Thursday, 11 July 2013

Interview with Aaron Wolfson, Radiotherapy specialist in Florida

Today I have an interview with Dr Aaron Wolfson from Florida. He uses radiotherapy to treat Dupuytren's and recently Ledderhose. I came across him when a patient I am in contact with was looking for a doctor in Florida and another patient I am in contact with is the patient they mention below. He seems happy with the way that he has been treated and said that the doctor I have interview here follows Dr Shaffer, that can only be a good thing. 

Aaron H. Wolfson, MD, FACR
Department of Radiation Oncology
University of Miami Miller School of Medicine
1475 NW 12th Avenue, D-31
Miami, FL 33136
Phone: (305) 243-4210
Fax: (305) 243-4363
To see this address On a map 

1) How long having you been treating Dupuytren's and Ledderhose disease and where are you based?

    I have been interested in treating patients with benign fibroblastic diseases (such as desmoids tumors, meningiomas, heterotopic bone, keloids etc) for over 20 years. I have only become interested in treating patients with Dupuytren’s and Ledderhose disease for the past three years. So far I have done four consults and one patient has accepted treatment (currently on a break).

2) Roughly how many Dupuytren's patients have you treated and how many Ledderhose patients have you treated? 

    See above. The patient has Ledderhose disease.

3) How common do you think Dupuytren's and Ledderhose are in the USA? They are supposedly more common in males then females and have been linked to smoking, alcohol consumption and diabetes are these risk factors you see in your patients? 
I actually don’t know the answer to this question. I get about three to four calls a year from all over the U.S. for the past three years. You are correct about the risk factors and most I have encountered have more than one usually.

4) Roughly what percentage of the patients you have treated have had a family history of these diseases? 

    The patient I am currently treating has a family member with this disease.

5) You treat with radiotherapy, what protocol do you use (dose, no of doses and gap between the 2 weeks of treatment etc.) and what is the success rate on these diseases with radiotherapy? 
     I use the regimen proposed by Dr. M.H. Seegenschmiedt of Essen, Germany in  which the patient receives once electron beam treatment to the region a day for 5 work days followed by an 8 to 10 week break at which time the patient receives an additional 5 daily treatments (3 Gy per fraction x 10 fractions in total = 30 Gy).

6) Why is radiotherapy a better course of action than other treatments such as surgery? 
    The data from dr. Seegenschmiedt show only about a 10% progression rate with radiation therapy with up to about 50% progression rate with surgery.

7) What are your thoughts on other treatments that are becoming available such as Xiapex? 

    I do not have any experience with Xiapex but I am sure more medications will become available.

8) Finally do you have any advice or other information that you would like to share with Dupuytren's / Ledderhose patients?

  My main advice is to have early detection of the disease in which it is in the nodule stage. It is very difficult to treat the disease in the cord stage.