Hi Barbara, a few comments that might help clarifying the efffect of NA, collagenase, and radiotherapy. Maybe your doctors might want to visit our web site, they will find a wealth of information and it might answer some of their questions, too.

NA: the rate of nerve damage with NA is about half of what is observed with classical surgery, see http://www.dupuytren-online.info/NA_side_effects.html and http://www.dupuytren-online.info/surgery...s_denkler_2.htm

collagenase: it is not collagen that is injected but an enzyme nahmed collagenase that dissolves collagen ... see http://www.dupuytren-online.info/dupuytren_collagenase.html

radiotherapy: most recent publishing: Seegenschmiedt et al. "Radiotherapy for Non-Malignant Disorders" (Springer, 2008). See also http://www.dupuytren-online.info/radioth...literature.html. Specifically on long term effects and a comparison with a control group which clearly demonstrates the positive effect of radiotherapy see http://www.dupuytren-online.info/M-Dupuy...py_Internet.ppt (published 2006). Both publications are in English, so my guess is that your doctors just haven't read anything about that subject since 2001. With regard to "causing hand cancer": world-wide not a single case of hand cancer caused by radiotherapy of Dupuytren's has been reported so far in the literature. Have they seen one or are they talking off their head?

Wolfgang

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On N/A: "I don't like NA as they are operating blind--surgeon can't see if they are hitting a nerve and can cause nerve damage" On Collagenese: Currently they have a trial going on, but it's closed to new patients. We are putting collagen in people and I don't like it as we don't know if the collagen can travel and clog your heart valves or other organs. Until long term effects are known, it's similar to the drugs that have been on the market, then recalled when people start having problems from them ...

... radiation treatment "there is no conclusive evidence that it works. There are no randomized trials. There is a trial that shows low vs high dose of radiation, and it showed no difference, so how do we know it's working?" "The dose that has been given to patients with this condition is 1/2 the dose a cancer patient gets....but, a cancer patient faces a life and death issue." ...
He wanted to know why the Germans haven't had any papers published on long term affects since 2001 as they have been doing it. His own patients never came for follow ups so he doesn't know the long term effects.

I can't remember which doctor said it, but one of them said that "

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Edited 02/09/09 16:40

Australia Calling.Hi Barbara, With regards to the book Radiotherapy for Non-Malignant Disorders I actually purchased the book in Germany .The chapters referring to Dupuytren /Ledderhose and the others relating to radiotherapy are written so that anyone of normal intelligence , not having a medical background can easily understand it. Try the library. New it cost $200 Euros, but on Amazon I noted a number of 2nd hand books at reduced prices in the US. I have a Cinical Investigation from Prof Seegenschmiedt published in 2001 but I need his permission to reprint. I have sent him an e-mail for his permission. Should he allow I can send you a pdf.file .Regards.

Edited 02/10/09 07:01

X-ray treatment is most effective at the early stages of Dupuytren's so I would not delay your treatment. I would not trust the opinion of the doctor as to how far the disease has progressed. I had a NA procedure performed in the USA and the doctor was only going to perform the procedure on one hand but I had him do it on a minor contracture on my right hand as well. Two months later I was in Essen, Germany having my hands evaluated/palpated by Professor Dr. Seegenschmiedt and he told me that the disease was quite advanced in my right hand, noticeable in terms of the lack of suppleness of my hands but not yet visible as contractures or nodules. So I had X-ray treatments performed on both hands.

X-ray treatment for cancer is done both at much higher dosages and also to much greater depths. The X-ray equipment is able to focus the X-rays to limit the depth of penetration to the dermal layers and minimize the radiation received by the muscles, cartlilage, and bones. Contrast that to radiating a tumor on an internal organ where the radiation is deeper and for a greater duration. Part of the reason for splitting the Dupuytren's treatments into two batches is to give the body time to recover from the radiation, which it is capable of doing.

When I had my second round of treatments performed in the USA (at 20 times the cost of the first round in Germany) the physician first had a CAT scan done to be able to do an exact mapping of my hands for the radiating equipment to be done using a linear accelerator to minimize the amount of tissue that would receive the radiation while treating the fascia tissue.

Having seen first hand the difference between the effectiveness of the X-ray treatment on my left hand which had severe contractures and my right hand that did not I firmly believe that had I been treated 8 months sooner my left hand would be in much better shape and that delaying the XRT greatly reduced the effectiveness of the treatment. Cancers that are treated early there is in general a 90% survival rate and for cancers detected and treated late there is a 10% overall survival rate, so it should not be surprising that early treatment of Dupuytren's which also involves cell mutation is more effective as well.