As we meander through our treatments, we all will be forced to face the needle. Injections, injections, we all will receive injections and infusions. Despite the commonality of this experience, we read very little about them, especially injection sites and the available technologies for these injections and infusions. We also do not learn about injection site negative reactions until we experience them.

My interest in sharing this information was prompted by Scott Goodman’s recent post ( 3rd Update which I posted on November 24, 2008) on this blog about his journey on chemotherapy. After Scott mentioned that, he had a port-a-cath inserted by a surgeon prior to starting his first chemotherapy infusion, I received a number of emails from people asking what was a port-a-cath?

I also wish to describe the Injection site reactions that occur when the drug escapes from the veins or IV catheter into the skin (extravasation). Drugs escaping into the skin cause two types of site reactions, irritants and vesicants.

Irritant reactions are characterized by short-lived and limited irritation to the vein. Symptoms include: tenderness, warmth, itching or redness that extends along the vein or at the injection site.

Vesicant reactions, which are sometimes called chemical cellulites, include symptoms that initially look like an irritation but then worsen, depending on the amount of chemical that has leaked under the skin.

Vesicants can cause redness and blistering. Larger amounts of vesicant leakage from the chemical being injected can lead to severe skin damage in a matter of days.

Sometimes symptoms from leakage of vesicants may be delayed for up to 6-12 hours after a chemotherapy injection. Itching is common in the absence of pain at the injection site.