In this post I’m going to tell you all about hyperbaric oxygen therapy (HBOT) as an adjunct to cancer treatment. HBOT, in combination with other natural and standard of care therapies, can help improve the success of your treatments, heal side effects and damage from toxic drugs and radiation, combat infections and so much more. In this post I will be dispelling some of the common myths around HBOT and sharing the studies showing how beneficial it really is when it comes to cancer.
WHAT IS HYPERBARIC OXYGEN THERAPY?
Hyperbaric oxygen therapy is breathing 100% oxygen under elevated barometric pressure in a special chamber. The chamber raises the pressure to 1.5 – 3 times higher than the normal pressure at sea level. With the elevated pressure and 100% oxygen (normal room air is only 21% oxygen), the oxygen becomes dissolved in the blood and tissues, leading to much higher levels than would be achieved by breathing 100% oxygen alone. The oxygen is also able to reach areas with poor circulation, where it might otherwise not be able to reach effectively.
Believe it or not, the first use of hyperbaric therapy was in 1662! A British doctor first tried this by placing patients in a steel container with pressurized room air. They did not even know what oxygen was at that time. When oxygen was discovered in 1775, they cautiously replaced the room air with 100% oxygen under pressure, thus hyperbaric oxygenation was begun.
In 1937, HBOT was successfully used to treat decompression sickness, also known as “the bends” in U.S. Navy deep sea divers. In the 1950s, HBOT was used to increase the effects of radiation therapy in cancer patients and was used as an adjunct treatment for head and neck and cervical cancers. Around the same time, another doctor started using HBOT for his cardiac surgery patients. Since that time, HBOT has been extensively studied and applied successfully for a variety of medical conditions including cancer.
FDA APPROVED INDICATIONS FOR HBOT
Here is a list of the Food and Drug Administration approved uses for HBOT in human medicine. HBOT for any of these indications may be covered by insurance.
Air embolism in blood vessels
Decompression sickness (scuba diving risk)
Anemia
Burns
Carbon monoxide poisoning
Traumatic crush injuries
Gangrene caused by a clostridium bacteria
Hearing loss
Severe bone and skin infections
Radiation injuries
Skin grafts
Loss of vision
Injuries to the skin, non-healing wounds
HOW HYPOXIA CAN CAUSE CANCER PROGRESSION
Hypoxia means low oxygen concentration. A hallmark of cancer is hypoxia in tumors and the tumor microenvironment. Every solid tumor is hypoxic. This is due to increased oxygen consumption by the rapidly dividing cancer cells and lack of oxygen delivery from the abnormal blood vessels formed during tumor angiogenesis, among other things. Cancer cells are very different than normal cells and they become adapted to this environment and thrive in these low oxygen conditions.
Uterine cancer patients often have a state of low-grade, subclinical hypoxia. This can be due to a number of factors including obesity, other diseases like diabetes, sleep apnea, chronic, shallow chest breathing, anemia, poor circulation and a sedentary lifestyle.
Numerous studies have shown that hypoxia can lead to tumor progression, metastasis, invasion and resistance to treatment. This makes hypoxia an attractive target for cancer treatment.
References
Role of hypoxia in cancer therapy by regulating the tumor microenvironment Read More
Targeting tumor adaptation to chronic hypoxia: Implications for drug resistance and how it can be overcome Read More
Here are some of the ways hypoxia causes cancer progression
- Hypoxia selects for more malignant cells and induces multiple adaptations in cancer cells, which allows for progression and growth
- Induces angiogenesis, the formation of new blood vessels in tumors
- Increases glycolysis, which feeds cancer cells
- Upregulates genes involved in cancer cell survival
- Activates invasive growth and metastasis through epithelial to mesenchymal transition and through the MAPK/ERK signaling pathway
- Preserves undifferentiated cancer cell states. These are more malignant and aggressive tumors that no longer resemble normal tissue
- Creates resistance of cancer cells to conventional treatments like chemotherapy and radiation
- Creates an immunosuppressive environment allowing cancer cells to hide from the immune system and survive
- Leads to over-expression of enzymes that break down antioxidants in the tumor microenvironment. This protects cancer cells and allows them to heal from damage
- Hypoxia makes the tumor microenvironment more acidic, which leads to multi-drug resistance
- Leads to the induction of hypoxia-inducible factors (HIFs), which play a distinct role in tumorigenesis. HIFs are over expressed in the majority of human cancers. They cause resistance to conventional therapies through a number of signaling pathways
HOW HBOT IS EFFECTIVE AGAINST CANCER
- Reduces tumor hypoxia by increasing the amount of dissolved oxygen in plasma and tissues. By reducing tumor hypoxia, all those things I listed above can be reversed making your body inhospitable to cancer Read More
- Improves the effectiveness of radiation therapy on solid tumors
- Overcomes chemotherapy resistance and improves the efficacy of chemo drugs by increasing tumor perfusion and cellular sensitivity
- Decreases chemotherapy toxicity in normal tissues
- Increases the formation of reactive oxygen species within cancer cells and induces apoptosis
- Prevents and treats delayed radiation injuries to bone, bladder, gastrointestinal tract and more
- Reduces the percentage of tumor recurrence after irradiation
- May be an effective treatment for peripheral neuropathy caused most commonly by chemotherapy. It restores blood flow and oxygen to the damaged nerves allowing them to heal and regenerate, relieving pain, tingling and numbness Read More Read More
- It helps wound healing. Injuries damage blood vessels and they leak fluid into the tissues, which causes swelling. The swelling deprives the damaged cells of oxygen and tissues start to die. HBOT reduces the swelling and floods the damaged tissues and cells with oxygen so they can heal
- Can block the action of harmful bacteria and their toxins and strengthen the immune system. By increasing the oxygen concentration in the tissues, they can resist infection. Many bacteria can’t withstand high oxygen levels and will die. It improves the ability of the white blood cells to find and destroy the bacteria
- HBOT helps with the formation of new collagen and new skin cells. This is especially important for healing radiation damaged areas and healing from surgery
- Augments the effects of photodynamic (light-activated) therapy to treat cancer
- Optimizes mitochondrial health in normal cells
- Reduces the HIFs (hypoxia inducible factors), which lead to cancer cell proliferation and are up-regulated in cancer cells
- Induces the preferential expression of anti-cancer genes in rat models
- Reduces inflammation and improves tissue healing
- Recruits immune cells to the tumor microenvironment
- Supports the resilience and function of normal cells, while causing stress and damage to abnormal cells
- Useful for treating anemia, a common problem in cancer patients
- Can speed up surgical recovery and help reduce pain, swelling and edema after surgery
- Is often helpful in reducing side effects of cancer treatments including fatigue, brain fog, anemia and mucositis
OTHER USES FOR HBOT BESIDES CANCER
HBOT may also be helpful in the treatment of arthritis, stroke, multiple sclerosis, autism, chronic fatigue, allergies, dementia, liver cirrhosis and gastrointestinal ulcers. It has also been described for use to help slow down the effects of aging. Some practitioners report using it for lyme disease, long covid recovery and healing neurologic conditions.
SOME COMMON MYTHS ABOUT HBOT AND CANCER
HBOT CAUSES TUMOR PROGRESSION
Up until 2012, it was thought that the use of HBOT could lead to tumor progression by increasing oxygen levels in the tumor microenvironment and promoting angiogenesis (new blood vessel formation) in tumors. However, in 2012 a study came out, which showed that not only was HBOT not contraindicated for cancer treatment, but that it could be beneficial.
Here is the summary and reference to that paper
To supplement the previous reviews, we have summarized the work performed on HBO and cancer in the period 2004–2012. Based on the present as well as previous reviews, there is no evidence indicating that HBO neither acts as a stimulator of tumor growth nor as an enhancer of recurrence. On the other hand, there is evidence that implies that HBO might have tumor-inhibitory effects in certain cancer subtypes, and we thus strongly believe that we need to expand our knowledge on the effect and the mechanisms behind tumor oxygenation Read More
After that report came out, more studies were done on the effects of HBOT on cancer. Over time, it was discovered that HBOT works differently in cancer cell biology than it does in non-cancer cell biology.
References
Hyperbaric oxygen and malignancies: a potential role in radiotherapy, chemotherapy, tumor surgery and phototherapy Read More
Hyperbaric oxygen as an adjunctive therapy in treatment of malignancies, including brain tumours Read More
To date, there are no studies that have shown that HBOT promotes malignant cell proliferation or cancer recurrence.
HBOT IS CONTRAINDICATED WITH ALL CHEMOTHERAPY DRUGS
There are only a few chemo drugs where HBOT may be contraindicated for use on the same day or within a certain time period as the HBOT. Many studies show that HBOT used concurrently with chemotherapy can actually potentiate the effects of the chemo drugs making the cancer cells more susceptible to treatment.
Drugs where they recommend using caution with HBOT are bleomycin, doxorubicin and cisplatin. In this review paper, they mainly reference studies done on animal models and the results were not clear cut. In fact, in their conclusion they say HBOT can be used with bleomycin, doxorubicin and cisplatin, but timing is a factor. Read More
HBOT SHOULD NOT BE USED WITH RADIATION THERAPY
Oxygen is a radiosensitizer. This means that oxygen is a requirement for radiation to kill cancer cells. Tumors with areas of hypoxia become resistant to radiation. Studies have shown that pre-treatment with HBOT before radiation therapy not only helps prevent injury, but can actually make the radiation therapy more effective.
One of the approved uses for HBOT is to heal delayed radiation injuries including soft tissue and bony necrosis (osteoradionecrosis) and it is very effective for these late complications. It can help heal radiation damage to bone, the gastrointestinal tract, bladder, rectum and more. Many times insurance will even cover the cost of HBOT for these problems.
POSSIBLE CONTRAINDICATIONS TO HBOT
It is always a good idea to discuss HBOT with your doctor(s) prior to starting. These are some reasons why HBOT may be contraindicated or you need to use caution before using it.
- Severe lung diseases such as emphysema or chronic obstructive pulmonary disease (COPD) or pneumothorax
- If you have ear problems or sinus troubles (i.e. a cold) and are unable to equalize (“pop”) your ears, this can be a problem
- Recent thoracic (chest) surgery
- If you have a pacemaker
- Recent eye/retinal/cataract surgery
- History of seizures
- Do not wear hard contact lenses in the chamber, only soft lenses that are gas permeable
- Congestive heart failure with an ejection fraction of 35% or less
- If you are on any of the chemotherapy drugs I mentioned earlier, make sure to discuss the timing of HBOT with your oncologist
- Claustrophobia may be a problem for some people. They make chambers that are glass so you can see out, which helps and some patients may be given a light sedative to help them relax
POSSIBLE SIDE EFFECTS
HBOT is considered very safe and side effects are not common and often temporary. Side effects are more common with prolonged, repeated therapies at high pressures above 2.0 ATA.
Mild side effects (temporary)
Ear pressure or pain, “popping” in the ears
Vision changes like nearsightedness
Sinus pressure or congestion
Flu-like symptoms
Fatigue or light-headedness
More serious side effects
Lung damage
Eardrum rupture or leaking fluid
Low blood sugar in diabetics on insulin
Seizures (very rare)
HOW TO USE HBOT
HBOT is a very common adjunctive treatment in integrative cancer centers. Some naturopathic clinics and chiropractic centers may offer HBOT as well.
HBOT is most commonly in a monoplace chamber for one person. Ideally, it is a glass chamber where you can see out, especially if you have claustrophobia.
A multiplace chamber is a room where several people get HBOT at the same time.
Ideally, a naturopathic doctor can guide you as to the best protocol for your particular situation.
HBOT sessions are typically 60-90 minutes long. How many sessions you need and how often you should get treatment is variable and depends on the conditions you are being treated for.
Fasting and being in ketosis is very beneficial during HBOT. It is not required, but it does make the HBOT even more effective.
The Ketogenic Diet and Hyperbaric Oxygen Therapy Prolong Survival in Mice with Systemic Metastatic Cancer co-author, Dr. Thomas Seyfried Read More
HBOT can be given with a range of pressures. The higher the pressure and the longer the sessions, the more risk for side effects.
As I mentioned before, do not wear hard contact lenses when receiving HBOT and make sure you can equalize (pop) your ears.
The downside of HBOT is the expense. If you are able to get it approved through your insurance, I would highly recommend this. If not, each session could cost $150-$600 depending on where you go. Many facilities will offer package deals.
IN CONCLUSION
HBOT is a very good adjunctive treatment for cancer patients for many reasons. It is expensive and may not be readily available, but I would encourage you to check into it. If you have radiation injuries, non-healing wounds, infections or peripheral neuropathy your insurance may cover treatments. It can’t hurt to ask. I personally have never done HBOT, but I do believe in it and am open to trying it in the future if I have any indications for it.
I’ll leave you with a video of Dr. Nasha Winters, a prominent naturopathic doctor who survived stage 4 ovarian cancer, discussing HBOT for cancer. Video
The Lord bless you and keep you; the Lord make His face shine upon you and be gracious to you; the Lord turn His face toward you and give you peace.
Numbers 6:24-26