Feldmeier J, Carl U, Hartmann K, Sminia P, et al.
Undersea & hyperbaric medicine : journal of the Undersea and Hyperbaric Medical Society, In.... Date of publication 2003 Apr 1;volume 30(1):1-18.
1. Undersea Hyperb Med. 2003 Spring;30(1):1-18.
Hyperbaric oxygen: does it promote growth or recurrence of malignancy?
Feldmeier J(1), Carl U, Hartmann K, Sminia P.
Author information:
(1)Radiation Oncology Department, Medical College of Ohio, Toledo, OH, USA.
It has been a concern that a therapeutic modality recommended as an adjunct to
healing and administered to promote proliferation of fibroblasts, epithelial
cells and blood vessels in a wound could also lead to proliferation of malignant
cells and angiogenesis in a malignant tumor. The first reported concern that
hyperbaric oxygen (HBO2) might have cancer growth enhancing effects appeared in a
paper by Johnson and Lauchlan in 1966. In a series of patients treated with HBO2
radiosensitization, they reported a more frequent than expected incidence of
metastases and an unusual pattern of metastases. The published literature from
clinical reports, animal studies and cell culture studies are reviewed. Putative
mechanisms whereby HBO2 could have carcinogenic effects are discussed. The
processes of angiogenesis in wound healing and in cancer growth are compared and
contrasted. In vitro, in vivo and clinical studies strongly suggest no more than
a neutral effect of HBO2 on tumor growth. In fact some studies suggest a negative
impact of HBO2 on malignant progression or formation. For angiogenesis,
similarities in wound healing and cancer are striking but significant differences
are found including the relative importance of angiogenic factors and the process
of cessation of angiogenesis. Tumors that grow in hypoxic environments are more
prone to metastases and more lethal to the patient. They are also more likely to
mutate toward resistant genotypes. Discussion of postulated mechanisms of
carcinogenesis including free radical and immunosuppressive effects points out
why they are not likely to enhance or cause cancer growth or initiation. In
conclusion, the published literature on tumor angiogenesis mechanisms and other
possible mechanisms of cancer causation or accelerated growth provides little
basis for HBO2 to enhance malignant growth or metastases. A history of malignancy
should not be considered a contraindication for HBO2 therapy.
PMID: 12841604 [Indexed for MEDLINE]
