Cancer treatment in children can last a long time—from a few months to over a year—depending on the type and severity of the disease. During this period, children often need intravenous (IV) medications such as chemotherapy, antibiotics, blood transfusions, and sometimes even nutrition if they’re too unwell to eat or drink. But how does all this happen? Does it mean a needle or a poke every single time? Thankfully, no.
Most oncology patients have a central line or central venous catheter (CVC), placed under their skin. This device is surgically inserted (under sedation) into a large vein above the heart, often through a vein in the neck, chest, or arm. Sounds scary, right? The idea of something being inserted so close to the heart was terrifying to me. But I still recall what the surgeon gently told me the day my son Rishaan got his central line. He said, “Don’t worry, there will come a day when I’ll remove it too, the day your child rings the bell to mark the end of treatment.” That line stayed with me. It gave me a flicker of hope when I needed it most.
A CVC is a thin, flexible tube placed into a large vein to make repeated access easier and less painful. Some catheters even have two or three tubes (called double or triple lumens), which allow multiple treatments to happen at the same time. Depending on the type, CVC may stay in place for months or years.
That said, living with a central line isn’t easy—especially for a toddler. Rishaan hated the “thing” hanging from his chest. The tubes, lumens, and caps were a constant reminder that something wasn’t normal. It was hard to explain to a young child that he must not tug at them. And bathing? That became a huge challenge. The tubes needed to be carefully covered with waterproof dressings to prevent infection, which meant some days we simply skipped the bath. It was heartbreaking to see that my little boy, who once loved his long bubble baths, wouldn’t go near water. But we tried different ways, got new bath toys, and bath bombs. I would keep the water level low and hold the tubes myself while he bathed. After a few difficult days, we eventually found a way.
Then there were the weekly dressing changes—painful, uncomfortable and scary for him. And also difficult for me to see him endure so much, I remember how helpless I often felt. But with the support of child life specialists and a promised treat, he slowly got used to it. At home, I had to learn how to care for the line, keep it clean, flush it with heparin, and change the caps. It was daunting at first. But we learned, together.
And just like the surgeon had said, Rishaan’s central line was removed after about ten months when he completed the frontline treatment. But since he wasn’t done with treatment entirely and maintenance chemotherapy still remained, a different device called a port was placed. A port is inserted under the skin, usually in the chest, just below the collarbone. It’s about the size of a quarter but thicker and you can feel a slight bump on the chest. Like CVC, a catheter runs from the port into a vein but the port doesn’t have any external tubes which makes day-to-day life a little more manageable. However, the child needs a poke through a special needle every time a medication, transfusion, or blood draw is needed. Still, ports can stay in for months and are easier to manage for weekly dressing changes are not required (if the port is not in use). It meant, for us, that bath time became simpler again and there were fewer daily reminders of illness.
Conclusion
Looking back, the central line and the port were both a medical necessity and an emotional hurdle. They simplified treatment but came with their own set of challenges. It is both surprising and heartbreaking to see how resilient kids can be—they adapt to things that seem so unnatural at first. If you’ve ever been to a pediatric oncology ward, you’ll know what I mean, you’ll find the most courageous little humans there. They truly are tiny superheroes.
And as for parents, don’t worry, amidst all the fears and tears, you will find the strength to navigate it all.
References:
https://kidshealth.org/en/parents/central-lines.html
https://www.schn.health.nsw.gov.au/bathing-and-showering-cvad-information-sheet
https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=aci2527#aci2530