Medical Oncologist
The infusion day
Getting the cannula or port accessed
A small needle into a vein in the hand or forearm — a short sharp scratch and then it is done. With a port, a needle goes through the skin into the port instead, which most people find easier. For most people this is the only uncomfortable part of the whole day, and the anticipation is usually worse than the moment.
NG
Medically reviewed by Dr. Naresh GunduConsultant Medical Oncologist · MBBS, DNB (Internal Medicine), DM (Medical Oncology, AIIMS) · last reviewed September 2026, next review due September 2027
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The short answer
What happens when the line goes in?
A small needle into a vein in the back of the hand or the forearm, held in place with tape. It is a short sharp scratch and then it is done. If you have a port, a needle goes through the skin into the port instead, which most people find easier than a cannula.
For most people this is the only uncomfortable part of the whole day. Knowing that in advance helps, because the anticipation is usually worse than the moment itself.
Veins get harder as treatment goes on
This is worth saying plainly. Repeated cannulas and the drugs themselves make veins tougher to find and use, so the part that was easy in cycle one can become the worst part of cycle six. It is expected rather than a sign anything has gone wrong.
Drink well the day before and that morning. Hydrated veins are markedly easier to find, and it is the one thing you control.Making it easier
What genuinely helps
Most of what makes this go well happens before the needle comes out — hydration, warmth and telling the nurse what you know about your own veins.
Warmth opens veins
Cold hands are the commonest avoidable problem, and day-care units are air conditioned. Keep your hands warm on the way in, ask for a warm pack or warm water to soak the hand, and let your arm hang down for a minute before they start.
Tell them what you already know
Which arm works, which vein has been used successfully before, which side to avoid entirely. You know your own arms better than anyone meeting you for the first time, and nurses are glad to be told rather than left to hunt.
Say if you are frightened of needles
It is common and nobody will think less of you. Say it before they start rather than after. Looking away, a numbing cream applied in advance, someone to talk to, or simply slowing down all help, and none of them can be offered if nobody knows.
Ask for someone more experienced
After two attempts, it is entirely reasonable to ask whether a senior nurse or a different person can try. Units expect this, it is not rude, and it usually works. Nobody benefits from a fourth attempt by the same pair of hands.
Which arm is off limits matters. If you have had lymph nodes removed or radiotherapy on one side, say so every single time.Not sure whether this applies to you?
Ask an oncologist
!
Tell the nurse immediately during the infusion
Pain, burning or stinging at the drip site · swelling, puffiness or tightness around it · redness or the skin feeling cool there · the drip slowing or stopping · fluid leaking around the needle. Press the call bell straight away rather than waiting for someone to pass. Some chemotherapy drugs cause real damage if they leak into the tissue around the vein, and the whole point of catching it early is that early is entirely manageable.
Side by side
Cannula and port, compared
Cannula in the hand or arm
Port under the skin of the chest
Put in fresh each cycle, removed before you leave
Stays in place for the whole course
Nothing to look after between cycles
Needs flushing and care between cycles
Gets harder as veins toughen over a course
Access stays straightforward throughout
No procedure and no extra cost to place
A short procedure to insert, with a cost
Some drugs are unsuitable for a small vein
Suits drugs that are harsh on veins
Risk of the drug leaking into tissue
Lower leak risk; small risk of infection or clot
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If you have a port
What accessing it is like
The skin over the port is cleaned, and a special needle is pushed through into the chamber underneath. It is a firm press rather than a scratch, and most people who have had both say it is easier than a cannula. The needle is taped down and stays for the session.
Numbing cream, if you want it
A cream applied over the port some time before you arrive takes the edge off considerably. Ask your team about it — it has to go on well before the appointment, so it is something to arrange at the previous visit rather than on the day.
Say if it hurts more than usual
Accessing a port should not be painful beyond the initial press. Pain, difficulty getting blood back, swelling, or the nurse struggling to flush it are all worth reporting, because a port can become blocked or displaced.
Watch the site afterwards
Redness, swelling, warmth, pain or any discharge around a port is reported the same day, not at the next cycle. Infection in a port is serious precisely because it sits directly in a large vein.
Never let anyone access your port who is not trained for it, and keep the port card or details with your file.Being straight with you
What this page cannot tell you
It cannot tell you whether you should have a port. That depends on which drugs you are having, how long the course is, what your veins are like and what it would cost you. It is a genuine conversation to have with your oncologist rather than a decision to reach from a page.
It also cannot tell you how your own veins will hold up. Some people complete a long course on cannulas without difficulty and others struggle by the third cycle. If it is becoming a problem, say so — that is the trigger for the port conversation.
What to do next
Drink well the day before and keep your hands warm on the way in. Tell the nurse which arm works and which is off limits. Say if you are frightened of needles. Ask for someone more experienced after two attempts. And report any pain or swelling at the site immediately.
Questions we are asked
Common questions about getting the line in
What if they cannot find a vein?
It is common, especially later in a course. Warm the hand, let the arm hang down, and drink well beforehand. After two attempts it is entirely reasonable to ask for a more experienced nurse. If it keeps happening, raise whether a port would be better for you.
Does it hurt?
A short sharp scratch for a cannula, a firm press for a port. For most people it is the only uncomfortable moment of the day. What should not hurt is the infusion afterwards — pain or burning at the site once it is running needs the nurse immediately.
Can I have numbing cream?
Often yes, particularly for a port. It has to be applied well before you arrive, so ask at the previous visit rather than on the day. It is a reasonable request and it makes a real difference for people who dread this part.
Why does it get harder as cycles go on?
Repeated cannulas and the drugs themselves make veins tougher and less easy to find. It is expected rather than a sign of anything going wrong. If it is becoming the worst part of your day, that is worth raising as a reason to consider a port.
Can they use any arm?
Not always. If you have had lymph nodes removed or radiotherapy on one side, that arm is usually avoided. Say so every time rather than assuming it is on file, because staff change between cycles and it matters.
What does it mean if the site starts hurting mid-infusion?
Press the call bell immediately. It may mean the drug is leaking into the tissue around the vein, which some drugs damage badly. Caught early it is entirely manageable. Never wait to see whether it settles or until the bag finishes.
Is a port worth it?
It depends on your drugs, the length of your course, your veins and the cost. It removes the hardest part of the day for many people and suits drugs that are harsh on veins. It needs a procedure and ongoing care. Discuss it with your oncologist rather than deciding alone.
I am terrified of needles. What can be done?
Say so before they start. Numbing cream arranged in advance, looking away, someone to talk to, a slower approach, or a different nurse all help. This is common and units deal with it routinely. Nobody manages it better by hiding it.
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Sources
- Cancer Research UK — Having chemotherapy
- Macmillan Cancer Support — Having chemotherapy
- National Cancer Institute — Chemotherapy to Treat Cancer
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
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