HBOT in Cancer Care, Supportive Use, Radiation Recovery and Post-Surgical Healing

Medically reviewed by The Clifford Clinic clinical team

Reviewer: Dr Gerard Ee, MBBS, SHUMEC-accredited (Singapore Hyperbaric & Underwater Medicine)

Practising at The Clifford Clinic, Raffles Place, Singapore

Last reviewed: June 2026

How we review: Articles in this hyperbaric oxygen library are written for The Clifford Clinic and reviewed by a doctor accredited through the Singapore Hyperbaric & Underwater Medicine Course (SHUMEC). Reviewers check medical accuracy and ensure claims align with current MOH, UHMS and peer-reviewed guidance.

Hyperbaric oxygen therapy does not treat cancer. It does not kill cancer cells, shrink tumours or substitute for the standard treatments, namely surgery, chemotherapy, radiation therapy, targeted therapy and immunotherapy. Any provider claiming otherwise is making a claim unsupported by evidence. HBOT does, however, have genuine supportive roles in cancer care, particularly in the recovery and reconstruction phases.

This guide sets out the three supportive indications, the uses the evidence does not support, and the Singapore referral pathways. For broader context, see our HBOT for radiation injury guide and our HBOT for post-surgery recovery guide.

 

What HBOT Does Not Treat

There is no good evidence that HBOT cures cancer, reduces tumour size in active disease, or substitutes for any part of standard oncological treatment. HBOT during active cancer treatment should be undertaken only with the knowledge and agreement of the treating oncology team, which holds the decision on timing.

A theoretical concern has long existed that raising tissue oxygen could promote tumour growth. Clinical studies in the recognised supportive indications have not demonstrated an effect on tumour behaviour in either direction, although the evidence base is not large. The question nonetheless remains legitimate, and any HBOT decision for a patient with active or recent cancer should be made by or in close coordination with the oncology team.

 

Where HBOT Genuinely Fits in Cancer Care

HBOT’s supportive role in cancer care covers three areas, namely late radiation tissue injury, complex post-surgical recovery (particularly compromised grafts and flaps after reconstruction), and wound healing in tissue compromised by previous oncological treatment. All three are recognised in the international hyperbaric medicine indication lists maintained by bodies such as the Undersea and Hyperbaric Medical Society (UHMS), and the first two are on MOH’s approved indication list for Singapore.

In all three, HBOT supports tissue that has been damaged by cancer treatment, not the cancer itself.

 

Late Radiation Tissue Injury

Delayed radiation tissue injury is the most established cancer-related indication for HBOT. It appears months or years after radiation therapy and affects soft tissue, bone or mucosa within or near the previously irradiated field, where radiation has progressively destroyed the small blood vessels supplying the area and left the tissue chronically short of oxygen and unable to heal. Common presentations include osteoradionecrosis of the mandible after head-and-neck radiation, radiation cystitis or proctitis after pelvic radiation, and chest wall tissue damage after thoracic radiation. Our dedicated HBOT for radiation injury guide covers this in detail.

The evidence for this indication is among the strongest in hyperbaric medicine, and MOH’s clinical criteria for MediSave or MediShield Life support are most often met. Treatment protocols are typically longer than other HBOT courses, often 30 to 40 sessions, because the benefit comes from the gradual growth of new blood vessels into the irradiated tissue, which accumulates across the course rather than following any single session.

 

Post-Surgical and Reconstruction Recovery

Cancer surgery often involves complex reconstruction, such as flap reconstruction after breast cancer surgery, free flap reconstruction in head and neck surgery and complex closures after sarcoma resection. HBOT has a supported adjunctive role in compromised grafts and flaps, because oxygen dissolved in the plasma at treatment pressure can reach tissue that a marginal blood supply cannot adequately perfuse in the early post-operative period.

The reconstructive surgeon, oncology team and hyperbaric clinician work together to decide whether HBOT is appropriate, when to start, and how the protocol fits into the wider recovery plan.

 

Wound Healing in Cancer-Compromised Tissue

Some cancer-related wounds heal slowly because of the underlying tissue damage from previous treatment, such as irradiated tissue with poor vascular supply, surgically reconstructed areas under tension and tissue that has been operated on multiple times. HBOT can be a useful adjunct in selected cases, alongside standard wound care, infection control and surgical management.

As with all wound HBOT, it is an adjunct, not a substitute. A wound with significant infection or large-vessel ischaemia requires those problems corrected first, since HBOT cannot compensate for an untreated source of either.

 

 

MediSave and MediShield Life note

Two separate Singapore healthcare schemes may apply to qualifying cancer-related HBOT cases. MediSave (CPF medical savings) can be used for up to S$100 per treatment session. MediShield Life (national health insurance) is a separate scheme with a claim limit of up to S$780 per treatment session. The two operate independently, and both apply only when the case fits an MOH-approved indication, including late radiation injuries and compromised grafts and flaps. Confirm eligibility with your treating doctor and the provider’s billing team.

 

The Singapore Cancer Care HBOT Pathway

In Singapore, the typical pathway for cancer-related HBOT runs through the patient’s treating oncology, surgical or speciality team. They diagnose the radiation injury, the post-surgical complication or the compromised wound, decide whether HBOT may be appropriate, and refer to a hyperbaric medicine service. Singapore General Hospital’s Hyperbaric and Diving Medicine Centre is the most established local pathway and integrates closely with oncology, ENT, urology, gynaecology and other specialities.

Selected patients may be appropriate for private clinic HBOT, particularly for post-reconstructive cases coordinated with their surgical team. Entry to that pathway is initiated by the surgical or oncology team rather than by the patient.

 

Working With Your Oncology Team

Any HBOT decision in a patient with current or recent cancer should be made in coordination with the oncology team rather than independently of it. Patients should tell their oncologist they are considering HBOT, share the proposed indication, and ask whether the timing is appropriate within the wider treatment plan. A responsible HBOT clinic initiates that conversation rather than waiting for the patient to raise it.

If a clinic recommends HBOT to a cancer patient without proposing any communication with the treating oncology team, the recommendation should not be acted on.

 

The Clifford Clinic Perspective

The Clifford Clinic’s clinical team holds a firm position on HBOT in cancer care. HBOT is supportive, never primary, and decisions belong with the patient’s oncology team. The clinic will not market HBOT as a cancer treatment, will not promise outcomes outside the established supportive indications, and will refer to hospital-based hyperbaric services such as Singapore General Hospital’s Hyperbaric and Diving Medicine Centre when that is the appropriate setting for the case.

The Clifford Clinic’s role in cancer care is post-reconstructive support, undertaken where the patient’s surgical team has asked for HBOT to support recovery after complex closure or in previously irradiated tissue. This sits alongside the clinic’s plastic surgery and Day Surgery work. Sessions are delivered through a hard-shell chamber at a therapeutic 2.0 ATA, with doctor-led screening by a SHUMEC-accredited clinician, in close coordination with the operating surgeon.

The clinic does not treat active cancer with HBOT. It does not run protocols intended to substitute for chemotherapy or radiation therapy. It does not market HBOT as a way to ‘detox’, ‘cleanse’ or ‘reverse’ cancer treatment. Patients seeking those framings are referred back to the standard oncological care that treats the disease.

Across four years and more than 200 patients, the clinical team’s consistent observation is that cancer-related HBOT produces meaningful results when it is matched to a recognised supportive indication, integrated with the oncology team, and delivered as a properly completed course at a therapeutic pressure.

 

Frequently Asked Questions

Does HBOT treat cancer?

HBOT does not treat cancer. It has supportive roles in managing tissue damage from cancer treatment, particularly late radiation injury and complex post-surgical recovery.

Can HBOT shrink tumours?

There is no good evidence that HBOT shrinks tumours or reduces active disease.

Is HBOT safe during chemotherapy?

Some chemotherapy regimens are contraindications for HBOT. Timing should be decided with the oncology team, and specific agents such as bleomycin and doxorubicin require particular caution.

Can HBOT help with chemo-related fatigue?

Research interest exists, although the evidence has not reached an established level. Persistent fatigue after chemotherapy should first be assessed for treatable causes such as anaemia, thyroid dysfunction, deconditioning and depression.

Will MediSave or MediShield Life cover cancer-related HBOT?

For MOH-approved indications such as late radiation injury or compromised grafts and flaps, both schemes may apply in eligible cases. Confirm with your treating doctor and the provider’s billing team.

Is private clinic HBOT or hospital HBOT better for cancer patients?

For classical cancer-related indications, hospital-based hyperbaric services integrated with oncology teams are usually most appropriate. Private clinics are appropriate for selected post-reconstructive cases coordinated with the surgical team.

Should my oncologist know I am considering HBOT?

The oncologist should always be informed. HBOT belongs inside the oncology plan rather than alongside it. Any responsible clinic will encourage that conversation.

Are there cancers where HBOT is more or less appropriate?

The supportive indications are condition-specific, not cancer-type-specific. The individual history should be discussed with the oncology team and a hyperbaric clinician.

 

Key Research References

• Undersea and Hyperbaric Medical Society. Hyperbaric Oxygen Therapy Indications, 13th Edition, covering delayed radiation tissue injury and compromised grafts and flaps.
• Marx RE. Osteoradionecrosis, a new concept of its pathophysiology. Journal of Oral and Maxillofacial Surgery.
• Bennett MH et al. Hyperbaric oxygen therapy for late radiation tissue injury. Cochrane Database of Systematic Reviews.
• Heyboer M et al. Hyperbaric Oxygen Therapy, Side Effects Defined and Quantified. Advances in Wound Care.
• Singapore General Hospital. Hyperbaric and Diving Medicine Centre, services and conditions treated.
• Ministry of Health Singapore. MediSave and MediShield Life claim limits for HBOT.
• Kirby JP et al. Essentials of Hyperbaric Oxygen Therapy, 2019 Review. Missouri Medicine.

 

To discuss supportive HBOT in coordination with your oncology team, book a consultation at The Clifford Clinic.