| Radiation Treatment in Portland, Oregon |
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09/28/2012 17:20
RetiredTeacher 
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09/28/2012 17:20
RetiredTeacher
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Re: Radiation Treatment in Portland, Oregon
Yes, she increased the area to include the new node. Now she said she will think about how to treat the new node in December. She says the electron radiation can be tricky because the edges are "fuzzy". She'll have to be careful not to overlap the section of hand that has been treated twice.
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09/28/2012 17:47
Lanod 
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09/28/2012 17:47
Lanod
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Re: Radiation Treatment in Portland, Oregon
RetiredTeacher:
Yes, she increased the area to include the new node. Now she said she will think about how to treat the new node in December. She says the electron radiation can be tricky because the edges are "fuzzy". She'll have to be careful not to overlap the section of hand that has been treated twice.
Good that Dr. Cha treated your index finger.
Re overlap, Prof. Seegenschmiedt says in his 2012 Phase III Clinical paper:
"We believe that out-field DD progression, occurs not very often, is then [treated] to a second RT series, as long as no major overlap with the primary RT portals exist".
I guess the phrase 'no major overlap' is encouraging for your case.
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10/03/2012 01:50
callie 
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10/03/2012 01:50
callie
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Re: Radiation Treatment in Portland, Oregon
I saw the radiologist today. I was surprised that she suggested radiating the entire palm as opposed to targeted nodules. I don't think I misunderstood her. Does this sound like the typical experience of any others?
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10/03/2012 05:35
wach  Administrator
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10/03/2012 05:35
wach Administrator
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Re: Radiation Treatment in Portland, Oregon
Hi Callie,
if you don't have nodules all over I would not irradiate the whole palm. Usually the nodule is irradiated together with a "safety margin" around it (to catch disease extnsions that are not palpable). Examples are shown on http://www.dupuytren-online.info/radiation_therapy.html. Radiotherapy is effective on existing nodules but does not exclude later occurance of new nodules. Therefore I can't see why one would irradiate the whole palm. Maybe except something like "for this price you can get your whole hand irradiated as well". But RT always also affects the healthy tissue and thus irradiation ought to be minimized.
Wolfgang
callie:
I saw the radiologist today. I was surprised that she suggested radiating the entire palm as opposed to targeted nodules. I don't think I misunderstood her. Does this sound like the typical experience of any others?
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10/03/2012 15:33
RetiredTeacher
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10/03/2012 15:33
RetiredTeacher
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Re: Radiation Treatment in Portland, Oregon
Dear Callie,
When I read the literature on RT, it said that "shielding of electron beams is more difficult, therefore typically the whole area is radiated". Dr. Cha says that the radiation dosage is very small and that the depth of the electron radiation is very superficial. The RT we are getting is nowhere near as scary as cancer patients get. I have had no side effects at all and I just completed my second round of treatment. So far, in the 8 months that these two new nodes have been growing, there is no contracture and I believe it is because of the RT in late June and late September. Did your insurance decide to pay? I wish you good luck with your treatment--whatever you decide to do.
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10/03/2012 15:40
RetiredTeacher
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10/03/2012 15:40
RetiredTeacher
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Re: Radiation Treatment in Portland, Oregon
Lanod:
RetiredTeacher:
Yes, she increased the area to include the new node. Now she said she will think about how to treat the new node in December. She says the electron radiation can be tricky because the edges are "fuzzy". She'll have to be careful not to overlap the section of hand that has been treated twice.
Good that Dr. Cha treated your index finger.
Re overlap, Prof. Seegenschmiedt says in his 2012 Phase III Clinical paper:
"We believe that out-field DD progression, occurs not very often, is then [treated] to a second RT series, as long as no major overlap with the primary RT portals exist".
I guess the phrase 'no major overlap' is encouraging for your case.
Yes, she told me yesterday that if the node on the index finger starts growing, she can do another round on just the finger. She said she was not worried about a small amount of overlap because the dose is so low and the depth is so shallow that she did not feel there would be any major problems with radiation. Thank you all so much for your caring! I now feel that I have a "forum" to talk with people who understand what I'm going through. I can live with the horrible scar from the first surgeon and the nodes, what I'm trying to avoid is the contracture since I do so much with my hands: quilt, sew, garden, paint, refinish furniture, etc.
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10/04/2012 02:54
RetiredTeacher
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10/04/2012 02:54
RetiredTeacher
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Re: Radiation Treatment in Portland, Oregon
RetiredTeacher:
Dear Callie,
When I read the literature on RT, it said that "shielding of electron beams is more difficult, therefore typically the whole area is radiated". Dr. Cha says that the radiation dosage is very small and that the depth of the electron radiation is very superficial. The RT we are getting is nowhere near as scary as cancer patients get. I have had no side effects at all and I just completed my second round of treatment. So far, in the 8 months that these two new nodes have been growing, there is no contracture and I believe it is because of the RT in late June and late September. Did your insurance decide to pay? I wish you good luck with your treatment--whatever you decide to do.
Callie,
Check out http://www.pushpullsigns.com/dupuytrensradiotherapy.html. He showed the plate that his dr. in Hamburg used and it looks a lot like the ones that Dr. Cha is using.
Vicki
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10/04/2012 18:35
callie
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10/04/2012 18:35
callie
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Re: Radiation Treatment in Portland, Oregon
Thank you Vicki. That is great information. I'm really hoping that Dr. Cha can push this through my insurance company. The Aetna Insurance information is a great document for all insurance companies to follow. That might be the breakthrough for RT in the U.S.
Are you having any side effects from the RT? How long did each of your visits with Dr. Cha?
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10/04/2012 19:10
RetiredTeacher
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10/04/2012 19:10
RetiredTeacher
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Re: Radiation Treatment in Portland, Oregon
Hi Callie,
I only saw Dr. Cha for a few minutes at the beginning of treatment and at the end of treatment mostly because I really didn't have any questions after researching RT on this site. The center is excellent at getting you in and out without hardly any wait--maybe 2 to 5 minutes. Then each treatment lasted about 30 seconds a hand. We had a great vacation! We went to the center in the morning and were able to do touristy things all afternoon! I have had no side effects, not even the dry skin because I'm using lots of Mary Kay extra emollient night cream and a 20% Urea cream I got online. I hope your insurance OKs this treatment. I have Blue Cross Blue Shield and they have paid everything. Of course, my out of pocket had been met prior to this.
I have had no new nodules within the radiated area--which is very encouraging!!!! Good luck to you.
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10/31/2012 16:51
callie
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10/31/2012 16:51
callie
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Re: Radiation Treatment in Portland, Oregon
This is an interesting development. I was turned down by my insurance for RT about 5 months ago. I kept working at it and now my insurance will cover RT. I think the deciding factor was the Aetna Insurance document that is on the internet saying that they consider RT as standard practice and is covered by them. I will be setting up my appointments today with Dr. Cha, Portland, Oregon.
That Aetna document:
http://www.aetna.com/cpb/medical/data/800_899/0800.html
Edited 10/31/12 18:55
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