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delayed radiation injury

"Treating the 14 conditions covered by OHIP"

Ontario HBOT

What is Radiation Damage?
Radiation therapy is used to treat tumors of all types, from tumors in the brain to those in the breast, prostate, uterus and gastrointestinal tract. Although radiation therapy is becoming more accurate and more successful in the treatment of cancer, there is still the potential that normal tissue is damaged in the process. This is called radiation damage, which may have a significant negative impact on a patient's quality of life.
Acute Radiation Injury
Acute radiation injury—damage that occurs right after treatment—usually heals with effective medical care, which may include antibiotics and blood transfusions. On the other hand, delayed radiation injury—damage that occurs at least six months after radiation treatment—tends to be more difficult to diagnose, and therefore, treat. A radiation oncologist or any other medical professional (i.e., primary care physician, plastic surgeon, dentist, etc.) may have trouble connecting the symptoms back to radiation therapy due to the amount of time in between the patient receiving radiation treatment and symptom onset. In fact, there are some instances in which warning signs don’t arise until many years after the initial treatment, which makes diagnosing delayed radiation injury even more of a challenge.
Radiation Damage Symptoms

Some symptoms for radiation damage include blood in stool, painful bowel movements, bladder spasms, erectile dysfunction, tissue inflammation, chronic pain in the area radiated, tissue necrosis (tissue death) and infections.

These symptoms often vary, depending on the type of cancer a patient had, and thus, the area treated.

Radiation Cystitis or Proctitis (Bladder Cancer or Prostate Cancer)

Patients complain of urinary frequency, pain, burning or bleeding. 

Radiation Tissue Injury after Mastectomy

Many women have surgical reconstruction after a mastectomy and radiation therapy. These women are at higher risk of post-operative complications due to poor circulation in the radiated area. Some women even develop open sores on their chest that will not heal and their skin may show signs of redness and/or irritation.

Dental Complications or Jawbone Problems following Head and Neck Surgery for Cancer

Individuals experience open sores, multiple caries or fractures of the jaw, as well as other muscle or skin issues. They may also have trouble swallowing and/or difficulty moving their neck.

Bowel Complications or Bleeding after Colon Cancer and Radiation

Diarrhea, urgency, incontinence, rectal pain and rectal bleeding are common symptoms patients experience after undergoing radiation therapy for colon cancer.

Personality and Neurologic Changes after Radiation Therapy for Brain Cancer

Those who underwent radiation treatment for brain cancer could possibly notice personality, memory and/or language changes. Numbness and tingling, balance issues, loss of bowel or bladder function and weakness of the arms or legs may also be present.

Recovering from Radiation Damage

Radiation injury destroys blood vessels, depletes tissue of the stem cells that keep it healthy, and causes scarring/fibrosis. Hyperbaric oxygen therapy (HBOT), a non-invasive, natural treatment that heals the body from the inside out, is OHIP approved for delayed radiation injury because it can reverse the detrimental effects of radiation damage.

Why Hyperbaric Oxygen Therapy?

An HBOT session, which takes place in a controlled environment overseen by a trained physician, physician assistant or technician, drives 10 to 14 times more oxygen into the blood stream at increase atmospheric pressure. This oxygen stimulus signals the body to regenerate blood vessels in the damaged tissue. It also has the ability to promote stem cell growth, decrease inflammation in the affected area(s), reduce scarring and strengthen the immune system.

In fact, the results of a 2013 study, titled “Hyperbaric Oxygen Treatment in Radiation-Induced Cystitis and Proctitis: A Prospective Cohort Study on Patient-Perceived Quality of Recovery,” demonstrate how HBOT is an effective and safe treatment strategy for late radiation therapy-induced soft-tissue injuries in the pelvic region.

Participants—all of whom underwent radiation therapy prostate or rectal cancer—received HBOT an average of 36 sessions. During each session, they were "delivered 100% oxygen at 2.0 to 2.4 atmospheres (ATA)."

 

According to the study's results, symptoms were alleviated in 76% of patients with radiation cystitis, 89% of patients with radiation proctitis, and 88% of patients with combined cystitis and proctitis. The improvement was sustained at follow-up visits in both domains six to 12 months after receiving HBOT. No severe side effects related to HBOT were observed.

How do I Qualify for OHIP Coverage?

In order to qualify for OHIP covered hyperbaric oxygen therapy for Post-Radiation Necrosis/Delayed Radiation Injury, the individual must have access to documentation supporting their diagnosis. A referral from a physician or specialist is preferred, however it is not absolutely necessary. Our medical director will look over all supporting documentation, and make the ultimate decision for qualification.

Additional Literature
The following documents are sourced from respected medical journals regarding Post-Radiation Necrosis/Delayed Radiation Injury, and Hyperbaric Oxygen Therapy (HBOT). 

Please click on the icon to open the PDF in your browser window. If you would like to download the PDF to your computer, right click on the icon and select "save linked file as". 
Reperfusion Microvascular Ischemia After Prolonged Coronary Occlusion: Implications And Treatment With Local Supersaturated Oxygen Delivery Hypoxia (Auckland, N.Z.) Vol. 7 65-79
Published: Oct 2019
Hyperbaric Oxygen Treatment for Failing Facial Flap
Postgrad Medical Journal
Published: January 2007
Hyperbaric Oxygen Therapy for the Compromised Graft or Flap
Adv Wound Care (New Rochelle) 
Published: January 2017
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