Hyperbaric Oxygen Therapy

What is hyperbaric oxygen therapy?

Hyperbaric oxygen therapy (HBO) treats wounds and other medical conditions using a pressurized chamber that provides 100% pure oxygen. The air pressure in the chamber is 2 to 3 times higher than normal. While in the chamber, you are breathing in pure oxygen (100% oxygen versus the 21% oxygen you normally breathe). This can help your body heal and fight some infections.

HBO is sometimes used as part of your cancer treatment. Your blood carries this oxygen throughout your body, which can help make your cancer cells easier to kill with chemotherapy and radiation. It can also be used to heal cells damaged by cancer and its treatments.

What is HBO used for?

The U.S. Food and Drug Administration (FDA) has approved HBO to help treat the following disorders:

• Air and gas bubbles in your blood vessels.
• Anemia.
• Burns.
• Carbon monoxide poisoning.
• Trauma from force or pressure on a body part (crush injury).
• Decompression sickness (scuba diving risk).
• Gangrene caused by bacteria called Clostridium (gas gangrene).
• Hearing loss.
• Severe bone and skin infections.
• Radiation injuries.
• Skin grafts.
• Loss of vision.
• Injuries to the skin (wounds).

The use of HBO for other conditions is still being studied and there are several clinical trials. There is not enough research to prove that HBO can safely and effectively treat other conditions that are not approved by the FDA.

How is HBO delivered?

The length of care varies but is often 20-40 treatments given 1-2 times per day. Treatment lasts 1-2 hours. There are two types of HBO chambers:

• One-person chamber (monoplace chamber), where you will lie on a table that slides into the hyperbaric chamber for treatment.
• Multiperson chamber (multiplace chamber), which is used for several people at the same time. You will either sit or lie with a mask or a lightweight hood over your face for oxygen delivery.

In a multiplace chamber, there will likely be a staff member there to help you if needed. There will not be a person with you in a monoplace chamber. Tell the staff if you have any drains, tubes, or pumps inside or outside of your body, if you have any dressings (bandages), or if you have diabetes. You will be told by your care team what you are allowed to have in the chamber with you. Hyperbaric chambers have a fire risk, so these orders must be followed closely.

Can anyone get HBO?

No, some people should not get HBO. HBO should not be used or should be used with caution if you are receiving bleomycin, cisplatin, disulfiram, mafenide acetate, or doxorubicin. If you have a collapsed lung (pneumothorax), lung disease, recent ear injury or surgery, sinus infection, seizure disorder, or if you have a fever or cold you should let your care team know so they can decide if HBO is an option for you. Make sure that your care team is aware of all the medications you are taking.

Why is HBO used in people with cancer?

Cancer treatment, mainly with radiation, can harm healthy tissues. It can lead to issues such as bleeding from the bladder, gut or rectum, harm to the jawbone, teeth, and throat, non-healing wounds, tooth decay, and soft tissue damage in the chest wall. The introduction of pure oxygen into the body can help heal these tissues by:

• Helping grow new blood vessels by getting more oxygen to those area(s).
• Reducing swelling and allowing better blood flow.
• Higher oxygen levels help white blood cells to kill bacteria and stop infection.
• Helping reduce fibrosis caused by radiation (Learn more about Radiation Fibrosis Syndrome).

The most common use for HBO in people with cancer is the care and prevention of osteoradionecrosis. Radiation can damage blood vessels within the bone. This makes it hard for the bone to heal itself. This side effect occurs most often after radiation to the mouth area. Osteoradionecrosis is caused by damage to the gum tissue. The jawbone(s) may be exposed through this damaged tissue. This can lead to pain, swelling, infection, and tooth loss. HBO is often used before and after surgery to help with healing and reduce side effects.

HBO can be useful in taking care of long-term side effects of cancer treatment. If you think that HBO may be helpful to you, speak to your care team.