Ledderhose Disease (Plantar Fibromatosis)
Ledderhose disease is a benign (non-cancerous) condition that causes lumps in the arch of your foot that, if left untreated, can grow and become tender and painful, especially when standing or walking. Sometimes people have a similar condition in their hands, called Dupuytren’s disease, which can cause contractures (fixed bending) of their fingers.
Radiotherapy for Ledderhose Disease
Radiotherapy is the use of radiation (for instance with X-rays) to treat disease. The radiation is directed towards the nodules (lumps) in your feet and changes the development and growth of the cells that make up those nodules, causing them to soften and shrink and reducing the pain in the affected area.
How the treatment works:
Your initial consultation. You will see a doctor who will ask you questions about your condition, examine your hands, and discuss treatment options with you, including the benefits and possible side effects of radiotherapy.
If you decide to move forwards with radiotherapy, you’ll need to sign a consent form for your treatment.
Your doctor will then outline the nodules and cords which are to be treated – a safety margin will be marked around the tissue to be treated – this allows us to treat the affected area while protecting the unaffected part of your hand.
A radiographer will then take a photograph of the region and make a tracing so that the area can accurately be treated each day. Some clinics will use a CT scan in order to guide the treatment. Your treatment will generally start around a week or two later.
Treatment. You’ll be asked to position yourself underneath the radiotherapy machine with your hand placed on a positioning bag for the duration of the treatment session.
Each appointment will take around 10 minutes, with the radiotherapy treatment itself taking around a minute to complete. You can leave straight away when each session is complete. Your treatment will be administered over five consecutive weekdays and then repeated after a break of around three months
The radiotherapy will be targeted to the same area throughout your course of treatment, even if the nodules in the foot seem to be decreasing in size. This is to limit the likelihood of regrowth.
Follow-up. You’ll receive a follow-up call from us to check how you are doing after your treatment.
Here you can discuss any problems, side effects or questions you may have.
Three months after your treatment, you’ll be sent a questionnaire so we can assess how your feet are. If necessary, you’ll be able to have an additional consultation over the phone, or at one of our clinics, to discuss your outcomes in more detail.
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Conditions We Treat
FAQ
Most Commonly Asked Questions
You shouldn’t feel any pain during your radiotherapy treatment, however, you may be a little tired afterwards.
The indications for radiotherapy depend on the particular condition that you have. Your doctor will discuss whether radiotherapy is the right treatment for you, explaining the effectiveness and the side-effects involved.
A physician referral is generally needed if you are using private medical insurance. If you are self-funding then generally you do not need a referral letter, although we will routinely send a copy of any letters that we write to your physician, for instance, a record of the consultation and the treatment.
You may experience some minor side effects after radiotherapy treatment. Your specific risk will be discussed with you during your initial consultation. During your treatment, you shouldn’t experience any pain, drowsiness or dizziness.
It’s important to note that the radiation dose is much lower than radiotherapy treatment for cancer, so that side effects tend to be mild.
You may find that in the two to three weeks after the end of your radiotherapy course, the skin on the sole of your foot, for example, may become a little red, sore or dry. This tends to be very minor, although about 1 in 100 people can get swelling or weeping around the area. Most people find putting some moisturiser around the treatment site is enough to treat the dryness.
Around one in five people find that the dryness continues in the long term. Some people notice minor changes in the skin and it may become thicker, thinner, rougher, or smoother than before the treatment.
While there is a theoretical risk of developing a cancer in the skin around the treated area, the risk is very small.
For a 50 year old, the life-time risk of developing a type of skin cancer in the treated region is in the region of 0.02% to 0.1% (between 1 in 5,000 patients and 1 in 1,000 patients). The risk of cancer will be slightly higher if you are younger and lower if you are older at the time of treatment. Your specific risk will be discussed in detail with your consultant.
Since the radiation is precisely targeted at the area, this avoids unnecessary exposure to the rest of your body and so there is no increase in cancer risk outside of the treated area.
If you have any concerns during your treatment, your radiographer or consultant will be available to answer your questions at any time.
