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Oncology · London

Private radiotherapy for early Dupuytren’s and Ledderhose in London, stabilising proliferative-phase disease.

Low-dose radiotherapy stabilises early proliferative-phase Dupuytren’s and Ledderhose disease - reducing the chance of progression to fixed contracture. Delivered by a clinical oncologist to the German protocol.

A radiographer guides a patient onto the bed of an advanced 3 Tesla MRI scanner in a London imaging suite

Indicative pricing

What a private radiotherapy programme for early Dupuytren’s costs in London.

Indicative ranges across UK private providers.

In short

£3,500–£6,500 per five-day course, with the second course after 6–8 weeks.

Programme Indicative range
Radiotherapy Dupuytren’s (5-day course) £3,500–£6,500
Second-course Dupuytren’s radiotherapy £3,500–£6,500
Radiotherapy Ledderhose disease £3,500–£7,000
Combined hand + foot programme £7,000–£13,000
Post-radiotherapy hand-therapy bundle £4,000–£7,500
Consultation only £250–£500

Prices vary by clinic, by the machine used (orthovoltage or linear accelerator), and by whether a hand-therapy bundle is included.

The problem

Wait for the finger to bend, and radiotherapy has missed its window.

The evidence for low-dose radiotherapy is strongest in early, proliferative-phase disease - nodule and early cord, before fixed contracture develops. Caught then, the staged 5 × 3 Gy protocol stabilises disease for years.

  • Told to “wait and see”?

    Wait-and-see is reasonable for very early nodules - but if disease is clearly progressing, radiotherapy is what changes the trajectory before contracture sets in.

  • Worried about the radiation?

    The total dose is very small and side effects are usually minimal. The long-term second-cancer risk is very small and discussed fully at consent.

  • Not sure if you are past the window?

    If your finger is already pulled down, radiotherapy is not the right step. A consultation confirms whether you are still in the treatable window.

When it helps

When radiotherapy for early Dupuytren’s or Ledderhose is the right next step.

Radiotherapy has a well-defined window. These are the situations where it stabilises disease and earns its keep.

  • Early proliferative-phase Dupuytren’s

    Nodule with no significant contracture - the window where radiotherapy earns its keep.

  • Palpable nodule

    A firm lump in the palm, often at the base of the ring or little finger.

  • Early palpable cord

    A thin cord forming under the skin, but the finger is not yet pulled down.

  • Ledderhose disease nodules

    Plantar fibromatosis - firm nodules on the sole of the foot, the same disease process as Dupuytren’s.

  • Progressive but not fixed-contracture disease

    Disease that is clearly changing - nodule growing, cord thickening - but the joints still move.

  • Prevention of progression

    Radiotherapy is used to stabilise disease and reduce the chance of progression to fixed contracture.

  • Aggressive fibromatosis diathesis

    Strong family history, early onset, bilateral disease or ectopic disease - the group most likely to progress.

  • Red flag: fixed contracture (>10–15°)

    Radiotherapy is less effective once contracture is established. Discuss surgical options - needle fasciotomy, collagenase or fasciectomy.

Course types

Not all radiotherapy courses are the same.

What each option on your treatment plan is actually for.

  • Standard 5-day German protocol (Seegenschmiedt)

    Five daily fractions of 3 Gy - 15 Gy total - delivered over one working week, then repeated after 6–8 weeks.

  • Repeat 6-week later (staged)

    The second five-day course is the essential part of the protocol. Long-term outcomes rely on the staged pair, not a single course.

  • Ledderhose radiotherapy

    Same 5 × 3 Gy schedule applied to plantar nodules - the sole of the foot is a small, well-defined field.

  • Combined hand + foot

    Where a patient has both Dupuytren’s and Ledderhose, both areas can be treated in parallel to one plan.

  • Post-radiotherapy hand therapy

    Splinting, stretches and scar management from a specialist hand therapist alongside the radiotherapy course.

  • Radiotherapy after surgery (specific cases)

    Occasionally used after needle fasciotomy or fasciectomy in aggressive disease - case-by-case, discussed with the surgeon.

  • Second-look review at 12 months

    Clinical review at one year to confirm stabilisation and pick up any progression that would need a different plan.

  • Consultation only

    A single opinion from a consultant clinical oncologist - useful if you want to know whether radiotherapy is still an option for you.

Safety and eligibility

Well tolerated, with a clearly defined window.

Radiotherapy for early Dupuytren’s is a very low-dose treatment, and side effects are usually minimal. What matters is the stage of disease - and pairing it with hand therapy.

  • Only for early disease

    Effective only in early proliferative-phase disease - nodule ± early cord, minimal contracture. Not a treatment for fixed contracture.

  • Not effective for fixed contracture

    Once the finger is pulled down, radiotherapy will not straighten it. Needle fasciotomy, collagenase or surgery are the right options.

  • Standard German protocol

    5 × 3 Gy, repeated after 6–8 weeks. This staged pair is what the evidence supports.

  • Very small dose, well tolerated

    The total dose is low and side effects are usually minimal. Most patients continue normal activity throughout.

  • Dry skin at the treatment site

    Short-term dryness or mild pinkness over the field is common. It settles with simple moisturiser in the weeks after treatment.

  • Long-term risk of second malignancy

    A very small long-term risk of a second cancer in the treated field. Discussed fully at consent so you can weigh it against expected benefit.

  • Not in pregnancy

    Radiotherapy is not given in pregnancy.

  • Not for children

    The protocol is for adults. Paediatric fibromatosis is managed differently and not by this pathway.

  • Combine with hand therapy + splinting

    The best outcomes come when radiotherapy is paired with a proper hand-therapy and splinting plan.

Reading your report

A radiotherapy report is short. Read the last part first.

Whichever area was treated, the report keeps to the same four parts.

A UK consultant clinical oncologist reviewing a treatment plan after a Dupuytren radiotherapy course

A quiet reminder

The first course is only the start - the second course, and the hand therapy, are what make it stick.

If you would like us to talk you through the plan before your second course, just ask.

  1. 01 Header

    Nodule / cord location and severity

    Which hand or foot, which ray or compartment, size of nodule, presence and length of cord, and any measured contracture.

  2. 02 Technique

    Protocol and treatment fields

    Dose per fraction, total dose, number of fractions, the treatment field marked on the palm or sole, and the machine used.

  3. 03 Findings

    Skin reaction and nodule response

    A brief note on any skin reaction over the field and the response of the nodule or cord to the first course.

  4. 04 Impression

    Expected stabilisation, second course, follow-up

    Read this first. The expected outcome - stabilisation of disease - the timing of the second course, and when to review.

Recognised by major UK insurers

BupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealix

Frequently asked

Everything we get asked about radiotherapy for early Dupuytren’s.

Quick answers on side effects, the protocol, second-course timing, cost and when to see a hand surgeon instead.

  • What does radiotherapy do for Dupuytren’s?

    Low-dose radiotherapy targets the active fibroblasts that drive early Dupuytren’s - the cells that make the nodule and the cord. The aim is to stabilise the disease so it does not progress to fixed contracture. It does not straighten a finger that is already bent.

  • How many sessions will I need?

    The standard German (Seegenschmiedt) protocol is two five-day courses: 5 × 3 Gy delivered on consecutive weekdays, then a 6–8 week rest, then the same course again. The staged pair is the treatment - a single course is not the same.

  • What are the side effects?

    The total dose is small and side effects are usually mild - short-term dry or pink skin over the treatment field, which settles with a simple moisturiser. There is a very small long-term risk of a second cancer in the treated field, which we discuss fully at consent.

  • How does it compare with surgery, collagenase or needle fasciotomy?

    Radiotherapy stabilises early disease before contracture sets in. Needle fasciotomy, collagenase and surgical fasciectomy are for correcting established contracture. They are complementary - not competing - and we route you to the right one for your stage of disease.

  • What is the evidence base?

    The strongest long-term evidence comes from the Seegenschmiedt group in Germany, showing sustained stabilisation of early Dupuytren’s at 5–10 years after the staged 5 × 3 Gy protocol. The approach is endorsed by the Royal College of Radiologists and ESTRO.

  • Can it be used for Ledderhose disease?

    Yes. Ledderhose (plantar fibromatosis) is the same disease process on the sole of the foot, and responds to the same 5 × 3 Gy staged protocol. Combined hand + foot programmes are common when a patient has both.

  • Can I have hand therapy alongside?

    Yes, and we strongly recommend it. Splinting, stretching and scar management from a specialist hand therapist improves long-term function and helps preserve movement - this is included in our post-radiotherapy bundle.

  • When is the second course given?

    Six to eight weeks after the first. This gap is deliberate - it gives the tissue time to respond and lets the radiobiological effect build. Long-term outcomes depend on completing the second course.

  • How much does it cost privately in London?

    A single five-day course is typically £3,500–£6,500 for Dupuytren’s and £3,500–£7,000 for Ledderhose. A combined hand + foot programme runs £7,000–£13,000. A consultation-only opinion is £250–£500.

  • When should I see a hand surgeon urgently instead?

    If your finger is already pulled down and you cannot lay your hand flat on a table, the disease is past the radiotherapy window - you need a hand surgeon for needle fasciotomy, collagenase or fasciectomy. Rapidly worsening contracture with pain also needs urgent surgical review.

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