards
• Swelling around or over the port
• Any discharge from the site
• Pain or tenderness that was not there before
• Skin that feels warm compared with the other side

If a dressing is in place, follow whatever your team told you about handling it. Do not peel it back to have a look unless you have been shown how.

A port infection does not always announce itself at the skin. Sometimes the first sign is a temperature and nothing else.

NCI's list of infection signs starts with a fever of 100.4 °F (38 °C) or higher, and goes on to include chills, cough or sore throat, diarrhoea, ear pain, headache or sinus pain, and a stiff or sore neck. Skin rashes, mouth sores and changes in urination are also on the list.

That list applies whether or not you have a port. Having one is a further reason to treat a temperature as an emergency and phone straight away, at any hour.

NCI's prevention advice for people having cancer treatment is short and practical.

• Wash your hands often and well, using soap and warm water
• If you have a catheter, keep the area around it clean and dry
• Stay away from people who are sick, and avoid crowds
• Follow food safety advice, including properly cooked meat, fish and eggs

Household members washing their hands matters as much as you doing it. Infection more often arrives via a shared kitchen than via anything dramatic.

Two things make an out-of-hours call go better. Know the number before you need it, and have your temperature reading ready.

Write the number somewhere you will find it at three in the morning, not just in a phone that might be charging in another room. Note the time your temperature was taken and what it was, and mention that you have a port, because that single fact changes how the person on the phone will triage you.

If you are told to come in, go. Do not wait for morning clinic to open.