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new nodule after radiation
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04/10/2013 21:24
dpiniowa 
04/10/2013 21:24
dpiniowa 
new nodule after radiation

Hi everyone. Has been a while since I have written on this site. I had radiation therapy two years ago on both hands and it seemed to stop the disease cold. About three weeks ago I felt that feeling in my right hand and knew before I even looked that I had a new nodule. The nodule is in the middle of the field of radiaiton and has about doubled in size since I found it. How many of you have had new nodules after radiation and those that have, have you found them to be as aggressive as the ones before treatment? I met with my radiologist to see if radiation was an option for this progression and he wanted to try other things first. I have done some research and some studies suggest that steroids shot into early nodules might shrink/soften/or slow down the progression. Have many of you tried this and has anyone had any success. I went to a new hand ortho that was reluctant to give me the shot, but he did, and I will probably do another one in six weeks. He is firmly against Radiation Therapy and gives no credibility to the fact that my disease completely stopped after radiation and all nodules disappeared, just a coincidence to him. Those hand orthos, same old story, just wait and see. Not my style, but of course I am vey disappointed and not sure what to do now, any suggestions, anyone re-radiate and if so when. Am I ok until the cords start to form again? I thought that I understood this disease and now I feel kind of lost. Looking for advise and similar stories which may help. Thanks! Lauri W

04/10/2013 21:57
callie 
04/10/2013 21:57
callie 
Re: new nodule after radiation

Are you sure this is a Dupuytren's nodule and not a ganglion cyst? The studies seem to suggest that irradiation is effective. But, the doubt is because often a person will have a nodule develop and then go dormant. That happened to me. I developed nodules on both my hands at the same time. On one hand the nodule produced a cord ant then over 90 degrees contracture in about 18 months. The other hand with two nodules went dormant for 13 years and caused no problems. The nodules almost disappeared.

The radiation only affects the active nodules and will not prevent future nodules. My Dr. said that I could have radiation a year later after having a radiation treatment, but that is controversial.

Edited 04/11/13 00:59

04/10/2013 22:34
switcombe 
04/10/2013 22:34
switcombe 
Re: new nodule after radiation

Hi Lauri, I understand the uncertainty you are dealing with. I, too, had a nodule develop right in the center of my radiation field. My treatment was completed 6 months ago. About 6 weeks ago a nodule popped up in my palm and quickly grew (within three weeks) to about the size of my other nodules before they were radiated. It was painful if I pressed it firmly (which I did often, after reading that maybe massage could help). In the last few weeks, it has seemed to be less sensitive to pressure and it has stopped growing. So I'm going to leave it alone for now and wait to see what develops.

Sharon

04/11/2013 00:05
dpiniowa 
04/11/2013 00:05
dpiniowa 
Re: new nodule after radiation

thanks for the replies, and I am hoping that I will hear from others that have had nodules after radiation and those who have tried steroid shots. This is definetely a nodule and I can tell that a new cord is starting. I am hoping it will stop growing, but am not confident. For those that are reading this please feel free to give input. I appreciate everyones experience and opinions!
lauriw

04/11/2013 07:14
spanishbuddha 

Administrator

04/11/2013 07:14
spanishbuddha 

Administrator

Re: new nodule after radiation

I have skin changes and a new nodule on my hand that was treated with RT 18 months ago. The nodule is in the area that was radiated. I was treated by ProfS in Germany and on my annual review asked about having further radiation. His advice was that half the treatment (5 x Gy) was possible under specific circumstances. The new nodule in my case is very slow growing and not painful with no sign of a cord, so I'm just letting it be for now.

It's not clear at all to me, from my limited reading of the literature, how RT could be a preventative treatment although there are a few personal accounts of DD not recurring after treatment. Instead the literature only provides hypotheses on how the treatment works for active proliferation of nodules/collagen.

04/11/2013 21:35
stephenp 
04/11/2013 21:35
stephenp 
Re: new nodule after radiation

I agree, conceptually it is difficult to imagine that RT can prevent the development of a new nodule or cord in an irradiated area since it probably involves new active fibroblasts laying down new collagen. However, if disease progression is dependent to some extent on systemic signals from other active cells a lower number of active cells may mean less active progression.

Hopefully those new nodules within the irradiation field will not progress to fast. Like others, I am hopeful as my hand that was treated about 18 months ago has been aching a lot more recently but no new nodules etc at this time.

04/11/2013 21:37
stephenp 
04/11/2013 21:37
stephenp 
Re: new nodule after radiation

Has Prof Seegenschmiedt re-treated the same site with RT in any/many patients?

04/12/2013 01:18
Tusk 
04/12/2013 01:18
Tusk 
Re: new nodule after radiation

I recall reading on this site that Prof S felt that RT was successful in about 70% of the cases. In other words, about 30% of the time, the disease would progress even after RT. Perhaps Wolfgang can shed more light on that.

I think it also makes a difference if you have a more aggressive disease (diathesis). Aggressive disease is more likely to recur following NA or surgery. Stands to reason that it might be one reason RT doesn't always control the disease.

04/12/2013 13:53
lori 
04/12/2013 13:53
lori 
Re: new nodule after radiation

Lauri,

Sorry to hear about the new nodule. i had a steroid shot prior to RT. The steroid shot did not stop the DD from progressing , but it did slow it down. Mine was progressing so quickly that I figured I would try anything to slow the progression until I could get into seeing a doctor. Mine went from a nodule to a large cord within a few months. I have been lucky and the DD has not come back after RT.

Lori

04/12/2013 15:11
JohnG 
04/12/2013 15:11
JohnG 
Re: new nodule after radiation

stephenp:
Has Prof Seegenschmiedt re-treated the same site with RT in any/many patients?

His papers describing his clinical trials describe his treatment protocol, and don't recall seeing a mention of treating the same site again. Some of those patients were first treated many years ago, so you'd think that some of them might have at least inquired about it.

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proliferation   conceptually   uncertainty   treatment   disappointed   disease   progressing   irradiated   disappeared   irradiation   preventative   nodules   controversial   radiation   contracture   straightforward   progression   circumstances   aggressive   Seegenschmiedt