"When David Wolfes hips began hurting in  he dialed back his fitness routine. But the Wyncote residents fivemile runs werent the problem. More than a decade after radiation helped cure his anal cancer toxic side effects of the treatment were progressively damaging muscles and nerves in his lower spine legs and hips. Medication and physical therapy gave him little relief. A specialist warned that a wheelchair might be in his future. Instead the tall trim yearold has made a dramatic recovery thanks to hyperbaric oxygen a centuryold technology that remains somewhat controversial http_chambers_helped_treat_concussions_but_so_did_placebo_treatment.html because of a lack of rigorous medical studies supporting its use. For  days in December and January Wolfe spent at least two hours a day breathing pure oxygen inside a giant pressurized chamber at the Hospital of the University of Pennsylvania. Supersaturating the blood with oxygen is believed to promote healing. Now six months after treatment each week Im feeling better said Wolfe a cancer clinical trials administrator for Merck. Im not back to running but Im off pain medications and back to work full time. Patients such as Wolfe are a triumph  and a mystery  for doctors. Penn radiation oncologist James Metz who treated Wolfes anal cancer in  recommended trying hyperbaric oxygen even though Metz and the hyperbaric medicine team had never used it to treat such a longdelayed radiation injury. This is outside the box. Ive never used it this far out Metz said. My radar is up if I see such an injury again. As we get more followup from David it will be important to publish this case so people will be aware. Diving into novel medicine Developed in Europe hyperbaric therapy was introduced in the U.S. in the early s. University of Kansas anesthesiologist Orville Cunningham used it to save gravely ill victims of the Spanish flu pandemic http But later he touted his treatment for everything from cancer to syphilis and was investigated by the American Medical Association leading some to dismiss him as a fraud according to historical accounts. In the s through the s hyperbaric oxygen was proven to help deepsea divers suffering decompression sickness and to combat carbon monoxide poisoning. Essentially the increased pressure in the chamber  double normal atmospheric pressure  reduces the size of harmful gas bubbles in the patients bloodstream so they dissipate. Penns hyperbaric medicine division grew out of that era of diving medicine research. The unit was established in  by Christian J. Lambertsen a primary inventor of scuba and the father of the U.S. Navy Frogmen. Penns hyperbaric chamber is a yearold submarineshaped behemoth complete with portholes that can accommodate up to eight patients and a technician. Its nickname is the beast. It speaks well of the design that it has held up so well said Kevin Hardy a Penn hyperbaric and emergency medicine specialist. Besides blood gasrelated trauma hyperbaric therapy has been approved to treat conditions including burns crush injuries stubborn diabetic wounds certain infections of the skin or bone and radiation injury. There is evidence that it fights infection stimulates growth factors and stem cells and triggers the development of blood vessels a process called angiogenesis. Nearly  U.S. hospitals have installed hyperbaric therapy units  either oneperson units that look like long plastic caskets or multiperson rooms according to the Undersea and Hyperbaric Medical Society. As with many medical technologies there are concerns about overuse. Hyperbaric therapy has boomed since . Thats when Medicare began covering it for certain diabetic wounds paying  for a twohour session  even though the evidence of effectiveness is sketchy Kaiser Health News httpskhn.orgnewshospitalsputmorestockinhyperbarictherapyfordiabeticsdespiteconcerns reported. READ MORE Persistent wounds fuel  billion business but does it work http Its expensive and some practitioners overuse it which gives a black eye to the field said Matthew Kelly chief of Penns hyperbaric medicine division. For Wolfe the therapy was a lifeline. Chasing a diagnosis Radiationinduced injury is common. After all half of cancer patients undergo radiation therapy. But the severity of damage varies and the symptoms can be mistaken for common problems such as osteoarthritis  especially when those problems show up long after the cancer treatment. Thats why Wolfe chased a diagnosis for more than three years after his hips began hurting in . As his leg numbness weakness cramps and pain grew steadily worse orthopedic and physical medicine specialists at Penn diagnosed him with arthritis bursitis and a series of muscle tears  in his hips his hamstrings and a thigh. The leg pain worsened and the weakness became chronic he recalled. My legs would sometimes buckle underneath me. Sitting and standing even for short periods became increasingly challenging. His treating physicians said the problems were unrelated to his  chemotherapy and radiation but he wasnt convinced. I just couldnt reconcile that the nature of the pain and symptoms could be normal agerelated disease he said. Wolfe searched the medical literature which led him to Michael D. Stubblefield an international expert in radiation fibrosis syndrome at the Kessler Institute for Rehabilitation in West Orange N.J. Stubblefield explained that radiation to Wolfes abdomen and pelvis had damaged the DNA in his healthy cells triggering them to produce fibrin which is normally involved in clotting. This fibrous protein damages blood vessels hampering the blood supply to ligaments tendons muscles and nerves. The process never stops or goes away although there may be no symptoms for years Stubblefield said. Stubblefield advised Wolfe to continue the supportive treatments that had barely helped physical therapy combined with drugs to relieve spasms inflammation and pain. About a year ago Wolfe took a medical leave from work. In desperation he went back to Metz. The radiation oncologist proposed hyperbaric therapy. Its a cumbersome timeconsuming procedure. Six days a week for up to five hours a day Wolfe sat in the chamber wearing a bulky oxygen mask. For safety reasons electronics cosmetics glass watches synthetic fabrics and even pens and newspapers are forbidden. Mostly Wolfe said he would doze or watch the movie that technicians piped in.  About three weeks after he began the sessions his physical therapist noticed subtle improvements. A few weeks later I was able to begin weaning off the pain medication Wolfe said. In late January I returned to work on a parttime basis progressing to full time. Stubblefield is thrilled for Wolfe  but cant say his success could be widely repeated. After Davids experience I did a medical literature search Stubblefield said. The data on effectiveness is still grim. In my experience with patients with chronic late radiation effects hyperbaric therapy is usually not helpful. There are exceptions and clearly hes one. I dont know why he responded where others havent. Theres no guarantee his response is durable. Wolfe can live with that. The quality of life Ive gotten back is wonderful he said. Its really profound to me to see the difference it has made."