HBOT for Post-Radiation Tissue Damage: Helping the Body Heal After Cancer Treatment

Ask anyone who has been through radiotherapy and they'll tell you the side effects during treatment were tough but expected. The burning skin, the tiredness, the sore throat or upset stomach, depending on where the radiation was aimed.

A mouth sore after a routine tooth extraction that just won't close. More often than you'd think, these trace back to radiation, and hyperbaric oxygen therapy is one of the few treatments that goes after the underlying cause.

What Is Post-Radiation Tissue Damage?

It's damage to the healthy tissue around the tumour that slowly develops after radiotherapy, sometimes months later and sometimes many years later. Doctors call it late radiation tissue injury, and the main problem is that the affected area gradually loses its blood supply, so it can't repair itself the way normal tissue does.

When Should You Suspect It?

• A wound or ulcer that has been open for more than a few weeks
• Bone showing through the gum, or ongoing jaw pain after dental work
• Bleeding from the bladder or back passage after pelvic radiation
• Skin that has turned hard, shiny, thin or darker, and breaks easily

Pain and stiffness that slowly worsen in the treated region can also be part of the picture, though on their own they're harder to pin on radiation.

How Does HBOT Help?

HBOT can push much more oxygen into hurt tissue than it usually receives. When people do the sessions again day after day for weeks, the body adapts. Over that time, it starts making new blood vessels in the same spot. This new vessel growth is the reason the recovery keeps going after the course ends.

In the chamber, you breathe oxygen that is close to pure. The air pressure is raised to about two times what you would have outside. At times it can be a little more than that.

With the extra pressure, the oxygen does more than stay on the red blood cells. A part of it also dissolves in the plasma. Then the oxygen can get into the body tissue, including areas where the vessels are not giving enough oxygen right now.

The daily rise and fall in oxygen levels, high inside the chamber and back to normal once you leave, acts as a trigger for angiogenesis, which is the medical term for new capillary growth. When Marx measured this in irradiated jawbone, he found blood vessel density came back to around 80 percent of normal by the end of a full course, and it stayed there afterwards.

With better circulation, a lot of things start working again. The cells that make collagen pick up pace, the immune system can fight off the low-grade infections that often sit in chronic wounds, and surgeons get a much healthier area to work with if an operation or extraction is needed.

Which Radiation Injuries Can HBOT Treat?

The best results have been seen in the jaw, bladder, rectum and soft tissue such as skin over the breast or neck. The Undersea and Hyperbaric Medical Society (UHMS), the main international body for hyperbaric medicine, lists delayed radiation injury as an approved reason for treatment.

The jaw is where we see a lot of worry. Head and neck cancer survivors are often told to avoid tooth extractions if they can, and with good reason, because pulling a tooth from heavily irradiated bone can leave a socket that never fills in. Many oral surgeons now suggest a set of HBOT sessions before and after the extraction. Not everyone agrees it's needed in every case, and that's something your surgeon and hyperbaric doctor should decide together.

Is There Solid Research Behind It?

For some conditions, yes. The evidence is strongest for radiation cystitis and head and neck injuries, while for general bowel complaints after pelvic radiation, the results have been disappointing.

A Cochrane review by Michael Bennett and colleagues pulled together the randomised trials and found that HBOT improved outcomes for late radiation injury in the head and neck, and in the anus and rectum, though the authors wanted more and better trials. Then in 2019, a Swedish-led trial called RICH-ART, published in The Lancet Oncology, compared HBOT with standard care in people with radiation cystitis. The HBOT group reported noticeably better urinary symptoms.

The HOT2 trial is the one that didn't go HBOT's way. It enrolled people with a wide mix of ongoing bowel symptoms after pelvic radiotherapy and found no clear benefit overall. We mention it because we'd rather you hear it from us, and because it shows why proper patient selection matters so much.

Could HBOT Wake Up the Cancer?

The other question almost every patient asks is whether all that oxygen could wake up the cancer. It's a fair thing to worry about. Researchers have looked into it, including a well-known 2012 review by Moen and Stuhr, and haven't found evidence that HBOT makes cancer grow or come back. We still like to have your oncologist in the loop before you start.

What Does a Course of Treatment Involve?

With radiation injury treatment, most people show up once a day. They usually come about five days each week. The plan is often around 30 to 40 sessions in total. Each one lasts around 90 minutes to two hours. Since new blood vessels take weeks to form, skipping sessions really does slow things down.

Here's roughly how it goes:

1. First comes a consultation with a hyperbaric doctor, who goes through your cancer history, the radiation you received, your medicines and any reports or scans you bring along.
2. We check your ears, chest and overall health to make sure pressurisation will be safe for you.
3. Your plan is built around the specific problem, and if surgery or dental work is coming up, the sessions are timed around it.
4. If you've had a procedure, you'll usually do another round of sessions afterwards to help it heal.

Is It Safe After Cancer?

Generally, yes, provided it's done by trained hyperbaric staff who follow proper guidelines. Side effects are usually minor and go away on their own.

1. Possible Side Effects

Ear soreness is usually the main issue. For most people it is not a big problem and can be handled. A few also notice that far vision gets fuzzy near the end of a longer course. This usually improves again within a couple of weeks. Some people feel wiped out after the first sessions, and that often settles down. Oxygen toxicity is uncommon during these treatments. It can lead to a seizure in rare cases, so the staff still monitors closely the whole time.

2. When HBOT May Not Be Suitable

There are cases where we'd hold off or not treat at all. An untreated collapsed lung is one. A few chemotherapy drugs, bleomycin, doxorubicin and cisplatin among them, need to be discussed with your oncology team first. None of this can be sorted out without a proper consultation, which is why that always comes before the first session.

Conclusion

Radiation treatment often helps people fight cancer. But it can also harm nearby tissue. After that, some areas may not have enough blood flow to repair themselves.

HBOT is used after radiation injury when the tissue needs help. The idea is to bring in more oxygen and support the body as it forms fresh small blood vessels. That is why doctors use it for jaw bone problems after radiation, bleeding related to the bladder, and wounds that have not healed for a long time.

If you're dealing with any of this, or you've been told you need dental work or surgery in an area that was irradiated, come and talk at Prana HBOT. The hyperbaric specialists follow UHMS guidelines and will go through your history with you, and with your oncologist if needed, before recommending anything.

FAQs:

1. Is it too late for HBOT if my radiation was years ago?

No. Radiation damage to blood vessels doesn't reverse by itself, so HBOT can still help whether your treatment was one year ago or fifteen.

2. How many sessions will I need?

Usually 30 to 40. If you're having surgery or an extraction, the common approach is about 20 sessions beforehand and 10 after.

3. Does it work for bleeding from the bladder after radiation?

Radiation cystitis is one of the conditions with the best evidence. The RICH-ART trial showed better urinary symptoms with HBOT, and many patients find the bleeding settles over time.

4. Could HBOT cause my cancer to return?

The research so far says no. Studies haven't found that HBOT increases the chance of cancer growing or recurring, though we always recommend involving your oncologist.