Melanoma & Diving

[@diveflyfish]

Can you be specific in your concern of overpressurization injury? Are you concerned with scar tissue not being able to off gas in a predictable manner, or scar tissue being damaged by the compression itself? Thank you for any clarification.

[@DrFJCronje]

Thanks for the great question! Post-melanoma surgery, especially when it involves the lungs, raises concerns regarding SCUBA diving due to potential complications with air trapping, scarring, and lung tissue integrity. Here are the specifics you were asking about: 1. Scar Tissue and Off-Gassing: After surgery, scar tissue may develop in the lungs. This scar tissue can alter the normal elasticity and function of lung tissues. One concern is whether this scar tissue could affect the ability to off-gas nitrogen efficiently during ascent. If scar tissue impairs this process, it could potentially lead to an increased risk of decompression sickness. 2. Overpressurization Injury (Barotrauma): Another concern is the potential for barotrauma. Scar tissue from surgery can make parts of the lung less flexible and more prone to injury. If the lungs are not able to equalize pressure properly due to scarring, it could lead to tearing due to uneven expansion of the fibrous (scarred) vs. unscarred (elastic) parts of the lung, resulting in lung barotrauma which can lead to a pneumothorax or gas embolism. 3. Mechanical Integrity of Lung Tissue: The mechanical properties of lung tissue may be altered post-surgery. Scarred areas can be stiffer and less compliant, making them more susceptible to rupture under pressure changes. In conclusion: Both the ability to off-gas nitrogen and the potential for barotrauma are significant concerns for individuals with lung scarring post-melanoma surgery. It’s crucial for individuals with such medical histories to consult with a physician, preferably one who specializes in diving medicine, before engaging in SCUBA diving. They can provide personalized advice and may recommend further testing, such as lung function tests or imaging, to assess the risks. Kind regards, Dr Frans Cronje

[@diveflyfish]

⁠@@DrFJCronjethank you for your response. That helps. Two other questions, would the barotrauma occur potentially with normal inspiration and expiration or more so IF inadvertently holding one’s breath during an ascent which is always a no no. I was curious if the increased density of the gas and function at depth would be sufficient to precipitate such barotrauma. In short is barotrauma more a concern with descent or primarily ascent? Thank you so much for your response. For sure MD consultation is paramount. Last question, would use of a CCR rebreather mitigate to any extent barotrauma concerns? Cheers