Soft Tissue Radionecrosis: Signs, Causes, and Treatment

More people survive cancer today than ever before, in part because of modern radiation treatments alongside advances in chemotherapy and surgery. However, some cancer survivors who were treated with radiation eventually develop sores that will not heal, bleeding with no clear cause, or tissue that feels hard and painful in the area that received treatment. These symptoms can develop if you have a condition known as soft tissue radionecrosis, a delayed injury that can appear months or years after radiation ends. Fortunately, evidence shows that hyperbaric oxygen therapy (HBOT) is linked to better outcomes for late radiation injuries affecting the head, neck, anus, and rectum.

Read on to learn more about what soft tissue radionecrosis is, why it happens, and how to find the best care for soft tissue radionecrosis in Metro Atlanta and North Georgia.

Who Is at Risk of Developing Soft Tissue Radionecrosis?

Soft tissue radionecrosis is the slow breakdown of skin, muscle, or the moist lining of organs like the mouth, bladder, and bowel after radiation. Doctors also sometimes call it delayed radiation injury or late radiation tissue injury. When the same process affects bone, it is called osteoradionecrosis. Anyone who received radiation can develop it, and the risk climbs with:

• Higher radiation doses or larger treatment areas
• Radiation combined with surgery or chemotherapy
• Smoking
• Diabetes or blood vessel disease
• A biopsy, surgery, or injury in the treated area
• Pelvic radiation
• Breast radiation

What Causes Healthy Tissue to Break Down After Radiation?

Radiation targets cancer cells, but healthy tissue nearby can also absorb part of the dose. Over the following months and years, that tissue can go through some changes, including:

• Fewer blood vessels: Radiation scars and narrows the small vessels that feed the area.
• Fewer working repair cells: The cells that rebuild skin and connective tissue lose much of their ability to divide.
• Lower oxygen levels: With less blood flow, the tissue receives less oxygen than it needs.

Together, these changes leave tissue with very little ability to heal, even when it looks normal. A small cut, a biopsy, or an infection can then open a wound that the body struggles to close.

Where Does Soft Tissue Radionecrosis Typically Show Up in the Body?

The signs of radiation-damaged tissue depend on which part of the body received radiation. Here is how soft tissue radionecrosis can look in three common treatment areas:

Breast and Chest Wall

• Sores at the lumpectomy scar, under the breast, or on the chest wall
• Skin that hardens, thins, or breaks open
• Lasting pain or swelling in the treated breast

Pelvis

After radiation for prostate, cervical, endometrial, bladder, or rectal cancer, signs can include:

• Blood in the urine or bladder pain, known as radiation cystitis
• Rectal bleeding or urgency, known as radiation proctitis
• Vaginal or vulvar sores and lasting pelvic pain

Head and Neck

After radiation for cancers of the mouth, throat, or voice box, signs can include:

• Sores inside the mouth or throat that will not heal
• Pain when swallowing
• Skin breakdown on the neck
• Swelling or tightness in the face, jaw, or neck

Any of these signs can also come from an infection or a cancer recurrence, so your oncologist should check them first.

How Does Hyperbaric Oxygen Therapy Help Delayed Radiation Injury?

The Undersea and Hyperbaric Medical Society (UHMS) reviews the research behind hyperbaric medicine and keeps a list of conditions with strong evidence for HBOT. Delayed radiation injury to soft tissue and bone has long been on that list. Medicare also covers HBOT for soft tissue radionecrosis when it is part of a broader treatment plan.

HBOT works well for radiation-damaged tissue because it goes after the root problem. During treatment, you breathe 99.7% medical-grade oxygen inside a pressurized chamber. The pressure pushes far more oxygen into your blood plasma, and repeated sessions prompt your body to grow new small blood vessels in the damaged tissue. As blood flow returns, the tissue can:

• Fight infection more effectively
• Build new collagen and healthy skin
• Close wounds that have stalled
• Reduce bleeding from fragile blood vessels

What Does HBOT Treatment for Soft Tissue Radionecrosis Involve?

Personalized hyperbaric oxygen therapy starts with a full evaluation by a hyperbaric physician, who reviews your radiation history and confirms that other causes have been ruled out. From there, treatment usually combines:

• A series of HBOT sessions, five days a week, for several weeks
• Wound care, including surgical debridement or negative pressure wound therapy when needed
• Regular updates shared with your oncologist and other specialists

When you compare options for the best soft tissue radionecrosis treatment in Metro Atlanta and North Georgia, look for physician oversight at every session, hard-sided clinical chambers, and UHMS accreditation. The same standards apply if you are searching for the best delayed radiation injury treatment in Metro Atlanta for bladder, bowel, or head and neck symptoms.

Finding the Best Treatment for Soft Tissue Radionecrosis in Metro Atlanta and North Georgia

Hyperbaric Physicians of Georgia has treated delayed radiation injuries since 1993, with clinics in Marietta, Sandy Springs, and Cumming. One of our team leaders is Dr. Helen Gelly, MD, who has worked in hyperbaric medicine and wound care since 1991, founded one of the first UHMS-accredited hyperbaric centers not affiliated with a hospital, and lectured nationally in both fields. Our Chief Medical Officer, Dr. David Schwegman, MD, FACEP, CWS, is a certified wound specialist who has focused on hyperbaric medicine since 2009 and was named a 2011 Atlanta Top Doctor by Atlanta Magazine.

Ready to let our team build a personalized plan to treat soft tissue radionecrosis in Metro Atlanta?