Understanding Extravasation from Chemotherapy

Some cancer treatment medicines are given through an IV (intravenous) line. The place where the IV goes into your vein is called the injection site. During treatment, sometimes medicine can leak out of the vein and into nearby tissue under the skin. This is called extravasation. It can cause a reaction at the injection site.

Chemotherapy (chemo) medicines may be grouped as irritants or vesicants.

  • Irritants can cause redness, warmth, swelling, or tenderness around the injection site. These symptoms may be mild and go away quickly. They often don’t cause bad damage to the skin or other tissues.

  • Vesicants can cause very bad skin damage, such as redness, blisters, and pain. This damage depends on the type and amount of medicine that leaks out (extravasates). Symptoms may start during or after your infusion.

Preventing reactions

Before you start treatment, ask your healthcare team if your medicine is an irritant or vesicant. Ask what symptoms of extravasation you should watch for and when to report them.

Your healthcare provider may advise using a central venous catheter (such as a port) to prevent extravasation. This is when a thin, flexible tube (catheter) is put into a larger blood vessel near your heart instead of an IV line in your hand or arm. Your provider may advise this method if:

  • You are getting a vesicant medicine.
  • You have small or fragile veins.
  • The medicine you are getting is given over a long time or at a fast rate.

Even with this method, extravasation may still occur. One way is if the port needle is dislodged.

Reporting symptoms

Tell your healthcare team right away if you have any of these symptoms around the injection site during or after your treatment:

  • Burning
  • Pain
  • Redness
  • Stinging
  • Swelling
  • Warmth
  • Leaking from the IV
  • Any other problems

Your care team can check the site, stop the infusion, and treat your skin as needed. Treatment depends on the type of medicine you are getting. Early treatment helps prevent more damage to the skin.