Hematologist
CION Cancer Clinics
Central lines in blood cancer treatment: Hickman and PICC | CION Cancer Clinics
A Hickman or PICC line is a thin tube placed in a large vein so chemotherapy, blood, platelets and antibiotics can be given, and blood taken, without repeated needles. A Hickman comes out on the chest and suits long, intensive treatment. A PICC comes out on the arm and is easier to remove. Both carry a risk of infection, so a fever with a line needs care the same day. At CION Cancer Clinics, our haematology team supports patients and families through treatment, cost questions and life at home.
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Medically reviewed by Dr. Basudev PokhrelConsultant Haematologist · last reviewed September 2026, next review due September 2027
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On this page
- Why would you need a Hickman or PICC line?
- What is the difference between a Hickman, a PICC and a port?
- What happens when the line is put in?
- How do a Hickman and a PICC compare?
- What do families worry about, and what is true?
- Which line is right for you, and what can this page not say?
- Common questions about Hickman and PICC lines
The short answer
Why would you need a Hickman or PICC line?
A Hickman or PICC line is a thin, soft tube that sits in a large vein and stays in for weeks or months. It lets the team give chemotherapy, blood, platelets and antibiotics, and take blood samples, without a new needle in your arm each time.
Why blood cancer treatment so often needs one
Treatment for leukaemia, lymphoma and myeloma can mean many blood tests a week, repeated transfusions and long drips. Some chemotherapy drugs also irritate small hand veins and can damage the skin if they leak. A line that ends in a wide vein near the heart carries these safely, because the fast blood flow there dilutes the drug straight away.
What it changes for you day to day
Most people find the line makes treatment far easier to bear. Blood tests stop hurting. Drips start quickly. The trade-off is that you now carry a tube that must be kept clean and dry, and that opens a path for germs into the blood. Looking after it well is part of your treatment.
A line is a tool, not a sign that the illness is worse. Many people start treatment with one on day one.Types of line
What is the difference between a Hickman, a PICC and a port?
All three end in the same large vein. They differ in where they come out of the body and how long they are meant to stay.
Hickman line
It enters a vein near the collarbone and then runs under the skin of the chest before coming out a little lower down. That tunnel under the skin helps hold it in place and keeps germs further from the vein.
Often chosen for
- Intensive leukaemia treatment
- Long courses with many transfusions
- Stem cell transplant planning
PICC line
It goes into a vein in the upper arm and is threaded up to the chest. It is quicker to place and easier to remove, and it usually has one or two tails hanging from the inside of the arm.
Often chosen for
- Treatment planned over some months
- People who prefer nothing on the chest
Port
A small chamber sits fully under the skin of the chest, with nothing outside. A special needle goes through the skin into it on treatment days. Between treatments you can bathe and swim more freely.
Less often used when counts will stay very low for long spells, because each access means a needle through the skin.Not sure whether this applies to you?
Ask an oncologistThe procedure
What happens when the line is put in?
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Blood tests first
Your platelet count and clotting are checked beforehand. If platelets are low, the team may give a platelet transfusion first so that the small cut does not bleed too much.
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Numbing the skin
You lie on a couch and the skin is cleaned and numbed with a local anaesthetic injection. You stay awake. Some people are offered a mild medicine to help them relax.
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Guiding the tube
An ultrasound finds the vein, and the tube is passed along it. You may feel pushing or pressure, but it should not be sharp. Tell the team if it is.
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Checking the tip
An X-ray or a live picture confirms the tip sits in the right place. The line is then fixed with stitches or a clip device and covered with a clear dressing.
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The first few days
The area is often sore and bruised for a few days. Mild pain relief your team suggests is usually enough. Watch the dressing for fresh bleeding and ask a nurse to change it if it lifts.
Side by side
How do a Hickman and a PICC compare?
Hickman line
PICC line
Comes out on the chest, below the collarbone
Comes out on the inner upper arm
Tunnelled under the skin, so it is held more firmly
Not tunnelled, held by a clip under the dressing
Suited to long, intensive treatment
Suited to treatment over weeks to some months
Removal needs a small procedure to free the cuff
Removal is usually a gentle pull on the ward
Arm is left free for daily tasks
Heavy lifting with that arm is best avoided
!
When the line needs attention today
If you have a line and you have a fever at or above the level your team told you to act on, or you shiver and shake, especially just after the line is flushed or used, go to the nearest emergency department now or call 108. Say you have a central line and are on blood cancer treatment. Go the same way if the arm, neck or face swells, or the line cracks, leaks or slips out. Do not wait for your next clinic day.
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Commonly believed
What do families worry about, and what is true?
"The tube goes into the heart, so it is dangerous."
The tip rests in the large vein just above the heart, not inside the heart muscle. That position is chosen because blood flows fast there. The real risks are infection and clots, and both are watched for closely.
"Once it is in, you cannot bathe for months."
You can wash every day. The dressing must stay dry, so you cover it or use a hand shower and keep the water away from it. Swimming and soaking in water are what you avoid with a Hickman or PICC.
"A line means treatment will be harder on the body."
It does not change the drugs or their strength. It changes how they reach you. For many people it removes the most dreaded part of each visit, which is searching for a vein.
"If the line gets infected, the treatment has failed."
A line infection is a known problem, not a verdict on the illness. It is treated with antibiotics, and sometimes the line is removed and replaced later. Telling the team early is what matters.
Being straight with you
Which line is right for you, and what can this page not say?
This page cannot choose a line for you. The choice depends on your diagnosis, how long treatment is planned, your counts, your veins, how far you live from the centre and who will help care for the line at home.
Who a line may not suit
A PICC may not suit someone whose arm veins are small or already scarred, or whose kidneys may need a fistula for dialysis later. A Hickman may not suit someone with very low platelets that cannot be lifted before the procedure. Some people with short treatment plans need no line at all. If a line is suggested and you are unsure, ask why this type and not the others.
Questions to take to your haematologist
Ask who will flush the line and change the dressing, and how often. Ask where to go at night if something goes wrong, especially if you live in a district far from Hyderabad. Ask how long the line is likely to stay in. At CION, the haematology team discusses these practical points as part of your plan and coordinates with the centre that places the line.
Keep a written note of the line type and the date it went in. Any emergency doctor will ask for both.Questions we are asked
Common questions about Hickman and PICC lines
Does putting in a Hickman or PICC line hurt?
The numbing injection stings for a moment. After that most people feel pressure and pushing rather than sharp pain. The site is often sore and bruised for a few days afterwards. If the pain is getting worse rather than better after that, or the area turns red and hot, tell your team.
How long can a line stay in?
A Hickman line can stay in for many months if it works well and stays free of infection. A PICC is usually meant for a shorter stretch, often weeks to some months. Your team takes it out when treatment ends, or earlier if it becomes infected, blocked or is no longer needed.
Can I sleep on the side where the line is?
Usually yes, once the first soreness settles. Tape the tails so they do not pull, and wear a loose vest or a mesh sleeve to keep them close to the body. If lying on it tugs at the line or hurts, sleep on the other side until you have asked your nurse.
Can children have a Hickman line?
Yes. Children with leukaemia very often have a tunnelled line or a port, because it spares them repeated needles. It is usually put in under a general anaesthetic for a child. Parents are taught how to keep it safe from curious hands and rough play.
Will I be able to see or feel the tube?
You will see the tails that come out of the skin, covered by a dressing. With a Hickman you may feel a slight ridge under the chest skin where it is tunnelled. Loose clothing hides it well. A port shows only as a small bump under the skin.
What if the line stops working or will not draw blood?
This is common and often simple. Changing your position, raising an arm or coughing can free it. If not, the nurse may use a medicine to clear a small clot inside the tube. Never try to force fluid through a blocked line yourself.
How is the line taken out?
A PICC is usually slid out gently on the ward and pressure is held on the arm for a few minutes. A Hickman has a small cuff under the skin that has to be freed, so it needs local numbing and a small cut. Both are short and you go home the same day.
Is the line covered by Aarogyasri or insurance?
When the line is part of an approved blood cancer treatment plan, it is often included under schemes such as Aarogyasri, CGHS, ECHS, EHS or PM-JAY, and under cashless insurance. Rules change, and what is covered varies by scheme and policy. Check your current entitlement with the scheme desk before the procedure.
Your Haematologist
Meet CION's haematologist. One specialist for your blood report and your plan.
Dr. Basudev Pokhrel reviews blood counts, transfusion needs and blood disorders, and works with the CION tumour board on blood cancers.
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Sources
- Cancer Research UK — Cancer treatment
- National Cancer Institute — Infection during cancer treatment
- Macmillan Cancer Support — Cancer treatment
- Blood Cancer UK — Blood cancer information
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.
Keep reading
Related pages
Caring for a Central Line at HomeDressings, bathing and daily checks once you are homeLine Infection: Recognising It EarlyThe signs that a line has become infectedNeutropenic Fever: The Single Most Important EmergencyWhy a fever with low counts cannot waitCounts, Fever and Infection in HaematologyThe full guide to counts and infection during treatment
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Been told you need a line?
Tell us your diagnosis and treatment plan. The CION haematology team will talk through which line is being suggested, why, and what caring for it involves.