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Getting radiation Monday. Size of area looks large.
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02/23/19 18:37
harryzone 
02/23/19 18:37
harryzone 
Getting radiation Monday. Size of area looks large.

Im getting radiation on monday. Traveled to get here so they sized me up yesterday. The area they “marked off” seems large. Worried about long term consequences of getting such a large area radiated. Does the radiation area like in the following/attached pic look normal? Thanks for your input/thoughts

Plus any words of wisdom or encouragement welcome. Im more afraid if this than i thought i’d be
Mostly worried about risk of sarcoma

Edited 02/23/19 18:56

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02/23/19 20:40
spanishbuddha 

Administrator

02/23/19 20:40
spanishbuddha 

Administrator

Re: Getting radiation Monday. Size of area looks large.

harryzone:
Im getting radiation on monday. Traveled to get here so they sized me up yesterday. The area they “marked off” seems large. Worried about long term consequences of getting such a large area radiated. Does the radiation area like in the following/attached pic look normal? Thanks for your input/thoughts

Plus any words of wisdom or encouragement welcome. Im more afraid if this than i thought i’d be
Mostly worried about risk of sarcoma
The total area being treated is quite normal, typically most of the palm and up to just below the PIP joints. The extension down to wrist is perhaps unusual, but maybe there are nodules or cords down there?

The dose usually used, 30Gy over several weeks is very low, orders below that used for cancers, and is on an extremity, and does not penetrate deeply below the skin. Still afaik no reported cases of (skin or any) cancer caused by this treatment.

Did you see our page on side effects, where we also attempted a risk estimate? https://www.dupuytren-online.info/radiot...de_effects.html

Another perspective here, https://www.thedupuytrenspractice.com/ra...y/side-effects/, what does your radiologist say?

02/24/19 08:12
Prof.Seegenschmiedt 
02/24/19 08:12
Prof.Seegenschmiedt 

Appropriate Size of Radiation Treatment Field

spanishbuddha:
harryzone:
Im getting radiation on monday. Traveled to get here so they sized me up yesterday. The area they “marked off” seems large. Worried about long term consequences of getting such a large area radiated. Does the radiation area like in the following/attached pic look normal? Thanks for your input/thoughts

Plus any words of wisdom or encouragement welcome. Im more afraid if this than i thought i’d be
Mostly worried about risk of sarcoma
The total area being treated is quite normal, typically most of the palm and up to just below the PIP joints. The extension down to wrist is perhaps unusual, but maybe there are nodules or cords down there?

The dose usually used, 30Gy over several weeks is very low, orders below that used for cancers, and is on an extremity, and does not penetrate deeply below the skin. Still afaik no reported cases of (skin or any) cancer caused by this treatment.

Did you see our page on side effects, where we also attempted a risk estimate? https://www.dupuytren-online.info/radiot...de_effects.html

Another perspective here, https://www.thedupuytrenspractice.com/ra...y/side-effects/, what does your radiologist say?

What is the Appropriate Size of Radiation Field (Portal) ?

Radiation therapy fields (also named portals) are usually constructed from the physical findings after careful palpation of the hand palm; thus, the marked nodules and cords in relation to the affected finger rays plus a safety margin of 1 cm lateral and about 2 cm longitudinal determine the individual RT field. I provide an example from the Groningen book, how far own findings and physician´s findings may differ (picture attached)

In the example of "harryzone" the RT-field appears rather small and too long on the area of the wrist, as there are rarely nodules to be found in that region.

With regard to "spanishbuddha" I agree with his comments: no published case of secondary malignancy induced by radiation therapy, but up to 20% overall short- and long-term complications and side-effects from surgery. Our informed consent for a patient around 50 years usually includes a statement about the possibility to develop cancer within the irradiated area of lesser than 1% within the next 30 years. I have never observed one case in more than over 1.000 patients treated so far.

Moreover, another note to the photo of "harryzone": the skin appears rather "dry" and "rough" and somewhat irritated by heavy mechanical work. If this is the case, a careful skin care during and after radiation therapy is important. I usually recommend Excipial Lipo Lotion with 4% Urea which is often used by patients with irritated skin suffering from neurodermatitis (https://www.excipial.de/produkte/urea/u-lipolotio/)

With best wishes for the upcoming treatment, Yours Prof. Seegenschmiedt

Edited 02/24/19 08:15

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02/24/19 14:50
harryzone 
02/24/19 14:50
harryzone 
Re: Getting radiation Monday. Size of area looks large.

Thank you so much for the responses spanishbuddha and Prof. Seegenschmiedt. I guess ill bring these up to my radiation doctor on Monday. Appreciate this forum and you gentlemen responding.

Edited 02/24/19 21:13

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