Where To Learn More About Managing The Costs Of Your Cancer Treatment
American Society of Clinical Oncology Web site: www.cancer.net
Has a special section for patients on the costs of cancer care, including a booklet on managing the cost of cancer care in English and Spanish.
Patient Access Network Foundation Toll-free number: 1-866-316-7263
Helps under-insured patients with certain cancer diagnoses cover out-of-pocket costs related to cancer care.
Patient Advocate Foundation Website: www.patientadvocate.org
Works with the patient and their insurer to resolve insurance problems also provides direct financial support to insured patients who are financially and medically qualified for drug treatments and/or prescription co-pays, co-insurance, and deductibles related to certain cancer diagnoses.
*Inclusion on this list does not imply endorsement by the American Cancer Society.
Our specialists are also available to answer your questions. You can reach them by calling 1-800-227-2345.
Neoadjuvant And Adjuvant Hormone Therapy For Early
Hormone therapy is sometimes given in conjunction with a definitive prostate cancer treatment, such as radiation therapy, in order to improve health outcomes. When hormone therapy is given in advance of a primary treatment, its known as neoadjuvant therapy when its given during or after a primary treatment, its known as adjuvant therapy.
What Are Medicare Contributions And Out Of Pocket Costs For Radiation Therapy
Medicare reimburses 70-80% of the cost of the treatment at private radiation therapy centres.
For most patients, an out of pocket cost , is the amount paid after the Medicare reimbursement is paid to you. For example, if Medicare covered 70% of treatment costs the breakdown may be as follows:
Direct cost of treatment $ 1,000
Less Medicare reimbursement $ 700
Out of pocket cost $ 300
This example does not represent actual treatment costs.
The reimbursement is usually paid within 1-2 days into your bank account that is registered with Medicare.
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Is There A Role For Focal Ablation Of Prostate Cancer
One of the unique characteristics of prostate cancer is the spectrum of the disease as it relates to disease aggressiveness, age range of those affected, and treatment priorities. The age range in a large personal series of approximately 5000 RP performed by one of the authors of this review is 36 to 81 years. The risk and extent of disease ranges from men with a single biopsy core with 1-mm GGG 1 cancer to all biopsies showing GGG 4 and 5 disease. The priority of some men is to cure the disease whereas others are motivated to preserve quality of life. It is reasonable to propose that the optimal management of prostate cancer should include AS, whole-gland treatment, and an alternative offering potential for oncological control with preservation of quality of life. We believe this option is FA of prostate cancer.
Employment Legal And Financial Issues
These costs may arise if you needs professional guidance on employment, legal, or financial issues related to your prostate cancer diagnosis. This may involve addressing loss of wages, learning about employment rights under the law, figuring out medical expenses during income tax filing, or writing a will.
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Other Factors Affecting Prostate Cancer Treatment Cost
Apart from the type of surgery or treatment and the choice of technology, the following are some of the factors that affect the overall prostate cancer treatment cost:
Type of Hospital
There are several hospitals around the world that provide world-class medical treatment to patients. The greater the number and quality of services offered by the hospital, the expensive is the treatment at the hospital.
Therefore, the total cost of prostate cancer treatment that you have to pay actually depends on the level of services that you expect from the hospital. To be able to receive five-star services from the hospital, you must be willing to pay lavishly for it.
Experience of the Surgeon
Expertise and skills of the treating doctor matter a lot when it comes to successful treatment of any cancer type. It takes a lot of patience, courage, and knowledge to treat a cancer patient and this is the reason why the most experienced surgeons tend to charge a greater fee for their services.
However, that does not mean that all the experienced and qualified surgeons charge fees that an average patient cannot afford. There are many highly educated and skilled doctors for prostate cancer treatment that offer their services with an equal compassion at a reasonable rate. Therefore, one must try to find a credible doctor with required credential who charges a fee that a patient can afford.
Length of Stay at the Hospital
Cost of Accommodation, Food, and Local Travel
|Cost per Day|
The Average Cost Of Prostate Cancer Treatment: Top Countries
Like any other cancer, prostate cancer treatment is delivered with the help of different modalities. Thus, the total treatment package cost differs from one patient to the other. The selection of treatment modalities that are best expected to work in the case of patients further depends on certain factors, including the following:
- Age of the patient
There are several other types of prostate cancer surgeries apart from prostatectomy and TURP. Two of the other types of surgeries include CyberKnife treatment , high intensity focused ultrasound , cryosurgery, and orchiectomy. However, these two forms of surgeries are less common and largely depend on the preference of the surgeon and the condition of the patient.
The exact prostate cancer surgery cost depends on several factors. The following are some of the factors that dictate the overall prostate cancer surgery cost:
- The type of incision and its location
- The type of technology used
- Type of procedure
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Radiation Therapy For Prostate Cancer
Radiation therapy uses high-energy rays or particles to kill cancer cells. Depending on the stage of the prostate cancer and other factors, radiation therapy might be used:
- As the first treatment for cancer that is still just in the prostate gland and is low grade. Cure rates for men with these types of cancers are about the same as those for men treated with radical prostatectomy.
- As part of the first treatment for cancers that have grown outside the prostate gland and into nearby tissues.
- If the cancer is not removed completely or comes back in the area of the prostate after surgery.
- If the cancer is advanced, to help keep the cancer under control for as long as possible and to help prevent or relieve symptoms.
Gathering Information To Inform Your Decisions
Although Dunn said cost shouldnt be a factor in determining the best course of treatment and what medications to take to treat the cancer, it does often play a role in a persons decisions.
According to Dunn, this may lead people to skip their treatment altogether or opt for a suboptimal treatment regimen that they feel they can afford. Dunn explains that HealthWell Foundations mission is to make sure that patients dont have to choose between their medication and paying for food or for rent or for anything else vital.
You will need to consider several pieces of information when making treatment decisions, including:
- what stage your cancer is in
- your age and life expectancy
- other health conditions you have
- your doctors opinion about the urgency of treatment
- odds that treatment will help or cure you
- potential side effects of treatment
With major medical decisions, its a good idea to get a second opinion from another doctor.
When youre deciding on a cancer treatment plan, the healthcare facility should be able to provide support for that decision.
Many treatment facilities provide financial counselors, patient navigators, or social workers who will discuss treatment costs with the patients based on their specific insurance plans. They will also try to find financial assistance for patients through organizations such as ours, McCourt said.
However, McCourt added that the demand for assistance is greater than the amount of available funding.
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Ucla Researchers Find A Wide Variation In Costs To Treat Low
How much does it actually cost to treat low-risk prostate cancer?
Now, for the first time, UCLA researchers have described cost across an entire care process for low-risk prostate cancer from the time a patient checks in for his first appointment to his post-treatment follow-up testing – using time-driven activity-based costing. And they found a wide variation in costs for the various available treatments that remained consistent over a 12-year period, indicating a better method to monitor costs could save valuable healthcare dollars, said study first author Dr. Aaron Laviana, a fifth year urology resident. This is the first study to truly investigate the costs of various treatments for prostate cancer over the long-term. As we move from traditional fee-for-service reimbursement models to accountable care organizations and bundled payments to curb growing health care expenditures, understanding the true costs of health care is essential, Laviana said. Traditional costing methods often lack transparency and can be arbitrary, preventing the true costs of a disease or treatment from being understood. This is important, as patients often receive a hospital bill with arbitrary charges that may or may not reflect their true treatment costs. This costing methodology creates an algorithm that allows organizations to assess their costs and see where they may be able to improve. Altogether, by maintaining similar quality, this will improve the overall value of care delivered.
Possible Risks And Side Effects Of Brachytherapy
Radiation precautions: If you get permanent brachytherapy, the seeds will give off small amounts of radiation for several weeks or months. Even though the radiation doesnt travel far, your doctor may advise you to stay away from pregnant women and small children during this time. If you plan on traveling, you might want to get a doctors note regarding your treatment, as low levels of radiation can sometimes be picked up by detection systems at airports.
There’s also a small risk that some of the seeds might move . You may be asked to strain your urine for the first week or so to catch any seeds that might come out. You may be asked to take other precautions as well, such as wearing a condom during sex. Be sure to follow any instructions your doctor gives you. There have also been reports of the seeds moving through the bloodstream to other parts of the body, such as the lungs. As far as doctors can tell, this is uncommon and doesnt seem to cause any ill effects.
These precautions arent needed after HDR brachytherapy, because the radiation doesnt stay in the body after treatment.
Bowel problems: Brachytherapy can sometimes irritate the rectum and cause a condition called radiation proctitis. Bowel problems such as rectal pain, burning, and/or diarrhea can occur, but serious long-term problems are uncommon.
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Original Medicare Covers Chemotherapy And Cancer Treatments
Medicare Part A and Part B make up Original Medicare, which covers some hospital and medical care needs.
Medicare Part B covers doctor visits, surgeries and outpatient hospital services, including chemotherapy. Medicare Part A provides coverage for inpatient hospital care.
How Medicare pays for chemotherapy depends on where you receive your treatment:
- Hospital outpatientYou will typically pay a Medicare Part B copayment for chemotherapy received in a hospital outpatient setting. Your copay will typically be a set dollar amount, rather than a percentage of costs.
- Doctors office or freestanding clinicAfter meeting your Part B deductible , youre typically responsible for paying 20% of the Medicare-approved amount for the treatment.
Original Medicare can also provide coverage for the following cancer treatment and screening services:
- Prostate cancer screenings
Appealing Medicares Decisions Regarding Cancer Coverage
You have the right to file an appeal in the event that Medicare does not reimburse a healthcare provider or service for something that you feel should be covered. That goes for whether youve already received the service or item, or if you believe that you should be eligible to receive it.
There are five levels to the appeals process that give you the opportunity to take your appeal all of the way to a judicial review by a federal district judge if you disagree with the decision made at any stage.
The exact process you will follow to go through this process depends on which type of Medicare plan you have. Also, if you need help with filing your appeal, you can either appoint a representative to help you or contact your State Health Insurance Assistance Program.
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Talk To Your Cancer Care Team
Your team is an important source of advice. Some men may benefit from having a low-risk tumor treated right away, even if they might have side effects. Discuss your treatment options and quality-of-life issues with your team.
This report is for you to use when talking with your health-care provider. It is not a substitute for medical advice and treatment. Use of this report is at your own risk.
Surgery For Prostate Cancer Treatment
Surgery is considered a first-line treatment for prostate cancer. Surgical removal of the prostate gland is recommended for patients with localized prostate cancer that does not have metastases. For more aggressive prostate cancer, surgery alone might not be enough.
There is an option of performing radical prostatectomy with a da Vinci robot. A tenfold imaging, highly detailed operating area, and microinstruments moving in any direction allow preserving the surrounding healthy tissues, avoiding blood loss, and minimizing the risks of urological problems or erectile dysfunction development.
Generally, surgery is aimed at preserving the erection nerves, and if possible, at preventing postoperative erectile dysfunction. Today, various surgical techniques are low-traumatic and allow sparing of the nerves responsible for erection.
Radiation Therapy And Private Health Insurance
Radiation therapy is usually an outpatient treatment and as such is not covered by private health insurance, regardless of the level of coverage.
Some private health insurance products will cover radiation therapy if you are being treated as an inpatient. You should speak to your health insurance provider to clarify coverage.
How Much Does Prostate Cancer Surgery Typically Cost
Prostate cancer surgery and care costs vary widely. Your costs can be influenced by:
Your insurance status
Your insurance coverage
Commonly, prostate cancer surgery involves a prostatectomy, which is a procedure to remove the prostate. A radical prostatectomy removes the gland and surrounding tissue.
Charges for a radical prostatectomy include:
Hospital fees, which comprise the majority of costs
Surgeon and anesthesiologist fees
According to a 2021 publication in the National Institute of Healths PubMed Central, the average list prices for a radical prostatectomy include:
An average $34,720 for hospital fees, with a range from $10,000 to $135,000.
An average $8,000 for physician fees, with a range from $4,028 to $18,720.
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Often Prostate Cancer Is Low
Many prostate cancers are found with a PSA blood test. Often these cancers are low-risk. This means:
- The tumor is small.
- It is contained within the prostate.
- It is probably growing so slowly that it will not become life-threatening.
Usually a man with low-risk prostate cancer dies of something else, even if he doesnt get treatment.
How Radiation Is Used With Other Cancer Treatments
For some people, radiation may be the only treatment you need. But, most often, you will have radiation therapy with other cancer treatments, such as surgery, chemotherapy, and immunotherapy. Radiation therapy may be given before, during, or after these other treatments to improve the chances that treatment will work. The timing of when radiation therapy is given depends on the type of cancer being treated and whether the goal of radiation therapy is to treat the cancer or ease symptoms.
When radiation is combined with surgery, it can be given:
- Before surgery, to shrink the size of the cancer so it can be removed by surgery and be less likely to return.
- During surgery, so that it goes straight to the cancer without passing through the skin. Radiation therapy used this way is called intraoperative radiation. With this technique, doctors can more easily protect nearby normal tissues from radiation.
- After surgery to kill any cancer cells that remain.
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Economic Analysis Of Various Radiotherapy Treatment Delivery Methods
Treatment techniques have evolved over the course of many years as a result of the technologic advancement. Improvements in treatment planning software as well as linear accelerators have allowed treatment techniques to transition from 2-dimensional treatment plans and techniques to 3-dimenesional treatment plans and then to IMRT. The increased work necessary for physicians, dosimetrists, and physicists needed to design and perform quality assurance resulted in increased reimbursement, both on the professional and technical sides. The development and implementation of IMRT was made possible by the further improvements in treatment planning software and linear accelerators, with the advent of multi-leaf collimators. IMRT treatment techniques, as reported elsewhere in this issue, made it possible to escalate the delivered radiotherapy dose while reducing both acute and late toxicity. The increased in delivered radiotherapy dose resulted in higher biochemical disease-free survival . IMRT was rapidly adopted as the standard of care in the treatment of prostate cancer because of these results without randomized clinical trials comparing IMRT to 3D conformal radiotherapy . Reimbursements for IMRT, however, were considerable higher when compared to 3DCRT dramatically increasing the overall cost of care for prostate cancer. Economic analyses using decision models were performed to provide evidence of cost-effectiveness of IMRT compared to 3DCRT.