Hi All Really thankful for the forum. Great service to all of us.
I had my first five radiation treatments during the week of Feb 25 thru Mar 1, 2019
I didn't feel anything during the treatments and felt fine the week after. About the second week after treatments my hands started to sting a bit. And this past week it seems like my nodules are getting worse. They are painful/itchy and seem to change size going from slightly bigger to smaller and back again when they feel like it. In other words, they seem really active.
I know it takes time and I'm only half way through my treatments but wanted to reach out to others to see if they have had similar reactions after the first week. I guess I was hoping they would start to settle down. They have always been active (started in October of last year) but like I said they seem quite angry since my first round of radiation.
Is this normal? Am I being impatient?
Thanks for the help
(PS full disclosure I'm a hand drummer and started to drum a little bit- lightly at first. maybe thats a factor. Just read the professors handout about taking care of hands after treatment (Here: https://www.dupuytren-online.info/Forum_...1551517552.html. Suggested reading for anyone undergoing raditiation. Thanks Professor. Appreciate you engaging with and for us!)
In none of the 6 series of RT on various parts of both hands I had an immediate reaction. After the first and after the second series on my right hand small nodules went away. Once I had reddening and peeling of the thin skin in-between fingers about three weeks after treatment (apparently the regeneration rhythm of the skin). I had some dryness on the palm of my right hand at times during the first twelve months. That has gone away.
The other existing nodules and cords have stopped growing wthout reacting otherwise to the treatment, and no new nodules or cords have appeared in the treated areas.
So for me RT has been successful without any serious or lasting side effects.
[56, Dupuytren diagnosis 2006, RH contracture and PNF/NA 2014, radiotherapy RH 2015, LH 2017 & 2018, night splint glove RH since 2015]
A few people report their nodules, hands or feet, seem to get sore soon after RT as if the DD beast is awakened, but it’s usually short term and settles down. My experience in one hand is similar and it took 18 months before I was convinced RT had made any effect. Like Stefan I had some minor side effects such as tanning and dry skin, the dry skin still occurs every winter but is easily fixed with appropriate hand creams.
I have heard of this and that is why the second set is usually 12 week break so that the next set can target any new proliferation. sometimes the radiation does trigger more activity and some have got new nodules in the facebook groups i am in. i just had first set and things are stable right now. you can always reach out to your RO
When DD continues to evolve, I believe it is in spite of RT rather than due to it. If the contrary was posted on Facebook without being clarified I would be concerned about the reliability of the information in that group.
Typical Reactions After Radiotherapy for Dupuytren Disease
Radiotherapy for nodules, cords and pathologic changes on the palmar fascia in Dupuytren Disease induces and has always effects on the skin, the subcutaneous tissue and down to the palmar fascia. Following radiotherapy typical symptoms may occur in the irradiated area including some itching, hypersensitivity of the skin, tingling and burning sensations and rarely even some pain symptoms. On the skin in the treated area some reddening (called erythema) can occur; eventually the irradiated subcutaneous tissue may develop some puffiness and swelling. The possible affected tissues in relation to the hand anatomy are shown on Figure 1 : Hand-Anatomy-Cross-Section-with-RT-depth profil
The typical zones of the radiation exposed areas of the hand palms (called radiation portal) are demonstrated on Figure 2. Dupuytren’s Disease_RT.Portal-Outline
The possible radiogenic side-effects are classified in 4 grades (according to the RTOG = Radiation Therapy Oncology Group or other groups). See attached link: Figure 3: Radiation Dermatitis Reactions
Usually after one course of radiotherapy with 5 x 3Gy up to a total of 15 Gy the grade 1 side effects occur in about 25 - 50% patients depending upon their individual risks (genetic disposition, additional diseases like diabetes mellitus, nicotine abuse etc.). Additional chemical, physical (heat, cold) and mechanical stress (heavy mechanical work) at the irradiated areas should be avoided during and about 2 - 4 weeks after radiotherapy. We usually recommend Excipial Lipo Lotion with 4% Urea for regular skin care during and after radiation therapy.
After The 1st RT series of 15 Gy the nodules and cords may not change or may to progress and not come to a stand-still; sometimes the nodules even seem to be "activated" with different observations like "swelling" and "hardening" which are not poor indicators for the later treatment outcome. Those individuals should be patient and await the 2nd RT series.
The best time points in follow-up to summarize the therapeutic effects on the disease and possible radiogenic side-effects are 3 months and 1 year after radiotherapy.