Condition support
Post-Radiation Injuries
Radiation therapy saves lives — but months or even decades later, some patients develop painful, hard-to-heal injuries in the treated area. Hyperbaric oxygen therapy is an established, evidence-based treatment for delayed radiation injury, and participating MD Hyperbaric centers accept insurance, including Medicare, for this on-label indication.
WHY DELAYED RADIATION INJURY MATTERS
Injuries Can Appear Months or Decades Later
What Is Delayed Radiation Injury?
Radiotherapy targets cancer cells, but it also affects the small blood vessels in surrounding healthy tissue. Over time this can cause the vessels to narrow and scar (obliterative endarteritis), leaving the tissue chronically starved of oxygen — hypoxic, hypovascular, and unable to repair itself. Symptoms can appear six months to decades after radiation treatment ends.
Radiation Cystitis (Bladder)
After pelvic radiation for prostate, bladder, cervical, uterine, or rectal cancer:
- Blood in the urine (hematuria), sometimes severe
- Urinary urgency, frequency, and burning
- Bladder spasms and pelvic pain
- Reduced bladder capacity and incontinence
Osteoradionecrosis (Bone, Typically the Jaw)
After head and neck radiation:
- Exposed, non-healing bone in the mouth (often following a dental extraction)
- Persistent jaw pain, swelling, or drainage
- Difficulty opening the mouth (trismus), chewing, or swallowing
- Risk of fracture in the weakened jaw
Soft Tissue Radionecrosis
In any irradiated area:
- Non-healing ulcers or wounds in the radiation field
- Radiation proctitis (rectal bleeding, urgency) after pelvic radiotherapy
- Chronic fibrosis, contracture, and lymphedema
- Fistulae and breakdown of previously healed tissue
HOW HBOT HELPS
Addressing the Underlying Oxygen-Supply Problem
Delayed radiation injury is fundamentally an oxygen-supply problem, and HBOT is one of the only treatments that addresses that underlying cause rather than just the symptoms.
Delayed radiation injury is fundamentally an oxygen-supply problem, and HBOT is one of the only treatments that addresses that underlying cause rather than just the symptoms. Breathing 100% oxygen under pressure:
- Re-oxygenates radiation-damaged tissue — raising tissue oxygen above the threshold needed for healing cells (fibroblasts, osteoblasts) to work
- Stimulates new blood vessel growth — in landmark studies of irradiated tissue, HBOT produced an 8–9x increase in capillary density (Marx RE, J Oral Maxillofac Surg 1983, PMID 6572704)
- Reduces fibrosis and inflammation — moderating the scarring process that stiffens irradiated tissue
- Supports surgical healing — improving outcomes when surgery (debridement, extraction, reconstruction, fistula repair) must be done in an irradiated field
Re-Oxygenates Radiation-Damaged Tissue
Stimulates New Blood Vessel Growth
Reduces Fibrosis and Inflammation
Supports Surgical Healing
Who can benefit?
Patients With Delayed Radiation Injuries
Patients With Radiation Cystitis
RICH-ART randomized controlled trial (Oscarsson et al, Lancet Oncology 2019, PMID 31537473): significant improvement in patient-reported urinary symptoms and quality of life for radiation cystitis versus standard care, with durable response at long-term follow-up (EClinicalMedicine 2025, PMID 40291346).
Read study (opens in a new tab)
Patients With Osteoradionecrosis
Marx protocols (J Oral Maxillofac Surg 1983, PMID 6572704; JADA 1985, PMID 3897335): established HBOT regimens for treating osteoradionecrosis and for preventing it when dental extractions are needed in irradiated jaws.
Read study (opens in a new tab)
Patients With Soft Tissue Radionecrosis
Radiation proctitis crossover RCT (Clarke et al, IJROBP 2008, PMID 18342453): significant improvement in refractory radiation proctitis versus sham in a double-blind crossover trial with long-term follow-up.
Read study (opens in a new tab)
Patients Having Surgery in an Irradiated Field
HBOT supports surgical healing — improving outcomes when surgery (debridement, extraction, reconstruction, fistula repair) must be done in an irradiated field.
Read study (opens in a new tab)Your Next Step
Ready to Discuss a Post-Radiation Injury?
Call to verify your coverage.
How We're Different
Why Choose MD Hyperbaric?
Here's why thousands of patients trust MD Hyperbaric to accelerate their recovery:
Patient Centered Care
We tailor your treatment to your needs and guide you through every step—so you feel informed, supported, and on track to recover faster.
The Most Advanced Chambers
We use the largest and safest FDA-cleared, hyperbaric chambers on the market, for comfort, results and peace of mind.
Expert Medical Oversight
Every treatment is overseen by licensed medical providers and delivered by trained staff with specialized expertise in HBOT.
Uncompromising Safety Standards
Our team follows strict protocols to ensure every treatment is delivered in a safe, carefully controlled environment.
How It Works
A Coordinated Path to Treatment
We guide you through every step—from consultation to treatment—with expert support and personalized care, all backed by a proven, physician-led process to ensure your safety and results.
Free Discovery Call
Speak with our team to learn more about HBOT and whether it's a good fit for you (optional).
Intake & Review
Complete a simple health form for our medical team to review. They will follow up if anything needs clarification.
Personalized Plan
You'll receive a custom protocol designed for your recovery.
Start Your First Session
Enter our roomy FDA-cleared hyperbaric chamber at your local center and start treatment with expert guidance.
Monitor & Measure
Our team will monitor and evaluate your response to treatment to ensure safety and optimal outcomes are achieved.
What Our Patients Say
Real Patients. Real Results
Post-Surgical Recovery“Getting HBOT helped me a lot with my wound healing. I noticed my scars remarkably lightened. My mood and energy levels improved as well in just three weeks of getting two sessions each week — despite my demanding work schedule, I felt like I had more energy.”Namae
Inflammatory Bowel Disease“I was prescribed HBOT by my specialist to treat a complex and traumatic issue stemming from IBD and reconstructive GI surgeries. I did a full course and absolutely saw improvement right away. The staff are amazing, very professional and caring.”Kathleen
Injury Recovery“I broke my wrist playing tennis and came to MD Hyperbaric Westchester to help speed up my recovery. After a few sessions I have felt a tremendous improvement in energy, sleep — and my doctor says my wrist is healing remarkably well.”John
Cancer Adjunct“I'm a breast cancer survivor, and after radiation near my lungs, I thought this treatment might be useful. I can feel a difference in my breathing and cognition. I definitely recommend it if your body has gone through a traumatic experience.”Aziza
Wellness“I recently began using Hyperbaric Oxygen Therapy at MD Hyperbaric, and it's been one of the most unique and impactful wellness treatments I've explored. I was drawn in by the potential benefits for anxiety, fatigue, and overall cellular repair, but I didn't expect it to feel this restorative — and my skin is glowing too!”Olesia
Still Have Questions?
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Clinical protocol
Typical Treatment Protocols
| Condition | Sessions | Frequency | Duration | Pressure | Reported Outcomes |
|---|---|---|---|---|---|
| Radiation cystitis (chronic / refractory) | 30–40 | 5x/week | 90 mins | 2.0–2.4 ATA | Improved urinary symptoms and QoL; reduced hematuria; durable at long-term follow-up (Oscarsson 2019 RICH-ART; 2025 follow-up) |
| Osteoradionecrosis (established, Marx Stage I–II) | 30–40, with surgery | 5x/week | 90 mins | 2.0–2.4 ATA | Resolution of exposed bone with surgical adjunct; improved bone and soft tissue healing (Marx 1983) |
| Pre-extraction prophylaxis (irradiated jaw) | 20 before + 10 after | 5x/week | 90 mins | 2.0–2.4 ATA | Reduced post-extraction osteoradionecrosis (Marx et al 1985) |
| Soft tissue radionecrosis (incl. proctitis, head & neck) | 30–40 (up to 60 for severe) | 5x/week | 90 mins | 2.0–2.4 ATA | Reduced bleeding and symptom severity; improved fistula closure and wound healing (Clarke 2008; Bennett 2016) |
Your exact protocol is set by our Medical Director in coordination with your treating specialists. Evaluation before treatment typically includes confirming the diagnosis, documenting that conventional therapy has been tried, and excluding recurrent cancer in the affected area — steps that also support insurance approval.
Supporting Research
Research on HBOT for Post-Radiation Injuries
Delayed radiation injury, including radiation cystitis, osteoradionecrosis and soft tissue radionecrosis, is an FDA-recognized indication for HBOT.
Radiation-induced cystitis treated with hyperbaric oxygen therapy (RICH-ART): a randomised, controlled, phase 2-3 trial
(opens in a new tab)Hyperbaric oxygen for radiation-induced cystitis: A long-term follow-up
(opens in a new tab)Early hyperbaric oxygen therapy improves outcome for radiation-induced hemorrhagic cystitis
(opens in a new tab)Osteoradionecrosis: a new concept of its pathophysiology
(opens in a new tab)Prevention of osteoradionecrosis: a randomized prospective clinical trial of hyperbaric oxygen versus penicillin
(opens in a new tab)HOPON: a randomized controlled trial of hyperbaric oxygen to prevent osteoradionecrosis of the irradiated mandible
(opens in a new tab)The use of hyperbaric oxygen for the prevention and management of osteoradionecrosis of the jaw: a Dana-Farber/Brigham and Women's Cancer Center multidisciplinary guideline
(opens in a new tab)Hyperbaric oxygen treatment of chronic refractory radiation proctitis: a randomized and controlled double-blind crossover trial
(opens in a new tab)Hyperbaric oxygen for patients with chronic bowel dysfunction after pelvic radiotherapy (HOT2): a randomised, double-blind, sham-controlled phase 3 trial
(opens in a new tab)Hyperbaric oxygen therapy for late radiation tissue injury
(opens in a new tab)Hyperbaric oxygen therapy and delayed radiation injuries (soft tissue and bony necrosis): 2012 update
(opens in a new tab)Prospective assessment of outcomes in 411 patients treated with hyperbaric oxygen for chronic radiation tissue injury
(opens in a new tab)The effect of hyperbaric oxygen treatment on late radiation tissue injury after breast cancer: A case-series of 67 patients
(opens in a new tab)UHMS Indications Manual — Delayed Radiation Injury (Soft Tissue and Bony Necrosis)
(opens in a new tab)Before Your First Visit
Frequently Asked Questions
Delayed radiation injury can develop anywhere from six months to decades after radiotherapy ends. If you have new bleeding, pain, or a non-healing wound in an area that was irradiated — even many years ago — it is worth being evaluated.
At participating MD Hyperbaric centers, yes — we are in-network providers and accept insurance, including Medicare, for delayed radiation injury, an on-label indication. Contact our center directly, or ask your urologist, oncologist, oral surgeon, or wound specialist to send a referral. We verify your benefits before treatment begins. Coverage depends on your diagnosis, your plan, and medical-necessity criteria; insurers typically expect documentation that conventional treatment has been tried and that cancer recurrence has been ruled out. Most plans require prior authorization, which we coordinate with your physician and insurer. We will explain your expected costs before your first session.
The RICH-ART randomized controlled trial found significant improvements in urinary symptoms and quality of life for radiation cystitis versus standard care, with a durable response at long-term follow-up (Oscarsson et al, Lancet Oncology 2019, PMID 31537473; EClinicalMedicine 2025, PMID 40291346). Established Marx protocols cover treatment of osteoradionecrosis and prevention when dental extraction is needed in an irradiated jaw (J Oral Maxillofac Surg 1983, PMID 6572704; JADA 1985, PMID 3897335). A crossover randomized trial reported improvement in refractory radiation proctitis (Clarke et al, IJROBP 2008, PMID 18342453), while a Cochrane review found evidence that HBOT can improve outcomes in late radiation tissue injury.
Yes — this is one of the most established uses of HBOT. A course of sessions before and after the extraction (commonly 20 before and 10 after) significantly reduces the risk of osteoradionecrosis, the non-healing bone injury that can follow dental work in an irradiated jaw. Ask your oral surgeon or dentist to contact us before the procedure.
HBOT for delayed radiation injury is given after cancer treatment is complete, and part of the pre-treatment evaluation is confirming there is no active malignancy in the treatment area. Our Medical Director coordinates with your oncology team. Discuss your individual situation with your oncologist and our medical staff.