Delayed radiation injury and hyperbaric oxygen
Radiation therapy saves lives, but in some patients it causes tissue damage that shows up months or even years later. Delayed radiation injury is one of the recognized medical uses of hyperbaric oxygen therapy.
What is delayed radiation injury?
Radiation damages small blood vessels in the treated area. Over time, the tissue can become scarred, poorly supplied with blood and low in oxygen. That can lead to problems such as:
- Osteoradionecrosis: bone breakdown, most often in the jaw after head and neck radiation
- Radiation cystitis: bladder bleeding after pelvic radiation
- Radiation proctitis: bleeding or pain in the rectum
- Soft tissue wounds that won't heal in an irradiated area
How HBOT may help
The thinking is that repeated sessions of oxygen under pressure stimulate the growth of new small blood vessels in the damaged area, gradually improving its blood and oxygen supply. That's why treatment courses are long, often 30 to 60 sessions.
The evidence
Research supports HBOT for some forms of delayed radiation injury, such as radiation cystitis and certain cases of osteoradionecrosis, and it is on the list of recognized uses. For other situations the evidence is less clear, and specialists continue to study who benefits most. Some patients have HBOT before dental surgery in a previously irradiated jaw; whether this helps is still debated.
Where it's done
Treatment for radiation injury is medical care. It happens at hospital or wound-care hyperbaric centers, at about 2.0 to 2.4 ATA, under a physician who works with your oncology team.
A note on cancer claims
HBOT treats some side effects of radiation. It is not a treatment for cancer itself, and the FDA has warned against claims that it is. If you're being treated for cancer, talk to your oncology team before trying any HBOT, including wellness sessions.
Questions to ask your doctor
- Is my problem a delayed radiation injury that HBOT is used for?
- How many sessions would I need, and where?
- Will insurance cover it?
- Are there any reasons, such as my medications, that I shouldn't have it?