One of the indications for hyperbaric oxygen therapy (HBOT) as approved by the Hyperbaric Oxygen Therapy Committee is radiation soft tissue injury. Recently, there have been increasing reports of patients benefiting from HBOT that have radiation cystitis and/or radiation proctitis. Radiation treatment can cause radiation vasculitis, resulting in vascular destruction and fibrosis of tissue. There are 3 proposed mechanisms that may result in the improvement that these patients are seeing:
1. stimulation of angiogenesis, which, in turn, increases tissue oxygenation
2. reduction in fibrosis
3. mobilization and increases in stems cells within the radiated tissue.
In our own clinic, we evaluated a woman who had received radiation therapy for cervical cancer. She was referred by her gynecologist, seeking some sort of relief for her patient. At initial presentation, she was complaining of pain, discharge, and frequent bleeding from the vagina. She was so uncomfortable and exhausted from the symptoms that she was staying at home and virtually unable to go outside. She was started on HBOT, 2.0 ATA for 90 minutes and after about 20 dives she began to notice improvement. Her drainage decreased, the bleeding resolved, her energy rebounded, and she has resumed her walks in the park, which she loves so much.
Some indications for HBOT certainly could benefit from more randomized controlled studies; however, the use of HBOT for improving the quality of life in those patients suffering from radiation soft tissue injury to the pelvis shows promise.