Q:  I’ve heard about hyperbaric oxygen therapy. Could it help me with problems I now have several years after radiation treatments for cancer?

A:  Hyperbaric Oxygen Therapy (HBOT) is a useful medical treatment that has been around for about a hundred years. HBOT was initially developed to treat decompression sickness (the bends), but has been found to be useful for many other medical conditions.

One of these conditions is soft tissue radio-necrosis. This is the damage to tissues and organs that is sometimes an inadvertent complication of radiation therapy for cancer. Most people develop these problems only to a minimal degree. But a small portion of people, who have been saved from cancer by radiation treatments, suffer annoying or painful complications months and years later. The problem of soft tissue radio-necrosis sometimes shows itself as spontaneous sores or wounds in the irradiated area. Sometimes, if a person requires a surgery in the same area in which he had previous radiation, the wound won’t heal well.  

Soft tissue radio-necrosis is also the umbrella term used for radiation cystitis and radiation proctitis. Radiation cystitis is bladder damage from previous radiation. It can cause symptoms such as bloody urine, frequent or urgent urination, bladder spasms, or urinary incontinence. Radiation proctitis describes radiation damage to the colon and rectum. Symptoms may include diarrhea, painful bowel movements or blood in the stool. Both of these conditions can be treated with HBOT and often very successfully.

The Wound Center of Columbus Regional Health has been using HBOT to treat many conditions including soft tissue radio-necrosis since 2011. A typical treatment involves a patient lying comfortably in a clear glass chamber watching television for about 90 minutes. The chamber is specially designed to handle pressure. During the treatment, the patient breathes 100% oxygen and the pressure within the chamber is gradually increased to 2 to 2.5 atmospheres. The patient may feel a little ear pressure, and will have to “pop” his ears (like on a drive through the mountains) by swallowing or holding his nose and blowing. The patient is in constant communication with a trained technician standing outside the chamber.  

The combination of breathing 100% oxygen and increased pressure allows a higher oxygen level to build up in the tissues. This higher oxygen level helps tissues repair themselves through a variety of cellular mechanisms. Patients with soft tissue radio-necrosis typically have HBOT treatments 3-5 times a week for 20 or more total visits.

Symptom check lists, wound photos and measurements, and occasionally cystoscopy (a urologist looking in the bladder with a scope), or colonoscopy (a gastroenterologist or surgeon looking in the colon with a scope) are used to determine when the maximum benefit has been met. Medicare and most insurance companies cover the cost of these treatments; as a matter-of-fact, soft tissue radio-necrosis is on the list of indications for HBOT specially developed by the Undersea and Hyperbaric Medicine Society.

If you think you have soft tissue radio-necrosis, such as a wound in a body area in which you received radiation treatments in the past, or bowel or bladder problems after radiation in that area, the team at The Wound Center of Columbus Regional Health would be happy to evaluate you for Hyperbaric Oxygen Therapy.

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