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THIS ARTICLE AT A GLANCE:

Hyperbaric oxygen therapy is FDA-approved for latent radiation tissue injuries.

Radiation therapy is a cancer treatment that uses radiation beams to directly kill cancer cells and shrink the size of tumors. Healthy tissue surrounding a tumor may be impacted, which may cause new symptoms, referred to as radiation injury. Post radiation injury is common and HBOT can target and repair damaged tissue caused by radiation treatment. 

Hyperbaric oxygen therapy has been used in various forms since the 1600s but became more widely recognized for its clinical medicinal uses in the early 19th century. Since then, this innovative technology has assisted many patients in healing from numerous challenges to their health.

Did You Know?

Hyperbaric oxygen therapy (HBOT) helps some patients with injuries or conditions following radiation therapy 


Radiation therapy is a cancer treatment that uses radiation beams to directly kill cancer cells and shrink the size of the tumor.  There have been advances in how long radiation therapy sessions last and how it is delivered to the target tissue. By targeting tumors more accurately, damage to the surrounding tissue will minimized.  These advances are helping decrease complications and expand the use of radiation therapy for different conditions.  However, even with those advancements, healthy tissue surrounding the tumor may be impacted, which may cause new symptoms.  Post radiation injury is common. 

As a matter of fact, we successfully and safely treat this condition over 3,200 times yearly in our practice.

It is important to note: 

  • Radionecrosis refers to the death of healthy tissues caused by previous radiation therapy  

  • Late radiation injury from radiation (also called latent or delayed) may not be identified by your physician because symptoms from radiation treatment can occur months to years after the initial radiation therapy.

For example, patients who receive radiation treatment for prostate cancer may experience health issues many years after their initial treatment, such as painful urination or blood in their urine, incontinence, rectal pain, or painful bowel movements. This can be challenging for patients since these symptoms don't necessarily occur immediately following radiation treatment, and patients aren't likely to think the cause is the radiation therapy they received months to years prior.

  • The damage to tissue is a result of whats called “the Fibroatrophic effect”. In this model there is depletion of STEM cells, development of fibrosis, and an increase in inflamatory cytokines. 

  • Tissue that is damaged by radiation may continue to break down over time if not treated. Healing the damaged tissue requires safe and effective medical intervention.

There are several types of latent radiation injury, which include:
  • Radiation Cystitis or Proctitis (Bladder Cancer or Prostate Cancer): Some patients complain of urinary frequency, pain, burning, or bleeding.

  • Radiation Tissue Injury after Mastectomy: Many women have surgical reconstruction after mastectomy and radiation therapy. These women are at higher risk of post-operative complications due to poor circulation in the radiated area. Some women develop open sores on their chest that will not heal due to prior radiation therapy.

  • Dental Problems or Jawbone Problems following Head and Neck Surgery for Cancer: Damage to the salivary glands and reduced blood flow from radiation therapy may cause open sores, multiple caries or fractures of the jaw, as well as other muscle or skin issues. Patients may also have trouble swallowing and/or difficulty moving their necks.

  • Bowel Problems or Bleeding after Colon Cancer and Radiation: Diarrhea, urgency, incontinence, and rectal bleeding are common symptoms.

  • Behavioral Changes after Radiation Therapy for Brain Cancer: Those who underwent radiation treatment for brain cancer may possibly notice personality, memory and/or language changes.
 
Hyperbaric oxygen therapy can target and repair damaged tissue caused by radiation treatment. 
 

Treating Radiation Damage with Hyperbaric Oxygen Therapy

It is estimated that one-third of U.S. hyperbaric oxygen therapy users are being treated for late effects of radiation therapyHyperbaric oxygen therapy has been used in various forms since the 1600s but became more widely recognized for its clinical medicinal uses in the early 19th century. Since then, this innovative technology has assisted many patients in healing from numerous challenges to their health, including the effects of radiation.    

Hyperbaric oxygen therapy is recognized by the FDA for a number of medical conditions, all of which are generally covered by insurance. HBOT is FDA-approved for latent radiation tissue injuries.  Hyperbaric oxygen therapy has been successful with many patients following radiation treatment by improving the oxygenation of the damaged tissues. 

Study Shows Hyperbaric Oxygen Therapy Improves Symptoms in Patients with Radiation Injuries

Research investigating the effects of hyperbaric oxygen therapy on radiation injuries showed that HBOT is a safe treatment modality for radiation therapy induced soft tissue injuries in the pelvic region. Symptoms were alleviated in over 75% of the patients and the improvement in symptoms was lasting, for more than 6-12 months after receiving hyperbaric oxygen therapy.  

Most symptoms related to delayed radiation injury can cause major disruption in a patient’s daily activities.  HBOT can help improve these symptoms. In a study presented by Cardinal et al., 84% of radiation-induced hemorrhagic cystitis patients had a partial or complete resolution of symptoms.  HBOT is even shown to reduce edema, ischemia, and tissue inflammation related to cerebral radiation and offer a neuroprotective effect to the brain.  Additionally, in breast cancer patients who received radiation treatments there was reduced pain in the arm and breast areas. 

 

How Does Hyperbaric Oxygen Therapy Work?

Hyperbaric oxygen therapy drives oxygen further into the body, ultimately delivering 10 to 14 times the standard amount of oxygen to damaged tissue. Increasing the oxygen diffusion throughout the body provides the nutrients required to promote healing and recovery. Other processes the body undergoes to heal injuries include anti-inflammatory benefits, altered gene expression and white blood cell enhancement.  The production of new blood vessels and the release of stem cells also helps to heal delayed radiation injury.  

In a randomized, controlled study evaluating radiation-induced cystitis, symptoms were relieved and the therapy was safe and well tolerated.  The treatments must be done in a medical grade hyperbaric chamber at a specific protocol, using pressure of 2.0 to 2.4 ATA. The treatments are time intensive and most patients are advised to receive hyperbaric oxygen therapy five days a week and usually require a minimum of 40 treatments in order to achieve their results. However, the total number of HBOT sessions can vary, depending on a patient's symptoms and his or her initial response to treatment. Usually patients start to notice a change in their condition at the 12 to 15 treatment mark.   

Discover the Healing Benefits of Hyperbaric Oxygen Therapy

At Hyperbaric Medical Solutions, we are inspired by the progress and success patients have experienced through hyperbaric oxygen therapy.

Contact our office at (516)-588-1836  for a consultation and to begin your healing journey.

 

Supporting Research:

Delainian. The radiation-induced fibroatrophic process: therapeutic perspective via the antioxidant pathway. Radiother Oncol. 2004

Cooper JS, Hanley ME, Hendriksen S, et al. Hyperbaric Treatment Of Delayed Radiation Injury. [Updated 2022 Aug 10]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470447/

https://pubmed.ncbi.nlm.nih.gov/24035333/

Cardinal, J., Slade, A., McFarland, M. et al. Scoping Review and Meta-analysis of Hyperbaric Oxygen Therapy for Radiation-Induced Hemorrhagic Cystitis. Curr Urol Rep 19, 38 (2018). https://doi.org/10.1007/s11934-018-0790-3

Prathivadhi-Bhayankaram, S., , cooper, j. S. Hyperbaric Oxygen Therapy for Cerebral Radiation Necrosis Secondary to Stereotactic Radiation: A Case Series. Graduate Medical Education Research Journal. 2022 Jul 14; 4(1). https://digitalcommons.unmc.edu/gmerj/vol4/iss1/7

Batenburg, M.C.T., Maarse, W., van der Leij, F. et al. The impact of hyperbaric oxygen therapy on late radiation toxicity and quality of life in breast cancer patients. Breast Cancer Res Treat 189, 425–433 (2021). https://doi.org/10.1007/s10549-021-06332-2

Nicklas Oscarsson, Bernd Müller, Anders Rosén, Pär Lodding, Johan Mölne, Daniel Giglio, Karin M Hjelle, Guro Vaagbø, Ole Hyldegaard, Michael Vangedal, Lisbeth Salling, Anders Kjellberg, Folke Lind, Otto Ettala, Olli Arola, Helén Seeman-Lodding, Radiation-induced cystitis treated with hyperbaric oxygen therapy (RICH-ART): a randomised, controlled, phase 2–3 trial,

The Lancet Oncology, Volume 20, Issue 11, 2019, Pages 1602-1614, ISSN 1470-2045.

{Updated: January 26, 2023}

 

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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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