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Where is the best place to have the needle for chemo treatment?

littlemac's picture
Posts: 22
Joined: Nov 2014

Hi.  My name is Laura.  I am going to have my 3rd round of Chemo in the next 3 days.  I have chemo on Thursday and Friday, Rituximab & Benadamustine.  During my first treatment in October, the needle was put in my hand.  I had issues for weeks after, with the veins in my wrists being sore and popping out.  It is fine now.  For my treatment in November they put the needle in my left arm and I did not have issues.  I had checked into the possibility having a port put in but they could not do so because the enlarged lymph nodes in my neck would have interferred.

My specific question is should I continue to use the arm?  Should I switch arms each treatment?  I also have blood drawn each week from the Right arm for testing. I am anticipating 1 to 3 more treatments ( I am hoping this is the case).  Will I have issues with scarring and vein damage if I stick with using my arms?  If anyone has any experiences they could share, I would appreciate it.  


Max Former Hodg...
Posts: 3699
Joined: May 2012

Welcome to the group, Laura. 

In general, the larger the vein, the better. That would suggest the arm over the hand. Speak to your infusion nurse or doctor about it. 

Better still (best of any location) is a port.  I do not know why nodes in the neck would be an issue, since the port is almost always placed in the chest, and go on the left or  right side, and the cath is then run to the largest vein in the body (the superior vena cava).

On the other hand, since you have only a few more treatments, continuing with the arm might not be too difficult. Switching arms is fine, if you have easy to get veins on both sides. I tend to have difficult to reach veins, and for blood draws they tend to end up using the same arm most of the time.  Depending on age, even bruised veins clear up and return to normal before too long after ending infusions. A am not aware of long-term issues with the veins after treatment, and I took an older friend who did not have a port for infusions many, many times. His arms were black for many weeks to perhaps a month following, but they did clear up.

Happy New Year !


littlemac's picture
Posts: 22
Joined: Nov 2014

Ho Max. I appreciatate your advice.  They had issues with enlaged lymph nodes along my collor bone and near the heart (this is what they felt would interfer with a port.) I will take your advice and switch arms tomorrow. I have easy to access veins in my arms, so it is probably best. 

Thank you for taking the time to reply.  Happy New Years to you!  I will be asleep, after the first day of infusion I will be out cold *December 31st).  But waking up January 1, 2015 will be a gift.  Every day is a gift.  I am just much more thankful and aware of this now.



po18guy's picture
Posts: 1223
Joined: Nov 2011

2 or 3 more should not be a problem. I was given a port immediately, as the chemo agents that I received were far better off diluted in a large vein. As well, I have been in treatment pretty much the last 6 1/2 years, so my arms would long ago have been trashed. In your case, I also would think that the arm is better than the hand. It sounds like they are hesitant to place a port, so I would switch arms from week to week. You told them about your hand, correct?  

littlemac's picture
Posts: 22
Joined: Nov 2014

I will have at least 2 more infusions.  After this one, I will have another PET scan to see how well chemo is working.  My doctor said I will have infusion #4 either way, then we will see.  Yes, I did discuss and show my hand to the doctor.  

Stay strong, you have been fighting for a long time.  I really hope you beat this.  Thanks for sharing your experience and knowledge.  Happy 2015!

Rocquie's picture
Posts: 857
Joined: Mar 2013

Hi Laura, In my experience with being stuck about a bazillion times over the past couple of years, some nurses and techs are much more skilled with needles than others. In the lab at my oncology clinic, there is a phlebotomist so good at it, I think she could stand at the door and throw the needle like a dart and it would land painlessly and precisely in a vein. 

On the other hand, a nurse was once gouging around in my arm, trying to start an I.V. until my husband finally stopped her and asked her to get someone else to do it. It made her mad but she did get someone else who went right into the vein.

For a recent procedure, the nurse tried to start an I.V. (for anesthesia) in my hand. The doctor was in the room talking to me at the same time. He spoke to her and she stopped and withdrew the needle. She informed me that my vein "blew out". A big blue bump rose up on my hand and it hurt! She calmly moved to a vein on my arm and got the needle in. And the doctor calmly proceeded to tell me about what he was about to do to me.

I once came home from a hospitalization with the insides of both arms completely bruised from the elbow to wrist. 

I do have a port (#2) for chemo, but I am very protective of it because of the nightmarish experience I had with my first port. I only allow it to be accessed for chemo. For everything else, my arms. But there is also another option for some and that is a PICC line, which is an IV access in the arm that can stay in place for weeks or even months. 

I'm sure your Doctor and Nurses will take the best care of you and your veins. 

Cheers! and (((Hugs)))



givingrace's picture
Posts: 161
Joined: Nov 2012

Hi ,

I am doing Rituxen and Bendamustine. I went threw a two year Rituxin treatment in 2010/2011  all in the arm. I never had a problem.  

This time after my 2nd infusions I started have pain in arms a week after infusion more like tissue or muscle pain. I was recommended heating pad for my pain....it does help alot. Make sure it's ok with your oncologist. 15min on then 15 off. Not to hot but tolerable. 

I was going to get port before my 3erd treatment but I fell threw the cracks and didn'tget scheduled fast enough. Then once I was able to schedule a port before my next treatment which is on Tuesday I got way too nervous and kept thinking I only have two more rounds of treatments left so I cancelled the scheduling of the port. I will just have my heating pad ready to go and hope for the best.

I will pray you can get threw your journey with minimal problems.  Keep strong. 



littlemac's picture
Posts: 22
Joined: Nov 2014

Well, I stuck with infusions in the arm this time and it was much better (Thanks Max & po18guy).  

Rocquie, I really hope it gets better for you.  I have had some discomfort, but my experience doesn't sound as challenging as the issues you have dealt with.  GG, I hope your last two rounds of chemo go well.  

I did use heat on my hand after the first infusion (with my doctor's ok) and it helped.  We will see what the next scan PET brings in the next couple of weeks. I know that progress have been made in just 3 treatments.  My hands/arms no longer fall asleep, hot flashes have stopped and the lymph nodes on back of my head, neck, arms & groin are noticeably smaller.  

So now it is just wait and see what the next step is. Thank you for reaching out, enjoy the New Year!


I will continue to think positively for all of us.  

onlytoday's picture
Posts: 610
Joined: Jun 2010

Hi Laura,

Welcome to the site!  Good luck with your next PET!

I had Bendamustine/Ofatumumab (2 day infusions, back to back) and they alternated arms.  My onc wouldn't let me get a port so we tried alternating.  It helped but it was still a bit rough on the veins.  They took over a year to begin to come back.

This was 2 years ago and I'm still in remission!!  So I am very very hopeful for you that this will do a nice job for you!  ( I would have had rituxan but when I originally had that I ended up with what they think was an allergic reaction)

Good luck and keep us posted!




littlemac's picture
Posts: 22
Joined: Nov 2014

Thanks for your response.  And thanks for the good luck wish on my upcoming scan.  I am really glad to hear that you have been in remission for 2 years. I have done well with the first 3 treaments so far.  I know I have made progress, but have to wait to see how much.

Having cancer has taught me how impatient I have been in my life.  I am learning to slow down and to be more patient!


littlemac's picture
Posts: 22
Joined: Nov 2014

Well my veins did start fighting back in this last treatment. They pulled away and were hard to find, but the nurses were good and finally were able to start infusions. It was kind of amusing to me- the body fights back in funny ways. 

My PET SCAN on January 26th showed complete resoluton.  I still had my 4th treament and will be doing 2 years of Maintenance treatments with Ritaximab.

Let's hope we both have a long remission! 


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