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NA after Radiation Therapy?
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AP_in_DC 

AP_in_DC 
NA after Radiation Therapy?

I was wondering if anyone has gotten NA after having RT, or if anyone knows if this is recommended. I was diagnosed about 3 weeks ago. At that time I only had nodules and a knuckle pad, but I've since developed what I think are 4 cords (in 3 weeks!) So this is moving fast. No contracture yet, but I am starting to get some tightness, especially when I try to stretch out my right thumb (there are two different cords going to the thumb).

I am investigating RT, and if I decide to do it, would like to move on it very quickly since this disease seems to be progressing so fast (it seems to change almost daily). I'm not sure if I'm a candidate for NA quite yet, but if the cords tighten up much more I definitely would be. Does anyone know if it would make since to go ahead and start the RT as soon as I can, with the option of getting NA later as needed? Obviously, I will ask this question of various doctors too, but I'd be very interested in the experience of those on this board as well - the more input the better!

Also, when they do RT, do they irradiate just the nodules and those part of the cords that fall within the margin around the nodule, or do they irradiate the entire cord as well? (This would would seem to cover a much larger area.)

Thanks for any input you can provide.

LubaM. 

LubaM. 
Re: NA after Radiation Therapy?


In November I had RT on my left hand with Dr. Tripuraneni at Scripps Clinic in La Jolla, CA. RT was done to most of the palm extending to about half an inch into the fingers, but the radiated area extended down the pointer finger all the way to the PIP joint.

I had a cord running down that finger from the palm down to the PIP joint. It has been noted on this forum that radiation doesn't help cords, but in my case the cord that was very small and thin is now completely gone and half of the nodules are much softer.

Also I gained range when opening my hand, I am able to open the hand better and the span is wider from pinkie to thumb. I consider the RT to have been successful so far in slowing down the progression of the disease. I also had RT on two nodules on my foot (Ledderhose) that are now softer and smaller.

I would definitely advise you to do RT as soon as possible. Dr. Tripuraneni said that NA is always possible after RT if needed.

You can go to my profile and email me if you would like more information, or ask more questions here on the forum.

flojo 

flojo 
Re: NA after Radiation Therapy?

I agree with Luba. My experience with RT was very good. It helped greatly. My understanding also is the NA does work after RT. If you wait until you have contracture, you will may have to have NA before RT, because the hand needs to lie almost flat while you're having RT. I recommend that you consider RT soon especially with yours progressing so rapidly.

CMurzda 

CMurzda 
Re: NA after Radiation Therapy?

If you think about it NA makes perfect sense as an option after RT. NA essentially breaks up the physical tissue of the cord causing it to be weakened so that it can be snapped. So why would irradiated tissue be a problem? RT doesn't harden the tissue nor does it prevent healing. Just some thoughts.

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