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Delayed Radiation Injury: Head & Neck Cancer

Neck Pain

Though radiation has become far more precise in its treatment of cancer in recent years, it still has the potential to negatively impact healthy tissue in the proximity of the target area. Effects can be acute or delayed; in the case of the latter, symptoms may not manifest until six months or longer after treatment, making them more difficult to diagnose and trace back appropriately.   

In instances of head and neck cancer, signs of delayed radiation injury (DRI) can include dental complications and proliferation of cavities, xerostomia, or dry mouth; difficulty swallowing, open sores and infections, and excessive pain,

Radiation: Doing Damage Over Time

Radiation, by its nature, uses high-energy rays to kill cancer cells. It may be chosen as a course of treatment for one of several reasons: as the primary healing protocol, to shrink a tumor prior to surgery, or to eradicate remaining cancer cells following a surgical procedure. This can be delivered via external beam radiation, or through the implantation of radioactive seeds, also known as brachytherapy

Though these ionizing rays are intended to kill cancer cells, the energy emitted has enough power to cause severe damage to healthy cells, blood vessels, and tissues which may be similarly exposed during treatment

Once affected by radiation, healthy cells can continue to break down over time. Side effects may include redness, irritation, and visible sores in the mouth and throat area, as well as changes in taste, loss of appetite, and nausea. In certain instances, there may be increased stiffness in the jaw area, and a subsequent inability to fully and comfortably open the mouth. Some patients experience reduced hearing in the ear closest to the radiated field; others may notice stiffening or swelling of the radiated area, causing further pain.

Healing Through HBOT

For those who have a history of radiation to the head or neck, and are experiencing these symptoms, speak to your doctor about the possibility of delayed radiation injury. Research shows that for many patients, DRI can be effectively addressed  through the use of hyperbaric oxygen therapy (HBOT). 

By regenerating any blood vessels damaged by radiation, HBOT can repopulate the affected area with new capillaries, thereby accelerating all stages of wound healing. This is accomplished by driving highly concentrated oxygen into the bloodstream at increased atmospheric pressure, and ultimately decreasing inflammation, stimulating growth factors in the affected area, and strengthening the immune system over time. 

On average, healing can be achieved within eight to 12 weeks by following a recommended protocol, though other factors can come into play, including additional medical conditions, the type and location of the cancer treated, and the duration of the radiation treatment. Most patients may start to notice a marked change in condition at the 12 to 15 treatment mark.


While every patient is different, and as such, may present with variations of symptoms as a result of delayed radiation injury, most have the potential to improve within several weeks via HBOT. 

For further information on delayed radiation injury, and the use of HBOT to alleviate symptoms of it, contact Hyperbaric Medical Solutions today. 

Alan Katz, MD, FUHM, FACEP, FAAEM

Written by Alan Katz, MD, FUHM, FACEP, FAAEM

Dr. Alan Katz, National Medical Director of Hyperbaric Medical Solutions (HMS), is double board certified in Emergency Medicine and Hyperbaric Medicine. He directs clinical operations, as well as education and research initiatives for HMS, particularly in exploring the use of hyperbaric oxygen therapy....

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