Herbert,

it started in my hand at about your age and I am now nearly 30 years older ... and my hands are still functional. You might read about radiotherapy (radiation therapy) on the left menu of this page. This is the best treatment in the very early stage and can postpone the need for further intervention for many years, at least it did for me.

Wolfgang

Herbert,

I was 34 when I was diagnosed, at the time Dupuytren's was progressing quite quickly, after some research I decided to have radiotherapy. As a result of the treatment, 11 years later my hands are in a better state than they were at 34! Ultimately you have to make your own decision on what is the best treatment; this website contains lots of useful information on which to base that decision. If you decide to have radiotherapy its most effective at an early stage, I had one regret with the treatment of my left hand, in that I probably left it for too long (3 months) before having the radiotherapy. As a result because thicker contractures had formed in those 3 months radiotherapy didn't completely remove them, by contrast my right hand which was treated at the right time has lost its contracture and nodules. But, radiotherapy does always work for everyone, the statistics are presented on some of the medical papers provided on this site.

You may find that your plastic surgeon tells you to wait until you have more severe contracture, and that other treatments like Needle Aponevrotomy and Radiotherapy are not effective. If this happens you may have to take any decision on your own, or ask on this forum for the names of Australian consultants who might have a more open mind about alternative treatments (a list of clinics specialising in NA and RT are provided on the website) - there are a number of Australians who regularly contribute to the site.

If you are interested in radiotherapy you need to decide whether your Dupuytren's is progressing and how rapidly. If its stable then you might not need treatment, but if its progressing you might need to act quickly, one way to measure progression is to for example take a photo of your hand once per month and take some notes on the flexibility of your hands; in this way you will get a more scientific feel whether your Dupuytren's is progressing.

It also might help to take some 'preventative' measures, I think mine was caused by a mix of family genetics and rock climbing. There appears to be a link, although difficult to prove scientifically between the progression of Dupuytren's and trauma to the hand. My advice, if you do anything (sports?) which causes impact on the hands is to invest in a good pair of gel padded cycling mitts to reduce some of the impact on your palm.

Philip, UK

I agree, get RT at early stages when it is "active". Don't wait for contracture and cords as RT typically doesn't help cords.
I did not find this site until I had contracture, albeit mild. It was hard to know what to do, but once I knew about NA and RT, I decided to have NA first to release cords in my palm and thumb. Because of my personal schedule, I waited 3 months to get RT. That happened to work out for me since it was evident by that time that RT was appropriate on my whole palm because nodules of various sizes were in every quadrant of my palm. There is still some tightness across my palm, but not nearly as much and nodules are softer or gone and even some of the residual cording has lessened. There is no evidence of progression and exactly one year ago, I was in the midst of my 2 weeks of RT. Before RT, it was clearly progressing. My radiologist said that in my stage with some contracture (about 15 degrees), it was the thing to do to have NA first to release the cords.
Each person can consider all options and make the best decision for himself. Doctors, especially the surgeons and plastic surgeons, either don't have a clue about alternative early treatments or are biased against them. I have educated my GP, dermatologist, physical therapist, dentist and any other medical practitioner that I come in contact with. They have all been VERY open and glad to have other options top offer their other patients. The only one who was clearly disinterested was my podiatrist when I was explaining about RT for my DD and that it works for Ledderhose's, too. BTW, she also pushed me to do surgery for some arthritis in my big toe for what she described as a bunion that needed surgery right away. She resisted my suggestion to try orthodics because it was "inevitable that I will have to have surgery eventually." I became my own doctor, went to Sports Chalet and bought some Super Feet orthodic inserts. They help quite a bit. If it bets worse, I'll have custom orthodics made. If I did had the surgery the podiatrist wants to do for a mild condition, I believe it might well trigger Ledderhose's for me.
I recommend considering all treatment options, then make the best decision for yourself. Until I made my treatment choices for NA followed by RT, all the doctors told me I'd have to wait until my hand is drawn up (they didn't say so, but they meant "like a claw"), then have surgery. That's all they knew, but we on this Forum know better, and now they know better after I educated them.

I have found it very interesting reading about DD tonight,
I am a 24 year old female and have DD, I have 3 lumps on my left hand under my ring, middle and index finger about 1/2 inch.
We do have family history of this my dad has had his little finger removed on his right when he was around late 30's to early 40's, and he has just had some kind of reconstructive surgery to straighten all fingers and thumb on other hand, currently seem successful, I also have a male cousin about 30 years old on my dad's s with it, at this point i think i am the only female with DD in the family.
We have been advise by my dad's reconstructive surgeon not to undergo and treatment for myself at this stage.

Im in Australia, (Victoria)

Edited 07/21/10 16:28

Albeit very small, there are increased risk of cancer in the radiated area in about 25 years. You would want to consider that factor, but looking at your family history, your genes appear to be particularly susceptible to Dupuytren's and apparently aggressive Dupuys since you get it so young. You being female and having it seems to also indicate aggressive Dupuys.

I would still suggest that you do all the research, consult with a radiologist who does RT, consider RT and weigh the pros and cons. Right now, that's the only thing out there that stops the progression. Maybe in many years to come, there will be something with gene therapy that will work, but that's a long time off.