Hi mellow

Welcome to the forum. The BSSH in the UK has also taken the position against RT. However there are a number of individual surgeons who are more open minded. The use of RT as a therapy for a range of conditions is well established, and you hardly hear surgeons worrying about that; although it is one of the standard questions in the NHS prior to surgery.

There are at least two things that get muddled, the long term effect on the hand, and the effectiveness of RT.

The long term effect at the worse seems to be superficial skin dryness and it should be remembered this is not penetrating radiation, just deep enough to reach the affected fascia and disease. Did your hand surgeon mention the least complicating options at his disposal if you do get a contracture, which would be NA/PNF or Xiapex? They are less likely to be affected by prior treatment using RT, since they are hardly invasive.

The effectiveness of RT is now well documented, and yes there are failures. I think the tricky area really is, if you do nothing now, what are the chances are it will quiesce or go dormant anyway, whereas if you had RT now, who is to say if it was really effective or the DD just entered the dormant phase it would have done anyway. But this is where the control studies show the effectiveness; and an experienced doctor will ensure the timing of RT is right to maximise the chance of success. Ask your hand surgeon to cite the evidence or facts he is basing his position on, and show him the links to the RT control studies. Or just find a surgeon more up to date.

Kind regards
SB

Peacefulbird, that's an excellent, easy to understand summary which can help many.

As I have written in other posts here, the hand specialist who performed my NA/PNF very successfully and efficiently didn't inform me about RT or the potential benefits of splinting. I found out about it here, fortunately. I went to great lengths to get him interested in RT, forwarding links and information, and offering to examine my hand before and after the RT in Hamburg. He didn't take up the offer, but said he'd try to talk to colleagues doing radiation in the hospital. We exchanged by email (already a big plus with a doctor here), but I haven't been back or heard back.

It is troubling how little interest many if not most doctors show in treatment options others than their specialty (and sometimes how incompetent or little knowledgeable they are even in their own specialty). As I find it hard to accept, I have gotten a referral from my general practitioner to an oncologist friend of his later this month. I have no idea about the knowledge and interest he has regarding Dupuytren's but I am not giving up hope that somehow, one day, it will be possible to make radiotherapy available and have it covered for Dupuytren's (and Ledderhose) in France, and keep trying to facilitate it.

Stef

[54 year-old male, DD diagnosis 2006, RH contracture and NA/PNF 2014, RT 2015, wearing night splint glove]

Thanks for sharing your experience Peacefulbird. I was/am similarly convinced of the benefits of RT - the view of the surgeon just made me debate with myself again. I mean in general who goes against the recommendation of a specialist. I suppose that's what second opinions are for!

meunier:

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spanishbuddha:

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The effectiveness of RT is now well documented, and yes there are failures.

I have to say for me the research - be it by Prof S and his team - or anyone else - on RT for DD - limited as it is over the time frame - would be hugely strengthened if they did a study on the whys and wherefores of their so-called failures. That would, I think, be most instructive as towards the practice's general medical acceptance ... and surely it would teach much overall. I think the documentation that exists - such as it survives - is weakened by this particular lack of address.