I originally posted this in another area but realized it is better as a new one (I think).

I was planning to have radiation therapy and just read postings on this website which have left me confused--evidently there has to be real activity in the last 6 months. I would appreciate an informed opinion as to whether or not my situation warrants radiation. There is no one in my area I can consult and would be grateful if those who are very familiar with radiation could answer. I know this is just an opinion from a distance, but it would help me. Here, radiation oncologists are not as exacting as in Germany and radiation for Dupuytren's is new and even controversial --and so I'm sure that if I request from a doctor who does it, I will have it--but as you point out, there are risks, and I wouldn't want to have this done for no reason.

I have a 4mm flat nodule directly on the PIP joint of the middle finger of one hand. It appeared 14 months ago. I've had it injected with kenalog a few times, hoping it would disappear, but it has not. Sometimes I've thought it has shrunk due to the kenalog, but other times it looks like it has not.

From looking at photos of 6 months ago I don't think the bulk of the nodule has grown appreciably, it is still pretty flat, but it looks like it has progressed about 1mm or so in its lower right corner to touch the bottom PIP joint line--it didn't do this 6 months ago. And what was a small 1-2 mm area that branched upward and just over the upper PIP joint line--this has become more definite with deeper "grooves" on either side. It looks like it will become a small cord--but it is not yet really palpable--it just looks like it. Below the PIP joint line what used to be a 2.5 mm fullness of tissue even 1 year ago has become 3.5mm in the last 6 months--it only extends down 4mm from the joint line but looks even more now like the beginning of a cord. What has become more apparent also is that the tissue directly below the PIP joint line is more fluctuant for a distance of about 5mm, making me think that the fascia under it has become abnormal--perhaps this will also become a cord. Also there is a band on the side of the finger--still on the joint that touches the nodule and it has become rough--like the underlying fascia has become diseased and sticks to it. This just appeared in the last 6 months.

I don't have any itching, but if I "play" with the nodule much, then I have some burning sensations and a kind of deeper "boring"-type of pain.

So all in all, I think there has been some progress in the last 6 months but it has been slight. I can imagine that in a year or so all that I described will become real cords and then contraction and so I would like to pursue radiation but I don't want to hurt myself unnecessarily. Maybe the nodule has reached the stage where it doesn't grow, but yet produces cord leading to contraction.

The other hand has a real contraction an is not candidate.

Thanks for any help