Chemo pump: Definition and how they work

A chemotherapy pump is a device that dispenses chemotherapy drugs at a slow, controlled rate into the body. Portable versions of these devices can allow a person to receive chemo in the comfort of their home.

Chemotherapy is a treatment that uses drugs to kill rapidly dividing cancer cells in the body. People will often undergo chemotherapy as part of an overall cancer treatment plan. About 650,000 people in the United States receive chemotherapy in an outpatient oncology clinic yearly.

Doctors often use and recommend chemotherapy pumps to deliver chemo drugs directly into a person's bloodstream at a constant rate over hours or days.

In this article, we discuss chemo pumps in more detail, including how they work, where people can use them, and how to look after them.

A chemo pump, also called an infusion pump, is a form of IV chemo in which a person receives chemotherapy drugs directly into their bloodstream through a tiny, flexible tube called a catheter. Using a pump enables a person to control the flow of the drugs and receive treatments that may last from several hours to a few days. This approach to treatment may be a simpler alternative to using oral chemotherapy drugs.

If a person is receiving chemotherapy in a hospital, they may receive it through a pump that attaches to a drip stand or IV pole. The stand often has wheels, and the pump operates on a battery, allowing a person to walk around with it. Other types of pumps are portable, meaning that a person can receive treatment at home. The choice of setting depends on the person's prescribed chemotherapy protocol and medical status.

There are different types of portable pumps that may or may not require a battery. A healthcare professional will show an individual how to operate the pump and then program it so that it delivers the correct dose of chemotherapy at the right time. A doctor may classify chemotherapy infusion pumps according to the below characteristics:

Many people who receive chemotherapy at home through a chemo pump use a non-electric balloon system, also known as an elastomeric pump. These are continuous pressure pumps that do not require a battery.

The pump consists of a balloon filled with the chemotherapy. It features two layers, with the inner one holding the chemotherapy and the outer cover protecting the inside. The pump provides the necessary pressure to infuse the medication at a preset rate. It also includes a flow restrictor that helps control how quickly the chemo infuses.

Another type of chemo pump is a computerized ambulatory delivery device (CADD). This device includes a battery and a cassette or infusion bag that contains the chemotherapy. A healthcare professional will program the pump to deliver the chemotherapy at an exact dose and at specific times. They will then lock the keypad so that the person cannot change the programming by accident.

Chemo pumps are one of the ways a person can receive chemotherapy. Depending on the chemo drug and schedule, a person may receive treatment in a hospital or an outpatient oncology clinic.

However, suitable candidates may be able to use a portable chemo pump at home. A person can carry a portable pump in a bag or on a belt holster and continue with their daily activities, such as bathing, sleeping, and doing light exercise.

It is advisable for a person to carry the pump in a small pouch that they may attach to their belt loop, carry in a bag, or place on a nearby surface. It is also essential to check the chemo pump from time to time to ensure that it is still pumping. For example, a person should inspect the tubing and ensure that there are no kinks in it.

Below are things to consider to avoid problems and ensure that the chemo pump works properly.

The placement of the infusion pump is important. It is best to keep the pump at a height where the tubing connects to a person's IV line. When standing, a person should ensure that the pump is in an area between their armpits and hips. Wearing it higher or lower may cause the medication to flow too fast or too slow.

The surrounding temperature can affect the flow of the pump. It may run too fast if it gets too warm and too slow if it gets too cold. A person should avoid anything that will significantly lower or raise the temperature of the pump, including:

A person may still do light exercise while using a chemo pump, and they can engage in sexual activity. However, they should avoid anything else that can raise or lower their body temperature, such as strenuous exercise that leads to sweating. It is also essential to ensure that the pump is secure during the exercise to avoid pulling on the IV catheter or dropping the pump.

When bathing, a person may place their pump on a stool or chair next to the bath or shower. Although the pump is water-resistant, it is not waterproof, and it is not advisable to submerge it underwater or expose it directly to a stream of water. It is also advisable to use a handheld shower or a sponge bath to avoid getting the catheter site wet.

When sleeping, it is best to place the pump on top of the bedcovers or on a bedside table. It is not advisable to place it underneath the covers, where it might get too warm. In addition, a person should avoid putting it on the floor or hanging it on a bedpost, as doing so may interrupt the flow of the medication.

Not everyone will receive injectable chemo drugs intravenously. There are various other options, which may include:

IT chemotherapy delivers the drugs to the spinal canal through a catheter to reach the cerebrospinal fluid, which is the fluid surrounding the brain and spinal cord. Doctors may use this mode of delivery to treat certain cancers that affect the brain. Other delivery methods cannot get the medication through the blood-brain barrier, the network of tissue and blood vessels that protect the brain from toxins.

A doctor may place the chemo drug directly into the artery that supplies the tumor using intra-arterial chemo. They often use this to treat a single area, limiting the drug's effect on other parts of the body. An example of this is the hepatic arterial infusion pump. A 2022 study involving people with multifocal intrahepatic cholangiocarcinoma found that intra-arterial chemo resulted in a similar overall survival as resection.

In situations where cancer is in an enclosed area of the body, doctors may limit the delivery of chemo drugs into a body cavity. Examples include intrapleural and intraperitoneal chemo, where a healthcare professional injects the chemo drugs into the chest or abdominal cavity, respectively.

Doctors may also give chemo drugs as an injection or shot through a muscle. The most common injection sites are the thigh and buttocks. With IM injections, the body absorbs the chemo drugs slower than it does with IV injections. This means that the effects of the chemo can last longer.

When the tumor is in a site that is safely reachable with a needle, a doctor may inject the chemo drug directly into the tumor. Some people may also refer to this as intratumoral chemotherapy.

Intravesical chemo involves filling the bladder with a chemo drug through a soft catheter. The drug stays inside for several hours before the doctor drains the bladder and removes the catheter.

A chemo pump is a device that delivers chemo drugs directly into the bloodstream through an IV line. This helps deliver a controlled amount of chemo drugs over a definite period. Different pumps and mechanisms are available.

A person can receive chemotherapy in a hospital setting, or they may be able to use a portable chemo pump to receive the treatment at home. A healthcare professional will set up the pump and provide instructions on how to use it. If a person has any questions about using a chemo pump, they can consult a member of their healthcare team.