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Is there a link between cancer and Dupuytrens?
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07/17/2013 23:17
Jaci

not registered

07/17/2013 23:17
Jaci

not registered

Is there a link between cancer and Dupuytrens?

I have just recently had NA done on my hand and am wearing a splint 24/7. I was explaining to my friend aboutDD and she quizzed me if there would be a connection between cancer and Dupuytren's seeing they both involve cells growing in abnormal ways. I thought it was an interesting question - any got any thoughts?
I'm not up on the complexities of both diseases (know just general knowledge) but am interested to hear what others know/think/have been told by specialists. Not a nice thought.

    07/18/2013 05:11
    maryis 
    07/18/2013 05:11
    maryis 
    Re: Is there a link between cancer and Dupuytrens?

    First off, thanks to whoever is hosting this site. I chose this thread because of the mention of cancer and Dupuytren's.

    My story may be a bit different than most but it does include both cancer and DD.

    A year and a half ago, I consulted a physician's assistant regarding a darkening spot on the back of my left hand (I am left handed). He advised me to have it biopsied although it didn't have any of the "classic" signs of cancer.

    The biopsy came back as a melanoma. I then had the MOHS procedure (I have photos if you'd like to see them). And three days later I had a skin graft with skin removed from my thigh.

    The surgery went really well. The skin graft has blended in quite nicely. Had the surgery at the Hand Center at the University of Virginia and had outstanding care.

    However...

    A few months later, I noticed a little "knot" in the palm of my left hand, exactly between the second and third finger. When it didn't go away, I hunted around on the internet and found "Viking Disease" and photos of a similar abnormality. The knot then started to grow and so I went back to the hand doctor who diagnosed it as DD. Since then, I have developed another nodule right underneath the large one It pretty much looks like a "Y" now with the top part of the "Y" running into my first and second fingers.

    The doctor said there was no way that the surgery could have triggered the DD. But I am not so sure about that. My right hand hasn't started to show any evidence of DD.

    I am not eligible for radiation therapy due to the melanoma. The alternative I have is the injections and 'crunching' of the cord and nodes.

    I have pain connected to the DD. I get really bad cramping in my hand across the knuckles etc.

    So, that's my story when it comes to cancer and Dupuytrens. I sincerely believe that the trauma of surgery and skin grafting triggered the DD. Despite what the hand surgeon says.

      07/18/2013 06:26
      Seph 
      07/18/2013 06:26
      Seph 

      Re: Is there a link between cancer and Dupuytrens?

      maryis; I don't think there is a link between cancer and DD but there is a lot of anecdotal evidence that you will see on this web site suggesting that hand trauma in many forms does seem to be able to trigger DD. I guess you need to have a predisposition to getting DD as all surgery and all hand injuries don't cause DD.

      And the curious thing is that it seems to be able to jump from hand to hand and foot to foot. I had no LD in my left foot prior to an operation to remove LD on my right and DD appeared in my right hand for the first time following surgery on DD in my left hand. Following each NA procedure that I have had there has been a short period of DD growth usually in a new place. So do I think your surgery could have triggered the DD in your hand - yes I do.

        07/18/2013 06:39
        Seph 
        07/18/2013 06:39
        Seph 

        Re: Is there a link between cancer and Dupuytrens?

        And for Jaci; I think of DD as the cancer you want to get. It is non life threatening and doesn't spread beyond your hands (or feet in the case of LD). I'm 59 now and have had this for 45 years. It seems to have triggered bilateral frozen shoulder which presented a few challenges for a year or two but that's it.

        Edited 07/18/13 09:39

          07/18/2013 08:12
          wach 

          Administrator

          07/18/2013 08:12
          wach 

          Administrator

          Re: Is there a link between cancer and Dupuytrens?

          There might be a link between cancer and Dupuytren's for several reasons

          a) as already indicated both are tumors though DD is benign

          b) epidemiological research reports that DD patients are slightly more likely to develop cancer,
          e.g. S. Wilbrand et al. "Cancer incidence in patients treated surgically for Dupuytren's contracture"
          http://www.ncbi.nlm.nih.gov/pubmed/10961556

          c) genetics research finds abberations in the Wnt signaling pathway which are also observed with cancer patients
          e.g. G. Dolmans et al. "Wnt Signaling and Dupuytren’s Disease"
          http://www.umcg.nl/SiteCollectionDocumen...mans%20NEJM.pdf

          All this are only indications. The link is not really understood, provided there is any. And there are no consequences with respect to prognosis or treatment.

          Wolfgang

            07/18/2013 23:11
            JohnG 
            07/18/2013 23:11
            JohnG 
            Re: Is there a link between cancer and Dupuytrens?

            That is interesting, Wach.

              07/19/2013 00:35
              Seph 
              07/19/2013 00:35
              Seph 

              Re: Is there a link between cancer and Dupuytrens?

              Yes interesting but importantly no causal connection indicated. The optimist in me wonders if the faulty Wnt Signaling is giving us Dupuytrens rather than cancer. Could it be saving us?

                07/19/2013 12:26
                JohnG 
                07/19/2013 12:26
                JohnG 
                Re: Is there a link between cancer and Dupuytrens?

                Seph:
                Yes interesting but importantly no causal connection indicated. The optimist in me wonders if the faulty Wnt Signaling is giving us Dupuytrens rather than cancer. Could it be saving us?

                The Swedish abstract suggests that we have a higher risk of cancer. I should get a copy of the full paper, however, to see if they controlled for the effects of tobacco and alcoholism. The abstract mentions that those two behaviors increase risk for DD, so you have to ask whether that behavior, and not the genetic part of DD, could account for the correlation of DD with higher cancer rates.

                  07/19/2013 13:42
                  wach 

                  Administrator

                  07/19/2013 13:42
                  wach 

                  Administrator

                  Re: Is there a link between cancer and Dupuytrens?

                  Good question, John. Statistcal linking is always an issue and does not show cause and effect. You might also have a look at http://www.ncbi.nlm.nih.gov/pubmed/11781116. When adjusted for smoking, the cancer effect seems to reduce and even vanish for some DD stages.

                  Wolfgang

                  JohnG:
                  Seph:
                  Yes interesting but importantly no causal connection indicated. The optimist in me wonders if the faulty Wnt Signaling is giving us Dupuytrens rather than cancer. Could it be saving us?

                  The Swedish abstract suggests that we have a higher risk of cancer. I should get a copy of the full paper, however, to see if they controlled for the effects of tobacco and alcoholism. The abstract mentions that those two behaviors increase risk for DD, so you have to ask whether that behavior, and not the genetic part of DD, could account for the correlation of DD with higher cancer rates.

                    07/19/2013 15:42
                    JohnG 
                    07/19/2013 15:42
                    JohnG 
                    Re: Is there a link between cancer and Dupuytrens?

                    Thanks, Wach.

                    I have now read all three papers that you mentioned.

                    It's clear from reading them that smoking and alcohol abuse are more common among DD patients than the general public.

                    It's also clear that DD patients that have advanced to the contracture stage have a higher cancer mortality.

                    After reading these papers, though, I'm still unsure whether the higher cancer mortality could just be due to the smoking and alcohol. The 2000 Swedish paper did not try to adjust for either of them when calculating the cancer risk. The 2002 Icelandic paper adjusted only for smoking, not for alcohol abuse.

                    Besides lung cancer, the kinds of cancer that seem to be most enhanced for DD patients, according to the Swedish paper, are oral, oesophagal, larnyx, liver and rectal cancers -- I think these are all enhanced with alcohol abuse, so it's too bad that the Icelandic paper adjusted only for smoking and not for alcohol abuse.

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