I consulted with Dr. Tripuraneni, Head, Division of Radiation Oncology, at Scripps Clinic, La Jolla near San Diego, CA. He is very pleasant & thoroughly explained everything. Just because he explained everything doesn't mean that I thoroughly understood it all, but I will tell you my understanding and I think it is mostly accurate. His specialty is in non-malignant radiation treatment. He has primarily done a procedure in the heart - 2000-3000 of them. Info in Scripps pamphlet given to me about RT says, "It can also be used to treat non-cancerous conditions, including blocked coronary arteries."
I asked how and why he had an interest in Dupuytren's. Dr. T. was asked by a friend to treat his wife for Dupuytren's in her hand. Dr. T did and she put his name on this website. He has treated about a dozen who picked up his name from this site.
He sees a relationship with the results of the heart procedure and how RT works for Dupuytren's. Now, that I can't explain! He asked if my DD is active, still progressing. I told him it seems to be as I feel itching at times and more nodules have grown over the last few months. He says RT works when Dupuytren's is active. He was honest about effectiveness & said that it is effective for about 2/3s of the patients and not so effective for about 1/3. Those odds sound very good to me & certainly best to stop the progression because there is no other option.
One more appointment is needed to map the area for RT. Then a very low dosage with a total of 20Gy (whatever that is) given over 10 days, M-F for two weeks in a row Daily RT for about 3 minutes. No dryness or side effects likely.
He carefully looked at my right hand, felt for nodules and cording. I had NA done about 6-weeks ago which was the thing to do as RT will not release cords. He marked areas on my hand & took a picture of my hand with the marks. I pointed out what I thought were nodules outside the marked areas. He expanded to include a bit larger area. I asked if it extended into my little finger. He felt again and said, "I don't know. I'd rather under-radiate. We can always do it again and get that area if it is clear that it is Dupuytren's." He is conservative. I like that philosophy even if it means going through the whole thing again.
I definitely am going to do this and I'd do it sooner, but I don't have that stretch of time until mid-July. I called today to schedule it and expect to finalize that tomorrow.
I live about 80 miles away. Anyone living far away wanting to get RT with Dr. T might try to plan 2-weeks in San Diego. It's a great place to stay!
Once I found Dr. Denkler and communicated with him, I had no doubt that NA with him was the thing for me. I now have no doubt that RT with Dr. T is the thing for me. I thought about talking with a local oncologist about doing it, but it is worth the travel, etc. to have Dr. T with his expertise and experience to do it.
Any questions?

Hi Australia Calling. You mention that your Oncologist has an interest in the treatment of Non-Malignant disorders and is on the conservative side. That's great and will instill confidence in you receiving the right treatment. He sounds very much like Prof Seegenschmiedt who explained exactly what you posted. Did you know ,you can contact the Dupuytren Society and obtain a pdf on the paper written by Seegenschmiedt which may be of interest. "Radiotherapy Optimization in Early Stage of Dupuytren's Contracture."I shows some sketches and the treatment procedure. The prof. has given permission for its use to members of the forum. Regards

Hi flojo, your post brings up an important topic that I would like to see more discussion on. That is , most posts I have read on radiation suggest that it is only viable in early stages of DD, because it doesn't actually relive existing contractions. Now as someone who has had both multiple NA's and surgeries on both hands, this was not encouraging. But, I couldn't help but wonder that if I had NA to release what's there now, why couldn't I then follow up with radiation with the same (potentially) positive results as someone in beginning stages? When you mention radiation as the only option for you is that due to being a more advanced case, like me? Any idea on what Dr. Tripuraneni's opinion is on whether radiation can help a more advanced case? thanks, matt

Hi flojo Australia Calling,First I am no expert and have no experience with NA. In Australia and US the use of NA is only now starting to pick up pace. However, I did raise the question about 18 months ago "Can Radiotherapy be used in conjunction with NA?" Having had keloids treated shortly after surgery. It is not uncommon to have Rt in low doses (less than the treatment of dups) within 24 hrs of surgery for keloids.In my thoughts ,I wondered why Radiotherapy could not be used after NA within a suitable time when things may start growing again. You may well answer the question.We will all be waiting on your outcome. The cords that you have, do they run across the hand (thumb to little finger ) or from the wrist to each finger. I know ,when I had Rt the area irradiated was increased slightly, outside of the palpable area identified with the nodules. This allows for a margin ,where growth may be taking place but cannot be identified. When I had RT I was supplied with records of dose rates, a copy of all photos ,photostat images of the hand etc. just incase I need further RT at later time. It is a point you might consider.

Hi. I was diagnosed with Dupuytren's last month and have been scouring the internet to learn as much as I can. It appears as if radiation is the only thing that can help delay the progression. My issues are that the doctors where I live, also Santa Cruz, CA, have never heard of it and don't seem that interested in learning about it/don't trust it. I've called Scripps 2x and both times was told that "I should wait until the disease had progressed". I thought that the point of radiation was to get it early?!

From Flora's post, does Dr. Tripuraneni have enough experience - esp. if she was pointing out to him more nodules that he didn't notice at first?

If more of you out there have experience with him/Scripps I would really appreciate feedback.

The other questions are - since I'm in an HMO, I'm not sure how to get my (reluctant) doctors to recommend radiation. I think it might be less expensive to fly to Germany etc. than to pay for it in the states but haven't talked to anyone about the costs in the US except in VA where the doctor thought it cost around $12,000!

Thanks so much, Diana