Radiation-induced hemorrhagic cystitis (HRC) can arise anywhere from one month to 10 years after the original radiation.
The resulting obliterative endothelialitis after radiation is hypovascular, hypoxic and hypocellular. This results in low self-healing rates and cessation of fibroblast activity. It also decreases tissue collagen matrix formation, angiogenesis, osteoblast/osteoclast activity, and tissue and bone formation.
Many physicians refer their patients with HRC to Hyperbaric Oxygen Therapy (HBOT) to heal the bladder wall and stop the bleeding. HBOT also helps relieve the sense of urgency that some patients experience as well, so they do not have to get up often in the night. This condition can of course be painful and occasionally life-threatening.
In fact, most insurance companies cover the cost of hyperbarics for patients with a sense of urgency after radiation therapy.
The authors of one large review report that 57% of the 44 patients had complete resolution and another 32% had improvement of 50-90%.  In another series of 196 patients, 76.3% had either complete or partial resolution. 
That said, early HBOT intervention is critical in achieving success and preventing loss of life. One study showed that hemorrhagic cystitis patients who do not receive HBOT treatments experience a 3.7% mortality rate.
Several studies have shown the effectiveness of HBOT in the treatment of HRC. In the three studies listed below, most patients had already failed conservative treatment measures. After receiving hyperbaric oxygen therapy, at least 76% of patients showed a significant resolution of their HRC. The actual percentages are:
Overall, researchers said that HBOT appears to be a very effective and economical approach to the treatment of HRC. They suggest that HBOT is the only therapy that has been demonstrated to promote healing of HRC.
This study included a challenging group of patients in whom blood transfusions were necessary, other modalities to stop bleeding had been attempted, and radical surgery or urine diversion was needed in some of the patients. Even in this difficult cohort, hyperbaric oxygen therapy showed a 76% resolution of HRC.
Some researchers had in the past raised the question of whether the improved tissue oxygenation from HBOT might boost residual malignant cells and rekindle cancer. In this study, Feldmeir et al, reviewed this issue and concluded that there is no evidence for either malignant or metastatic cell enhancement under HBOT.
In fact, early animal studies have shown that HBOT inhibits and reverses breast tumor growth. We look forward to sharing additional research as it emerges.
As a provider, your office fills out and faxes back the Patient Referral Form. Have questions? Call us!
We make sure the patient understands treatment and then follow the prescribed protocol to get the patient on the road to recovery!
Our medical staff meets with the patient to ensure that HBOT is appropriatre, and contacts Medicare or private insurance to receive authorization.
Hyperbaric medicine, also called hyperbaric oxygen therapy or HBOT, is a medical treatment where a patient sits or lies in pressurized chamber and breathes 100% oxygen. In HBOT, oxygen dissolves into the blood, thus raising the oxygen concentration to very high levels.This increased oxygen is a primary building block for tissues, muscle, and bone repair. Among other benefits, it kicks off cell reproduction, heals injuries and infection more rapidly, and decreases inflammation.
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.
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.
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.
The CPT code for HBOT is G0277.
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.
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.
Corman et al