Hyperbaric Oxygen Therapy Can Help With Radiation-Induced Bleeding

By Amy Geiszler-Jones
Wednesday, May 1, 2019

Hyperbaric therapy can be a treatment option for the small percentage of male patients who develop hemorrhagic cystitis or proctitis following appropriate radiation therapy for prostate cancer.

A patient undergoes hyperbaric oxygen therapy at Ascension Via Christi Wound Healing and Hyperbaric Therapy Center

About 3 to 5 percent of men who’ve undergone radiation therapy for prostate cancer develop bleeding from the bladder, says Marilee McBoyle, MD, the Medical Director at Ascension Via Christi Wound Healing and Hyperbaric Therapy Center at 848 N. St. Francis in Wichita.

Marilee McBoyle, MD, Medical Director at Ascension Via Christi Wound Healing and Hyperbaric Therapy Center

“For that subset of men who do, it’s very miserable,” she says. “Some of them encounter multiple hospitalizations, which may necessitate a cystoscopy to irrigate and empty the bladder of clots as well as control the bleeding. Sometimes they’ll bleed enough to require a transfusion.”

Radiation treatment may have a damaging effect on blood vessels, causing the vessels to become weak and fragile with resultant bleeding. Hyperbaric oxygen therapy can provide the needed oxygen to aid in angiogenesis, the formation of new, healthier blood vessels.

The air we breathe typically provides about 20 percent oxygen under one atmosphere of pressure. Patients in a hyperbaric chamber breathe 100 percent oxygen under two to two-and-a-half atmospheres of pressure. Once in the transparent chamber, patients may experience some of the same sensations as they would when traveling in an airplane or driving in the mountains as atmospheric pressure increases.

“For men with hemorrhagic cystitis, treatments can range between 20 to 40 treatments, each taking two hours and administered Monday through Friday,” says Nancy Trafelet, RT, the Program Director. It takes about 10 minutes to achieve the appropriate atmospheric pressure. After administering pure oxygen for 90 minutes, another 10 minutes is needed for decompression. To help pass the time, patients can watch TV or a movie on a monitor outside the chamber while a trained staff member remains with the patient in the treatment room.

After receiving 20 treatments, the patient is assessed for progress, and a decision is made regarding continuation of more treatments.

“When patients start seeing positive results, they are excited,” Trafelet says.

Hyperbaric therapy can also help women who experience bleeding following appropriate radiation treatment for a gynecological or rectal malignancy, Dr. McBoyle says.

The Ascension Via Christi wound center began offering hyperbaric oxygen therapy in December 2013.

Patients typically require a referral from their urologist or primary care physician before being seen at the Ascension Via Christi Wound Healing and Hyperbaric Therapy Center in Wichita. For questions, call 316-268-5881.

Another Treatment Option for Reducing Prostate Cancer Side Effects

The Cancer Center at Ascension Via Christi St. Francis now offers SpaceOAR, a system designed to reduce radiation therapy side effects in men undergoing prostate cancer treatment.

SpaceOAR provides a layer of protection between the prostate and the rectum, helping eliminate or reduce rectal complications or side effects.

David Bryant, MD, Medical Director for Radiation Oncology at Ascension Via Christi

When used together to treat prostate cancer, CyberKnife and SpaceOAR combine precision with extra protection, says David Bryant, MD, Medical Director for Radiation Oncology at Ascension Via Christi. Ascension Via Christi in Wichita has the area’s only CyberKnife Center, a noninvasive alternative to surgery that delivers high-dose radiation with such precision that it can treat prostate cancer in five doses compared the 44 required by standard radiation therapy.

“While the incidence of rectal complications with CyberKnife is extremely rare, the SpaceOAR system provides an extra assurance for men undergoing prostate cancer treatment,” Dr. Bryant says.

With the system, patients are injected with SpaceOAR hydrogel, a soft, gel-like material used to position the anterior rectal wall away from the prostate temporarily.

“This creates a space to further protect the rectum during radiotherapy,” Dr. Bryant says, adding that patients undergoing CyberKnife therapy both with or without SpaceOAR typically report no discomfort and can resume their normal activities immediately after treatment.

For more information, visit viachristi.org/prostate-cancer.