Therapies that we consider as research or experimental

 

Cryotherapy (also called cryosurgery)

Cryotherapy is occasionally used to treat Morbus Ledderhose (Ledderhose disease). The nodule and the surrounding tissue is deeply frozen, which kills the nerves' ends in this area. The purpose is to reduce pain and shrink the nodules. Literature documents only a single case where a Ledderhose patient was treated with cryotherapy. In that case the treatment was successful and the nodules also reduced in size. Another successful treatment of Ledderhose has been reported recently and here we publish cryotherapy details. For further information on cryotherapy you might e.g. have a look at cryotherapy_overall or at the cryotech web site. Because we are not yet aware of studies with good statistics regarding cryotherapy of Ledderhose or Dupuytren, and we have no indication of side effects or long term results except the general ones of cryotherapy, we consider this therapy for Ledderhose or Dupuytren as still experimental, although cryotherapy itself has been in use for many years and side effects are usually minor. For Dupuytren's contracture we doubt whether fingers can be released and we are concerned about the side effects of killing nerve ends in the hand's palm. For treating feet (Morbus Ledderhose) recent results of cryosurgery are encouraging.

Laser therapy

Laser therapy is occasionally applied to Ledderhose (we are not aware of its application to Dupuytren). Doubts have been raised regarding the effectiveness of laser therapy but we know of Ledderhose patients that were satisfied and the nodules were successfully reduced in size. The outcome might, besides others, depend on the type of laser and is probably best for small nodules, i.e. in the initial stage of the disease. As no generally accepted statistics have been published so far, we consider this therapy for Ledderhose as still experimental.

Antiestrogen (Tamoxifen)

So far research seems to be restricted to laboratory conditions, and Tamoxifen cannot (yet?) be viewed as a proven therapy. "Tamoxifen, by neutralizing or downregulating TGF_2, may prove to be a method to manipulate and control Dupuytren’s contracture in the clinical setting. Eventually, through further clinical investigation, it may be possible to halt or even reverse this progressive and debilitating disease." Cited from M. A. Kuhn, X. Wang,  W. G. Payne, F. Ko, and M. C. Robson, Tamoxifen Decreases Fibroblast Function and Downregulates TGF_2 in Dupuytren’s Affected Palmar Fascia, Journal of Surgical Research 103 (2002) p 146–152.

 

5-Fluorouracil

Lab experiments showed that 5-fluorouracil caused a dose-dependent, selective, and specific decrease in collagen production by Dupuytren's fibroblasts. "The clinical implication is that 5-fluorouracil could possibly reduce extracellular matrix production and therefore reduce recurrence of Dupuytren's disease of the hand." NW Bulstrode et al. "5-Fluorouracil Selectively Inhibits Collagen Synthesis" Plastic & Reconstructive Surgery 116 (2005) p 209-221 abstract.

 

Mechanical treatment / massaging

Two patients independently reported that intense massaging of their cords and nodules with a ball (wooden or plastic) over months eventually seemed to remove the Dupuytren tissue. In one case this observation was confirmed by a doctor. We don't know how that worked and whether it would work for other patients. This is far from being a therapy but we consider it worth mentioning.

Diet

Various diets have been proposed to reduce or stop tumor growth. Most famous are possibly those based on the Warburg hypothesis. Otto Heinrich Warburg, Nobel laureate in medicine in 1931, observed that cancer cells get their energy mainly from glucose rather than by absorbing molecular oxygen from the blood, which is what normal cells do. He suggested that this faulty respiration causes cells to become cancerous (Warburg biography and wiki_article). Later research built on his thesis (Warburg revisited, Science_article) and very recently results from University of Jena, Germany, confirmed his theory (Jena_article_in_German).

Also proposed are low or zero carbohydrate diets (e.g. Wolfgang Lutz' "Living without Bread"). Recently a phase 1 study on the effect of a low carb diet on cancer had been started at a German hospital at Wuerzburg but is now on hold due to low funding (Time article on low carb study). 

Some patients report successful reduction of Dupuytren nodules after 6 months of vegetarian, no alcohol, no coffee diet. - A female patient in our German forum tried a diet strictly avoiding progesterone to reduce the growth of breast cancer and observed a positive effect on Dupuytren nodules and cords. The diet she had used was a vegetarian one, additionally avoiding milk products (vegan diet).

Other diets e. g. suggest a high intake of antioxidants, e.g. a patient reported that his Dupuytren nodules significantly decreased when he eat excessive amounts of tomatoes during the harvest period. Similarly, taking NAC seems to reduce growth rates and soften cords, probably due to the high lycopene (antioxidant) content of tomatoes.

So far reports of successful diets provide only anecdotal evidence, no sound statistics and no comparison to control groups. We therefore consider diets as experimental and remind patients that diets may have severe side effects.

 

Page last modified: 05/11/2008