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04/13/2016 01:13
stephenp 
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04/13/2016 01:13
stephenp
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RT following surgery or NA
Does anyone have experience of using RT following any other treatment to try to slow or stop recurrence? I realise that there would need to be sufficient time to allow full healing.
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04/13/2016 05:18
newman 
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04/13/2016 05:18
newman
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Re: RT following surgery or NA
Hi the subject of Radiotherapy soon after surgery was raised by Prof Seegenschmiedt in a Society meeting which I attended in Munich a couple of years back. Maybe Wolfgang may have some further comment as the meeting was in German I might not have the full explanation but in essence he could not seen why not? in certain cases. Ie patients that have the disease in an aggressive form such as myself. There were patients in the US I remember at some years back that had had RT after the NA. I cannot remember if there was any further postings about their experiences.
Edited 04/13/16 08:21
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04/13/2016 05:42
wach  Administrator
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04/13/2016 05:42
wach Administrator
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Re: RT following surgery or NA
Studies have been started evaluating the effect of RT after surgery (in Germany) and after NA (in the USA). Both will need considerable time, many years, to see whether RT is reducing recurrence significantly. So, yes, research is under way but it will probably take 5 years or so before we are seeing results.
Wolfgang
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04/13/2016 06:49
Stefan_K.
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04/13/2016 06:49
Stefan_K.
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Re: RT following surgery or NA
wach:
Studies have been started evaluating the effect of RT after surgery (in Germany) and after NA (in the USA). Both will need considerable time, many years, to see whether RT is reducing recurrence significantly. So, yes, research is under way but it will probably take 5 years or so before we are seeing results.
Wolfgang
That would be very helpful. There is very little doubt in my mind that RT after NA/PNF would make a lot of sense, and that localized on the area where the cord was broken to specifically prevent ends from reconnecting through the creation of new collagen deposits. I have seen a video of Prof S. talking about the phenomenon and I am surprised this apparently isn't being practiced and hasn't been studied more for decades already. Perhaps at least in certain cases it would be possible to break the cord in different places if additional NA/PNF is required, so that the same areas don't need to be irradiated too often.
If I ever needed NA/PNF again, that is definitely something I would ask for (and start night splinting within days).
By the way, how is the decision typically made on which part of the cord the NA/PNF is best performed? I suppose that if palpation detects a narrower, supposedly weaker area, that would be a prime target, but are there other considerations, such as the typical location of blood vessels or nerves, and is the procedure, when needed, typically performed in the same spot?
Stef
[54 year-old male, DD diagnosis 2006, RH contracture and NA/PNF 2014, RT 2015, wearing night splint glove]
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04/13/2016 15:29
spanishbuddha Administrator
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04/13/2016 15:29
spanishbuddha Administrator
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Re: RT following surgery or NA
Stefan_K.:
wach:
Studies have been started evaluating the effect of RT after surgery (in Germany) and after NA (in the USA). Both will need considerable time, many years, to see whether RT is reducing recurrence significantly. So, yes, research is under way but it will probably take 5 years or so before we are seeing results.
Wolfgang
That would be very helpful. There is very little doubt in my mind that RT after NA/PNF would make a lot of sense, and that localized on the area where the cord was broken to specifically prevent ends from reconnecting through the creation of new collagen deposits. I have seen a video of Prof S. talking about the phenomenon and I am surprised this apparently isn't being practiced and hasn't been studied more for decades already. Perhaps at least in certain cases it would be possible to break the cord in different places if additional NA/PNF is required, so that the same areas don't need to be irradiated too often.
If I ever needed NA/PNF again, that is definitely something I would ask for (and start night splinting within days).
By the way, how is the decision typically made on which part of the cord the NA/PNF is best performed? I suppose that if palpation detects a narrower, supposedly weaker area, that would be a prime target, but are there other considerations, such as the typical location of blood vessels or nerves, and is the procedure, when needed, typically performed in the same spot?
Stef
[54 year-old male, DD diagnosis 2006, RH contracture and NA/PNF 2014, RT 2015, wearing night splint glove]
Although not quite answering your questions the video by Dr Gary Pess on how he does NA, on the symposium site is quite useful. http://www.dupuytrensymposium.com/program_2015.php
Similarly for Collegenase.
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04/18/2016 19:43
Stefan_K.
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04/18/2016 19:43
Stefan_K.
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Re: RT following surgery or NA
spanishbuddha:
Although not quite answering your questions the video by Dr Gary Pess on how he does NA, on the symposium site is quite useful. http://www.dupuytrensymposium.com/program_2015.php
Yes, indeed. Thanks a lot for that great collection of links. Learned a lot again.
Stef
[54 year-old male, DD diagnosis 2006, RH contracture and NA/PNF 2014, RT 2015, wearing night splint glove]
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