I learned a lot about what Medicare wants when I filed an appeal for them not paying for the oncologist because Scripps didn't even try. That's a big part of why I contacted LLUMC and got set up for my next radiation with them. ( Medicare paid for the big ticket item, the actual radiation, but not the oncologist. Go figure.)

The denial was because "RT is not a standard of practice for Dupuytren's." Lots of information on this site can help build a case, but we need to collectively get the documentation together.

Hi callie,

usually nodules develop into dermal pits and then cords, at least that's the way that Vernon Luck describes in his paper on Dupuytren's pathogenesis http://www.dupuytren-online.de/downloads/luck.pdf. Probably there are exceptions to this rule but in your case it may well be that you had a nodule deeper in the skin that you only noticed when it convoluted into a dermal pit.

In any case, radiotherapy might work on the pit but it works better on the initial nodule. The ideal target is a just detected, growing little nodule. The chances that RT can stop it and make it shrink are very good. Your nodule that popped up a month ago is likely very suitable for RT. Wishing you the best

Wolfgang

callie:

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I would be a prime candidate from everything I have read. This nodule popped up about a month ago on my little finger and a cord is starting to go up the finger and down the palm from the nodule. At the same time a nodule developed in the web of the thumb. This after being dormant for about 15 years. It is the first nodule I have had. Before it was dermal pits that started the cord.

A question I have is, does the radiation therapy work on the dermal pits?

I have an appointment Thursday with the Dr. in the oncology dept. who has done one other person with Dupuytren's. I will at least find out how the insurance coverage will be.

Edited 02/29/12 11:14

Hi all, its an interesting discussion sofar, here are my little additional comments:

I think as long as nothing specific AGAINST the GROWING TISSUE (= PROLIFERATING CELLS) is done they continue to grow and the disease extends to the regions where it usually shows up. I personally watched my case (after problems with my feet) i.e. one hand for 6 months, before my physician, Prof. Seegenschmiedt, was willing to take action. He wanted to BE SURE TO IRRADIATE only ACTIVE DISEASE, but he and I didn't waited any longer, as we both aggreed that radiation is by far the BEST OPTION FOR EARLY DUPUYTREN without functional deficit.

Greetings from Larry

Thank you Wolfgang, the pictures from the link above were interesting for me. My contracture was almost identical to the pictures in Stage 4 (greater than 135 degrees). I have been too conservative I guess in labeling my contracture at 90 degrees, more like about 140 degrees.

Edited 03/02/12 18:02