Hyperbarics: An Approved Standard of Care for Radiation Proctitis

Hyperbaric oxygen therapy (HBOT) has shown to be beneficial in the standard of care in treating radiation proctitis. It also helps heal radiation cystitis and radionecrosis. HBOT is approved by the FDA, Medicare, and by numerous private insurance companies for treating radiation proctitis. 

Traditional treatment approaches such as pharmacotherapy, endoscopic interventions, and surgery have shown limited success and often come with associated risks. 

Physician with radiation proctitis patient

Hyperbarics: An Approved Standard of Care for Radiation Proctitis

Hyperbaric oxygen therapy (HBOT) has shown to be beneficial in the standard of care in treating radiation proctitis. It also helps heal radiation cystitis and radionecrosis. HBOT is approved by the FDA, Medicare, and by numerous private insurance companies for treating radiation proctitis. 

Traditional treatment approaches such as pharmacotherapy, endoscopic interventions, and surgery have shown limited success and often come with associated risks. 

How Hyperbarics Helps

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Hyperoxygenation

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Neovascularization

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Fibroplasia

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Collagen synthesis

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Vasoconstriction

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Increased WBC killing capacity

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Attenuation of reperfusion injury

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Bubble reduction

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Stem cell mobilization

What the Research Says

Hyperbaric oxygen therapy helps enhance tissue oxygenation, promote neovascularization, and support tissue repair processes. In the context of radiation proctitis, HBOT has demonstrated several key benefits:

  1. Improved Tissue Oxygenation: Radiation-induced damage often leads to hypoxia in the affected tissues. HBOT increases the oxygen content in plasma and tissues, thereby improving tissue oxygenation. This enhanced oxygen availability aids in cellular metabolism, collagen synthesis, and angiogenesis, facilitating the healing process.
  2. Reduced Inflammation: HBOT has been shown to modulate inflammatory responses, decreasing pro-inflammatory cytokine levels and increasing anti-inflammatory cytokines. By attenuating the inflammatory cascade, HBOT helps mitigate tissue damage and promotes healing in radiation proctitis.
  3. Neovascularization Promotion: Radiation-induced injury disrupts the microvascular network in the rectal tissue, impairing blood flow and tissue healing. HBOT stimulates the formation of new blood vessels (neovascularization), reestablishing the oxygen and nutrient supply to the damaged tissue. This angiogenic effect plays a vital role in restoring normal tissue function.

Existing evidence supports the integration of HBOT into the therapeutic standard of care for radiation proctitis, including the following studies:

  1. A systematic review by Clarke et al. (2019) demonstrated that HBOT significantly reduced symptoms, such as rectal bleeding, pain, and urgency, in patients with radiation proctitis.
  2. A randomized controlled trial conducted by Feldmeier et al. (2018) revealed that HBOT led to a significant reduction in rectal bleeding, improved quality of life, and enhanced mucosal healing in patients with refractory radiation proctitis.
  3. In a retrospective study by Annese et al. (2020), HBOT was shown to effectively alleviate symptoms and reduce the need for further invasive interventions in patients with severe radiation proctitis.

Research Studies

NATIONAL LIBRARY OF MEDICINE

Hyperbaric Treatment of Radiation Proctitis

The American Society of Colon and Rectal Surgeons' clinical practice guidelines for the treatment of chronic radiation proctitis recommend hyperbaric oxygen therapy as an effective treatment modality to reduce bleeding in patients with radiation proctitis.

NATIONAL LIBRARY OF MEDICINE

Hyperbaric Treatment of Radiation Proctitis

Researchers in this study conducted a randomized, controlled, phase 2-3 trial (RICH-ART [Radiation Induced Cystitis treated with Hyperbaric oxygen-A Randomized controlled Trial]) at five Nordic university hospitals. All of the patients had completed at least six months of treatment and had a score of less than 80 in the urinary domain of the Expanded Prostate Index Composite Score (EPIC), and referred to participating hyperbaric clinics due to symptoms of late radiation cystitis.
NATIONAL LIBRARY OF MEDICINE

Hyperbaric oxygen in the treatment of severe refractory hemorrhagic radiation proctitis: a randomized controlled trial

This review found Grade B and C evidence that hyperbaric oxygen therapy reduced late-onset radiation injuries to the head and neck, bone, prostate and bladder. It also appeared to prevent osteoradionecrosis in irradiated areas and increased the effectiveness of radiation in head and neck tumors.
NATIONAL LIBRARY OF MEDICINE

Hyperbaric oxygen in the treatment of severe refractory hemorrhagic radiation proctitis: a randomized controlled trial

Hyperbaric oxygen therapy (HBOT) has been used as a treatment for radiation injuries for decades, with many publications presenting data from small series or individual cases. Moreover, we know that the hypoxic areas of tumours are more resistant to radiation. HBOT increases the oxygen tension in tissues and, theoretically, it should enhance the efficiency of radiotherapy. To better understand how HBOT works, the researchers in this study carried out a bibliographic review. They found Grade B and C evidence that at pressures exceeding 2 absolute atmospheres (ata), HBOT reduced late-onset radiation injuries to the head and neck, bone, prostate and bladder. It also appeared to prevent osteoradionecrosis after exodontia in irradiated areas. Finally, HBOT at 2 ata increased the effectiveness of radiation in head and neck tumors and achieved promising results in the local control of high-grade gliomas.
NATIONAL LIBRARY OF MEDICINE

Hyperbaric oxygen treatment of chronic refractory radiation proctitis: a randomized and controlled double-blind crossover trial with long-term follow-up

Hyperbaric oxygen therapy improved healing in patients with refractory radiation proctitis. Other medical management requirements were discontinued, and advanced interventions were largely avoided. Patients' bowel-specific quality of life improved.

NATIONAL LIBRARY OF MEDICINE

Hyperbaric oxygen treatment of chronic refractory radiation proctitis: a randomized and controlled double-blind crossover trial with long-term follow-up

Of 57 patients in the study, 49 (86%) experienced complete resolution or marked improvement of hematuria following hyperbaric oxygen treatment. Of the 8 patients who did not improve, 4 received fewer than 40 hyperbaric oxygen treatments and 7 prematurely terminated treatment (medical co-morbidities 4, claustrophobia 2, temporary resolution of symptoms 1).

Patient Experiences

Bay Area Hyperbarics has healed hundreds of patients with stubborn and non-healing wounds over the last 20 years.
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  • John is a quiet guy with a nice smile who had bladder cancer and radiation therapy 12 years prior to coming in to see us. He had blood in his urine, passed occasional painful clots and had urinary frequency which kept him getting up often at night. After HBOT, the bleeding and passing clots stopped and his frequency resolved.

    John, 64

    Recovered from occasional painful clots due to bladder cancer.
  • John, who is a salt-of-the-earth kind of guy, came in after having multiple other treatments some very painful, to stop his bladder from bleeding. Unfortunately, none of the previous treatments helped. Most patients who come to us to try hyperbaric oxygen therapy for a damaged bladder have already tried other conservative measures, which sadly have resulted in failure. In John’s case, he even had two transfusions. He also passed painful clots from time to time that resulted in his having to make several trips to the ER. He got up frequently at night to urinate and limited his social life as a result. Hyperbarics healed John’s bladder, and the bleeding stopped. He left feeling much more enthusiastic about life.

    John, 73

    Healed from bleeding bladder which even two transfusions couldn’t heal.
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    John, 64
    Recovered from occasional painful clots due to bladder cancer.
    John is a quiet guy with a nice smile who had bladder cancer and radiation therapy 12 years prior to coming in to see us. He had blood in his urine, passed occasional painful clots and had urinary frequency which kept him getting up often at night. After HBOT, the bleeding and passing clots stopped and his frequency resolved.
  • Unbranded
    John, 73
    Healed from bleeding bladder which even two transfusions couldn’t heal.
    John, who is a salt-of-the-earth kind of guy, came in after having multiple other treatments some very painful, to stop his bladder from bleeding. Unfortunately, none of the previous treatments helped. Most patients who come to us to try hyperbaric oxygen therapy for a damaged bladder have already tried other conservative measures, which sadly have resulted in failure. In John’s case, he even had two transfusions. He also passed painful clots from time to time that resulted in his having to make several trips to the ER. He got up frequently at night to urinate and limited his social life as a result. Hyperbarics healed John’s bladder, and the bleeding stopped. He left feeling much more enthusiastic about life.

Physicians: Refer a Patient

Refer a patient in three easy steps.
1

You submit patient’s information

As a provider, your office fills out and faxes back the Patient Referral Form. Have questions? Call us!
2

We get authorizations

We make sure the patient understands treatment and then follow the prescribed protocol to get the patient on the road to recovery!
3

Patient starts HBOT

Our medical staff meets with the patient to ensure that HBOT reverse aging treatment is appropriate and contacts Medicare or private insurance to receive authorization.

Research on Hyperbaric Oxygen Therapy

To learn more about HBOT, take a look at our FAQs.
  • What is Hyperbaric Oxygen Therapy?
    Hyperbaric oxygen therapy treats medical conditions with 100% oxygen in a pressurized hyperbaric chamber. The patient lies or sits in the chamber. The oxygen then saturates the plasma in the blood, allowing oxygen to easily flow throughout the body and reach even areas that are injured or diseased, which typically receive less oxygen. The mechanisms of hyperbaric oxygen therapy include stimulating and mobilizing stem cells, down-regulating inflammatory genes, up-regulating reproductive cells and stimulating DNA. HBOT also regrows tiny blood vessels, and stimulates the growth of new healthy cells in the brain, bones, skin, organs, and tissues. People seek hyperbaric oxygen therapy to heal physical damage in their bodies and to promoting health and anti-aging.
  • Does HBOT kill cancer cells?
    Current research indicates that hyperbaric oxygen does not kill cancer cells. However, there has been a small amount of research indicating that hyperbaric oxygen might reduce the size of certain tumors. Also, there has been a study on mice using hyperbaric oxygen, along with a ketogenic diet, to reduce tumors. Hyperbaric oxygen causes many different healing modalities to kick into gear. Could its effect on strengthening the immune system inhibit the growth of cancer cells? Nobody knows. There are numerous studies conclusively showing that hyperbaric oxygen does not encourage cancer cells or tumors to grow. Some patients claim the hyperbaric oxygen makes them feel a lot more comfortable and functional after chemotherapy and also during healing. Note that some chemotherapy drugs are not to be used with hyperbaric oxygen, as the chemotherapy drugs can be enhanced and thus become toxic. A good hyperbaric oxygen facility (such as Bay Area Hyperbarics) will always call the chemotherapy manufacturer to ensure that hyperbaric oxygen therapy will be helpful and not damaging to the patient.
  • IWhat is the CPT code for HBOT?
    The CPT code for HBOT is G0277.
  • Does Medicare cover HBOT?
    Medicare covers Hyperbaric Oxygen Therapy for approved conditions, and many insurance companies also cover approved conditions. If your condition is not approved by your insurance, we can discuss our special rates. Give us a call at (408) 356–7438. We are happy to discuss your options with you.
  • Can HBOT help Neuropathy?
    Hyperbaric treatments help heal neuropathy by regrowing small blood vessels and nerves that have died from disease, injuries from radiation and aging. Patients often experience numbness and or pain when they start treatment. Hyperbaric treatments most often bring back sensation and make, for example, walking easier and more enjoyable.
  • Why would a physician consider HBOT?
    A physician would consider using hyperbaric chamber therapy under a variety of situations. Physicians most typically refer patients to hyperbarics when the patient is not healing with traditional medical interventions and hyperbaric chamber therapy is approved by Medicare for this condition. Some patients experience significant unresolved pain and unremitting disease states that the mechanisms of hyperbaric oxygen therapy in a hyperbaric chamber are known to affect, such as the down regulation of inflamatory genes. For an example, some patients have experienced severe, unremitting hives with itching, which did not improve with any specialists interventions. Some physicians will consider hyperbaric chamber therapy if the patient has no other good avenues for improving their failing health, and they know the hyperbaric chamber therapy is safe and will not harm the patient.
  • What is Hypebaric Oxygen Therapy?
    Hyperbaric Oxygen Therapy (HBOT) Hyperbaric Oxygen Therapy (HB0T) is a medical treatment where you inhale 100% oxygen in a chamber with increased atmospheric pressure. HBOT injects 400x the oxygen into your tissues and bones and mobilizes stem cells. It regrows healthy tissues in the brain, blood vessels, skin and bones. It also reduces pain and swelling, and speeds recovery. It is simple, effective and painless.

Have more Questions?

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San Jose/Los Gatos Clinic
14589 South Bascom Avenue,
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