Hyperaric Medicine Team Joins War On Cancer
Main Category: Cancer / OncologyAlso Included In: Radiology / Nuclear Medicine
Article Date: 17 Jun 2008 - 2:00 PDT
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The University of California, San Diego Medical Center's Hyperbaric Medicine Center is part of a nationwide effort to compile and evaluate data in order to validate whether cancer patients being treated for radiation-related wounds heal more quickly and more thoroughly with hyperbaric oxygen therapy.
Each year in the United States, approximately 1.2 million Americans are diagnosed with cancer, half of whom receive radiation therapy. About five percent of those individuals develop problems or "late effect" wounds related to the radiation. Specialists say hyperbaric oxygen therapy is beneficial in managing radiation related injuries, and that a large-scale collection and analysis of data across treatment sites will help substantiate this working knowledge.
"As individual entities, it is difficult to know just how beneficial a therapy is until you can measure it across thousands of patients," said Ian Grover, M.D., Medical Director, Hyperbaric Medicine Center at UC San Diego Medical Center. "So as health care professionals, it is very important to collaborate on our varying experiences through studies such as this registry."
Radiation therapy can leave behind wounds on the skin, or cause blood in the urine or stool. The increased exposure to concentrated levels of oxygen through hyperbaric oxygen therapy helps re-generate blood vessels, thus delivering more oxygen to the wounded area and facilitating healing.
The information gathered at UC San Diego Medical Center will be merged with other leading centers across the U.S. The institutions have already shared findings from 2004 and 2005 and will be contributing data from 2006 and 2007 as well. The combined results will form a data base that will be used to demonstrate the merits of this therapy to other physicians and health care insurers.
"To ensure that this therapy becomes widely available, we must further define and demonstrate its benefits," explained Robert Bartlett, M.D., President of the American College of Hyperbaric Medicine.
In 2006, Bartlett, along with Jeffrey Niezgoda M.D., Medical Director, Centers for Comprehensive Wound Care & Hyperbaric Oxygen Therapy, Aurora Health Care Hyperbaric & Wound Care Associates, in Milwaukee, Wisconsin designed a web-based registry to capture the success of U.S. doctors and nurses who employ this form of therapy.
"This will help us design the best course of treatment for these patients. And we can pass this information along to insurance companies, demonstrating that it is a valid, front-line therapy," said Grover.
About the UC San Diego Hyperbaric Medicine Center
The UCSD Hyperbaric Medicine Center treats patients in accordance with the Undersea and Hyperbaric Medical Society guidelines for the use of hyperbaric oxygen therapy (HBOT).
HBOT is a form of medical treatment that grew from the experience gained by treating deep-sea divers with the "bends," but now is primarily used to treat patients with problem wounds from radiation therapy and diabetes. The therapy's purpose is to increase the amount of oxygen in the blood. During hyperbaric oxygen therapy, the patient breathes pure oxygen. At the same time, the pressure surrounding the patient's body is slowly increased to two to three times the normal atmospheric pressure.
HBOT allows the blood to carry more oxygen to the tissues, promoting new tissue and blood vessel growth, and assisting in the healing process by permitting skin grafting or spontaneous healing. A high level of oxygen in the blood helps to fight infections caused by a variety of bacteria, some that only live in the absence of oxygen. It also enables white blood cells to destroy many kinds of bacteria more efficiently.
As the only hyperbaric chamber in San Diego County open 24 hours a day, seven days a week, UC San Diego Medical Center's hyperbaric chamber plays a critical role in the San Diego County Emergency Medical System. The UC San Diego center is always available for emergency situations, such as diving accidents, carbon monoxide exposures or treatment for emergent ICU patients.
At UC San Diego Medical Center, HBOT is delivered by having a patient lie or sit in a large tube resembling a small submarine, lined inside with padded, bench-style seating for up to 12 people at a time, six on average. It is sealed and pressurized with air to a level several times normal atmospheric pressure. Once the patients are at "depth," they are placed on 100% oxygen for a total of 90 minutes. Patients typically rest, read, watch television or sleep during this two hour treatment. On average, it takes 30 to 40 treatments over six weeks to see marked improvement in healing.
Initially used to treat diving complications, hyperbaric oxygen therapy is used for many indications from the specialties of: orthopedic surgery, general surgery, plastic surgery, maxillofacial and oral surgery, infectious disease, radiation oncology, and emergency medicine.
Media: Dr. Grover, his team and patients are available for interviews.
For more information on UC San Diego's Hyperbaric Medicine Center, please visit: http://health.ucsd.edu/specialties/hyperbaric.
University of California, San Diego Health Sciences
200 West Arbor Dr.
San Diego, CA 92103
United States
http://www.sandiego.edu
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Hyperbaric Oxygen Therapy (HBOT)
posted by Gregory D. Pawelski on 17 Jun 2008 at 10:56 pmIt's good to see a resurgence of research into this valuable technology. Radiation-induced necrosis is a serious reaction to radiation treatment. It may result from the death of tumor cells and associated reaction in surrounding normal brain or it may result from the necrosis of normal brain tissue surrounding the previously treated metastatic brain tumor.
The diagnosis of radiation-induced necrosis is difficult to confirm. Many patients have a mixture of tumor and radiation necrosis and a biopsy may be necessary to distinguish it. Neither symptoms nor radiographic findings clearly distinguish radiation-induced necrosis from tumor. However, the FDG-PET Scan and T1-SPECT studies are useful in differentiating radiation-induced necrosis from recurrent tumor.
Hyperbaric Oxygen Therapy (HBOT) is a useful therapeutic option for patients with confirmed symptomatic radiation necrosis. Until the new millenium, the only treatment for patients was pentoxifyline or heparin therapy, and it was almost always unsuccessful. Both Duke University for Hyperbaric Oxygen Therapy and the University of Cincinnati previously had clinical trials on this science. The most common condition treated at some Hyperbaric Oxygen Therapy Centers is tissue injury caused by brain radiation therapy for cancer.
Wound healing requires oxygen delivery to the injured tissues. Radiation damaged tissue has lost blood supply and is oxygen deprived. Chronic radiation complications result from scarring and narrowing of the blood vessels within the area which has received the treatment. Hyperbaric Oxygen Therapy provides a better healing environment and leads to the growth of new blood vessels in a process called re-vascularization. It also fights infection by direct bacteriocidal effects. Using hyperbaric treatment protocols, "most" patients with chronic radiation injuries can be cured.
Hyperbaric oxygen therapy is administered by delivering 100 percent oxygen at pressures greater than atmospheric (sea level) pressure to a patient in an enclosed chamber. Hyperbaric oxygen acts as a drug, eliciting varying levels of response at different treatment depths, durations and dosages, and has been proven effective as adjunctive therapy for specifically indicated conditions.
Oxygen is a natural gas that is absolutely necessary for life and healing. Purified oxygen is defined as a drug but is the most natural of all drugs. Oxygen under pressure is still the same gas but is more able to penetrate into parts of the body where the arterial flow is hindered, producing ischemia (loss of blood flow) and hypoxia (lack of oxygen). When oxygen under pressure is breathed by a patient in a sealed chamber, it is termed a hyperbaric oxygen treatment (HBOT).
In addition to raising the arterial levels of oxygen 10 to 15 times higher than that produced by normal atmospheric pressure, the pressure exerted within the body can and does exert therapeutic benefits on acute and chronically traumatized and swollen tissues.
Sources:
Hyperbaric Medicine Service at UVA
Hyperbaric Medicine, John Muir Medical Center
Duke University Center for Hyperbaric Medicine
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