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Hyperbaric Oxygen Therapy (HBOT)

Oxygen that is given at a pressure that is higher than the pressure of the atmosphere at sea level. In medicine, breathing hyperbaric oxygen increases the amount of oxygen in the body…It is being studied in the treatment of some types of cancer. Hyperbaric oxygen may increase the amount of oxygen in cancer cells, which may make them easier to kill with radiation therapy and chemotherapy. National Cancer Institute

Who should not use HBOT?

Absolute Contraindications
Source: National Library of Medicine

There is currently only one absolute contraindication to hyperbaric oxygen therapy (HBOT): untreated pneumothorax. Placing a patient in a chamber and changing the pressure around them can result in a tension pneumothorax occurring on the ascent, which could quickly become life-threatening.

Chemo drugs

This Study says: It is, however, important to underline that Mayer et al. list up five chemotherapeutic agents (doxorubicin, bleomycin, disulfiram, cisplatin, and mafenide acetate); all of which are strongly contradictory in combination with HBO due to potential potentiation of toxicity.

HBOT and Chemotherapy

Study: HBO treatment overcomes tissue hypoxia and promotes the development of new blood vessels…thereby rendering the tumour cells more sensitive to chemotherapeutic treatments.

We conclude that the administration of HBO can provide many clinical benefits in the treatment of tumours, including management of highly malignant gliomas…HBO can also increase the cytostatic effect of certain drugs, which may render standard chemotherapy more effective.

Hyperbaric oxygen therapy effectively treats long-term damage from radiation therapy

Source: UCLA Health
More than 11 million people living in the U.S. today have been diagnosed with cancer, and about half of them have received radiation therapy (radiotherapy). While improved radiotherapy techniques have increased treatment precision and reduced side effects caused by radiotherapy, the high doses of radiation used to kill cancer cells may still cause long-term damage to nearby healthy cells in some patients. By helping the blood carry more oxygen to affected areas, hyperbaric oxygen therapy (HBOT) has been proven effective for these patients.

Long-term side effects
For most cancer patients who experience negative effects from radiotherapy, the side effects are short-term and appear within six months of their last exposure to radiation. Depending on the patient’s sensitivity to radiotherapy, the type and dose of treatment and location of the cancer, patients may experience scarring and narrowing of the blood vessels (intimal proliferation in the arterioles) within the treatment area. This can lead to inadequate blood supply and result in chronic, long-term side effects including death or damage to soft tissues or bones (necrosis, radionecrosis or osteoradionecrosis), poor wound healing and related problems such as life-threatening infections. As many as 10 to 15 percent of patients receiving high doses of radiotherapy will experience these late side effects from radiotherapy, which may be delayed for several months or years after treatment has ended.

Hyperbaric oxygen therapy
HBOT has emerged as an effective treatment for some patients who previously had little hope of recovering from late side effects of radiotherapy. HBOT increases the amount of oxygen in the blood by exposing patients to pure oxygen within a sealed chamber set at pressures greater than the ambient atmosphere, with results that can be measured using a transcutaneous partial pressure oxygen (TCPO2) monitor before and after treatment. Experts believe HBOT helps patients by stimulating growth of new blood vessels following radiation-induced damage.

HBOT has the longest history of success in treating or preventing damage to the jaw bone resulting from radiation treatment, but has also been effectively used to treat radiation-induced damage to the head, neck, chest wall, abdomen and pelvis. For example, HBOT may prevent tooth loss or collapse of the jaw bone in patients previously treated for head or neck cancers, promote successful skin grafts or flaps following reconstructive surgery in patients treated for breast cancer, and eliminate persistent urinary bleeding (radiation cystitis) in patients treated for prostate cancer.

More studies into the effects of HBOT

This study says:  From the preliminary results got from the current study, we identified that HBO sensitizes human gastric cancer cells to Melatonin-induced apoptosis [programmed cell death] through a variety of complicated molecular mechanisms. HBO may provide a novel candidate supplemental treatment method for further development of potential anti-gastric cancer therapeutics. The combination of HBO and Melatonin could be a promising treatment for advanced gastric cancer.

This study says: We conclude that the administration of HBO can provide many clinical benefits in the treatment of tumours, including management of highly malignant gliomas. Applied immediately before irradiation, it is safe and well tolerated by patients, causing rare and limited side effects. The results obtained with a combination of HBO/radiotherapy protocol proved to be especially favourable compared to radiation treatment alone. HBO can also increase the cytostatic effect of certain drugs, which may render standard chemotherapy more effective.

The authors of this review concluded: These small trials suggest that for people with LRTI [ late radiation tissue injury] affecting tissues of the head, neck, anus and rectum, HBOT is associated with improved outcome.

This study found: Despite the fact that behavior and prognosis of the triple positive and negative subtypes of cancer are different, the HBOT had a similar suppressive effect on tumor growth, indicating that they share a common oxygen dependent anti-tumor mechanism…HBOT significantly reduced both numbers and total area of the metastatic lesions

This study includes the case report of A 74-year-old Japanese female underwent left radical mastectomy for breast cancer in 1987. Radiation therapy was initiated 6 weeks after the surgery. In February 2013, she was diagnosed with a late-onset radiation-induced skin ulcer that developed 25 years after radical mastectomy. The patient was treated with HBO2 a total of 101 times over the course of 1 year and completely recovered.
The study authors concluded: Hyperbaric oxygen therapy can be performed safely for even more than 100 sessions in patients with radiation-induced skin ulcers and osteomyelitis. Hyperbaric oxygen therapy can be considered as an alternative, conservative treatment when surgical resection for late-onset, radiation-induced skin ulcers is not indicated because of fragile skin in the irradiated areas.

This study aimed to present the findings of a new registry of radiation injuries that was developed to evaluate the outcomes and treatment parameters of HBO treatment (HBOT) when applied to patients experiencing the late effects of radiation therapy.
Results: A total of 2538 patient entries with 10 types of radiation injuries were analyzed…Clinical outcomes following HBOT were positive with symptoms that improved or resolved varying from 76.7% to 92.6%, depending on injury type.
Conclusions: Outcomes from a large patient registry of radiation-induced injuries support the continued therapeutic use of HBOT for radiation injuries.

This study included 57 women treated with HBOT for late radiation-induced tissue toxicity (LRITT)… Before HBOT, patients had severe complaints of pain in the
arm/shoulder (46 %),
swollen arm/hand (14 %),
difficulty to raise arm or move it sideways (45 %),
pain in the area of the affected breast (67 %),
swollen area of the affected breast (45 %),
oversensitivity of the affected breast (54 %),
skin problems on/in the area of the affected breast (32 %)…
post HBOT, severe complaints were still experienced in 17%, 7%, 22%, 15%, 13%, 15%, and 11 % of the women, respectively. Differences were all significant. The NRS pain score improved at least 1 point (range 0-10) in 81 % of the patients.
The study authors concluded: In these breast cancer patients treated with HBOT for LRITT, the patient-reported outcomes were positive and improvements were observed. HBOT was a well-tolerated treatment for LRITT and its side-effects were both minimal and reversible.

This retrospective study included 71 patients with postradiation hematuria (PRH) treated with HBO in a university hospital center between January 2003 and December 2013.
Results: PRHs were severe (grade ≥3) in 50 (70.4%) of the cases. Radiotherapy was indicated in the treatment of prostate cancer in 61 (85.9%) patients. The median length of time between hematuria and HBO was 8 months. Prior to HBO, 46 (64.8%) patients underwent electrocoagulation of the bladder. HBO sessions were compounded by 9 cases of barotraumatic otitis, 5 cases of transient visual disturbance, and 1 case of finger paresthesia. On average, 29 (3-50) sessions were carried out. Treatment was effective in 46 (64.8%) patients, 37 (52.1%) of whom were completely cured.
Conclusion: HBO completely resolves PRH in 52.1% of cases.

This review says: We included 19 trials in this review (2286 participants: 1103 allocated to HBOT and 1153 to control). For head and neck cancer, there was an overall reduction in the risk of dying at both one year and five years after therapy, and some evidence of improved local tumour control immediately following irradiation…There was a lower incidence of local recurrence of tumour when using HBOT at both one and five years … There was also some evidence with regard to the chance of metastasis at five years

Any benefits come at the cost of an increased risk of severe local radiation reactions with HBOT However, the available evidence failed to clearly demonstrate an increased risk of seizures from acute oxygen toxicity .

For carcinoma of the uterine cervix, there was no clear benefit in terms of mortality at either one year or five years…Similarly, there was no clear evidence of a benefit of HBOT in the reported rate of local recurrence. We also found no clear evidence for any effect of HBOT on the rate of development of metastases at both two years and five years…There were, however, increased adverse effects with HBOT.

With regard to the treatment of urinary bladder cancer, there was no clear evidence of a benefit in terms of mortality from HBOT at one year… nor any benefit in the risk of developing metastases at two years When all cancer types were combined, there was evidence for an increased risk of severe radiation tissue injury during the course of radiotherapy with HBOT…and of oxygen toxic seizures during treatment

Authors conclusions: We found evidence that HBOT improves local tumour control, mortality, and local tumour recurrence for cancers of the head and neck. These benefits may only occur with unusual fractionation schemes. Hyperbaric oxygenation therapy is associated with severe tissue radiation injury.

This study concluded: HBOT appears to have some utility for the treatment ofpatients with radiation-induced xerostomia [dry mouth]. These effects can be achieved even if HBOT is utilized years after completion of radiation therapy, making it a possible option in patients with cancers refractory to traditional treatments. Although other currently available therapies are palliative in nature, HBOT seems to have long-term impacts on subjective assessments of dry mouth and on QoL [quality of life] as far as 18 months after completion of therapy. In general, patients had increased stimulated saliva output, decreased sensation of dry mouth, and trends toward improvement in QoL related to dry mouth and sticky saliva.

Where can I get this treatment and more information?

Available in clinics worldwide

Some of the clinics in Ireland:
Bandon Hyperbaric Oxygen Centre (Cork)

Oxygeneration (Galway)

Oxycare (Dublin)

The National Hyperbaric Centre (Dublin)

Cancer Ireland has no association whatsoever with these clinics.

Cancer Survival Tips

Page updated 2024

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