The role of Hyperbaric Oxygen Therapy in enhancing quality of life in breast cancer survivors.


Defeating breast cancer is often not the end of the battle. With the advent of breast conserving therapies such as lumpectomy, radiation is more commonplace. However as a consequence so are the side effects such as late radiation-induced tissue toxicity (LRITT). LRITT occurs to the normal, adjacent tissues and can arise months to many years later. It can present as skin changes, pain, swelling, limitation in movement or impaired healing after reconstructive surgery. These problems can have significant and lasting impact on the quality of life. Therapeutic options are limited. Hyperbaric therapy however has been shown to significantly reduce the impact of the late effects of radiation after breast cancer.

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HMS's Dr. Paul Cianci presented with Albert R. Behnke Award

HMS’s Paul Cianci, M.D. F.A.C.P. F.U.H.M. and Emeritus Professor of Internal Medicine at the University of California Davis was recently presented the Albert R. Behnke Award for his significant contributions to the field of Diving and Hyperbaric Medicine. This honor is the highest award in the field worldwide. He was previously received the Spencer and Boerma awards for scientific and clinical contributions to the field. Dr. Cianci received his undergraduate degree at Springfield College, his medical degree at New Jersey College of Medicine (now Rutgers), and his internship and residency at Oakland Naval Hospital.  He served eight years on active duty in the Navy during the Vietnam conflict providing care for sick and wounded Marines and later as a Reserve officer, as Western U.S. Diving Medical Officer for all diving units west of the Mississippi.  His significant contributions have contributed to the health, safety and well- being of Naval divers including development of an emergency dive procedure procedures for the onsite treatment and evacuation of Navy divers suffering from Decompression Sickness in remote sites. He additionally developed an ‘off the shelf system’ for delivery of on-site treatment with oxygen. Both of these were later was promulgated to the entire Fleet. He served as President of the Undersea and Hyperbaric Medical Society, consultant to the Surgeon General of the Air Force, the Navy and the National Oceanic and Atmospheric Administration and the State of California. He has lectured in North America, Central America, The Caribbean, Europe, The Middle East and Asia. Dr. Cianci remains active in the field of Diving and Hyperbaric medicine working at Hyperbaric Medical Services.

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Sudden Hearing Loss: More Common than We Thought

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Losing one of your senses needs to be addressed urgently, because once lost, it might not come back. The sudden loss of hearing in one ear should be treated as a medical emergency.

Over 66,000 NEW cases of Idiopathic Sudden Sensorineural Hearing Loss (ISSHL) present every year in the United States.[1] (  This is defined as a loss of greater than 30 decibels over 3 contiguous frequencies over a 72-hour period.   The ENT literature says that between 1/3 to 2/3 of patients will have spontaneous recovery, but many of these only regained 50% of their previous hearing.  Prompt and aggressive treatment is appropriate to salvage as much hearing as possible.

Treatment usually involves steroids, either intravenous, oral, or intratympanic injections, or a combination of these. Adding hyperbaric oxygen therapy has been shown to improve outcomes. A recent study showed that patients that had combination therapy of steroids and hyperbaric oxygen had a 61% higher chance of achieving complete hearing recovery than those that just got steroids. [2]

Why would HBOT help? One of the causes for sudden hearing loss may be due to a lack of oxygen to the cochlea, the part of the inner ear responsible for hearing. Hyperbaric oxygen is designed to increase the amount of oxygen that is dissolved in the plasma and increases the available oxygen to this area.

Multiple studies have affirmed that starting hyperbaric oxygen therapy early in the course of this disease confers better benefits. Both the Cochrane Review[3] and the clinical practice guidelines [4]of the American academy of Otolaryngology-head and Neck Surgery include hyperbaric oxygen as a reasonable addition to steroid therapy.

Almost all studies that have researched the combination of hyperbaric oxygen and steroids in sudden hearing loss recommend early implementation of hyperbaric oxygen therapy.

Many insurance carriers are starting to cover this therapeutic option, but even if the plan does not cover it, you should consider starting hyperbaric oxygen therapy.  Most patients started to see clinical benefit within 2 weeks or 10 treatments, although some needed up to 20 to achieve the best outcomes.

If you have sudden hearing loss, see your ear nose and throat physician immediately, and then consider adding hyperbaric oxygen to the treatment protocol.

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1. Alexander, Thomas H., and Jeffrey P. Harris. "Incidence of sudden sensorineural hearing loss." Otology & Neurotology 34.9 (2013): 1586-1589.

2. Rhee T, Hwang D, Lee J, Park J, Lee JM. Addition of Hyperbaric Oxygen Therapy vs Medical Therapy Alone for Idiopathic Sudden Sensorineural Hearing Loss: A Systematic Review and Meta-analysis. JAMA Otolaryngol Head Neck Surg. 2018;144(12):1153–1161. doi:10.1001/jamaoto.2018.2133

3. Bennett MH, Kertesz T, Perleth M, Yeung P, Lehm JP. Hyperbaric oxygen for idiopathic sudden sensorineural hearing loss and tinnitus. Cochrane Database of Systematic Reviews 2012, Issue 10

4. Stachler, Robert J., et al. "Clinical practice guideline: sudden hearing loss." Otolaryngology—Head and Neck Surgery 146.3_suppl (2012): S1-S35.