Hyperbaric oxygen treatments for complications of radiation therapy

One-half of the new cases of invasive cancer will receive radiation therapy as a part of their cancer treatment. Radiation doses must be adequate to control the cancer; otherwise, there is no purpose in treating the patient. Radiation specialists design their treatment protocols to give the best dose to control the tumor and still have no more than 5% of patients develop late radiation injury.

Radiation side effects are generally divided into two categories. First, there are those that happen during or just after the treatment, called acute reactions. Second, there are those that happen months or even many years after the treatment, called chronic complications. Hyperbaric oxygen Therapy (HBO) mainly is used to treat the latter.

Unfortunately, chronic complications often may not get better with time and are likely to get worse. Almost all chronic radiation complications result from scarring and narrowing of the blood vessels within the area which has received the treatment. If this process progresses to the point that the normal tissues are no longer receiving adequate oxygen supply by the blood, death or necrosis of these tissues can occur. In the past, a severe level of necrosis would require surgical removal of the damaged tissue. This would be a devastating blow for a patient whose cancer has been cured. For example, though it occurs rarely, a patient who has had cancer of the voice box cured might require the removal of the voice box due to radiation damage. Chronic radiation damage is called "osteoradionecrosis" when the bone is damaged and "soft tissue radionecrosis" if it is muscle, skin or internal organs which have been damaged by the radiation.

Since the 1970’s, surgeons of the head and neck region have come to recognize the value of hyperbaric oxygen treatments in treating damage of the jaw bone due to radiation. Hyperbaric oxygen has had some of its most dramatic successes in treating or preventing damage to the jaw bone as a result of radiation treatments. It has now also been applied to damage of the brain, damage of muscle and other soft tissues of the face and throat, damage to the chest wall, abdomen and pelvis as a result of radiation treatment. Papers in medical journals also report success in treating damage to the bladder and intestines and the breast due to radiation. The high dose oxygen provided in the hyperbaric chamber is carried in the patient’s circulation to the site of injury to be available for repair of the damage done by the narrowing and scarring of the blood vessels. Each treatment typically takes one to two hours, and usually 30-40 daily treatments are needed for healing radiation damage.

Most insurance companies, including Medicare, will provide coverage to pay for hyperbaric treatments for chronic radiation injuries.