Jad:

Finally …. One that I might be able to answer …

:-)

This depends on your documentation and the fiscal intermediary. 6 months, in my opinion, is an imaginary number. If you can document severe pain, bleeding (and, if necessary, requiring transfusion), etc., then I think that you have made a good case to start HBOT. This is especially true with 6000cGy radiation.

And, 40 treatments (for rectal complications) is just the beginning. We frequently have gone on to 60 treatments before seeing relief.

So, my opinion is to carry on and document all the radiation complications that support your case.

gene

Just an FYI for me … what was the radiation source? Electron beam? Neutron?

gene

I'm not a radiation oncologist ... but ... the reason that I asked is that neutron beam therapy has very heavy ions and creates more effect in normal tissue. Photons vs. electron beam ... I'm not certain.

Peer review. We would plan 40 treatments. Often, the intermediary would clear 30 treatments. So, we would hold at 30 treatments and ask the GI doc to have a look at the area in question. Then, that was our peer review. If still friable or bleeding tissue, 10 more.

After 40 treatments, we might wait several weeks to a month, then review symptoms again. If still present, plan 20 more treatments.

You might want to review Dick Clarke's RCT ... years ago now ... but the best resource for radiation proctitis and HBOT.

Good luck, Jad. <When you see Toups, tell him that I recommended 100 treatments with no peer review!!!>

Here is a copy.