Costlier Prostate Cancer Treatments Gain Popularity

Newer technologies for treating prostate cancer have surged in popularity in the last decade -- and they have come with a hefty price tag, according to a report published this week.

Researchers estimate that the increased use of certain prostate cancer treatments, such as less invasive surgery and advanced radiation therapy, tacked on an additional $350 million in healthcare spending in one year alone.

The big question remains: is it worth the cost?

"There really isn't data on whether this saves more lives," Dr. Paul Nguyen, the lead author of the study, told Reuters Health.

Instead, he and his colleagues compared the type and cost of prostate cancer treatments from 2002 to 2005.

They gathered data from 45,000 men who had Medicare, the U.S. federal health insurance program for people over age 65.

Of those men who had surgery in 2002 to treat their cancer, roughly one out of 100 received minimally invasive surgery, in which the surgeon makes several small openings to get to the prostate instead of one long incision. In 2005, that number jumped to 28 out of 100 men.

"There was a very rapid uptake of these treatments," Nguyen, at the Dana-Farber Cancer Institute and Brigham and Women's Hospital, said.

A minimally invasive surgery for prostate cancer costs a few hundred dollars more than a conventional surgery, the researchers found.

For radiation treatments, the shift to more advanced -- and costlier -- approaches was more dramatic.

In 2002, 28 out of 100 men received "intensity modulated" radiation therapy, which is a newer type of radiation treatment that is thought to be more precise than conventional radiation techniques.

Three years later, 81 out of 100 men were treated with the more advanced radiation therapy.

The researchers estimated that each treatment with the advanced radiation therapy cost about $11,000 more than another popular technique, called "3-D conformal" radiation therapy.

Nguyen said the numbers don't tell the whole story; for one, they may be an underestimate because the study didn't include the upfront costs of installing new machines and training staff to use them.

On the other hand, the numbers may be overestimate. If the newer techniques reduce hospital stays or prevent damage to other tissues, they could save money in the long run, Nguyen said.

For instance, the advanced radiation technique has been found to be less damaging to rectal tissue.

Dr. Andre Konski, the head of Radiation Oncology at Wayne State University School of Medicine and the Barbara Ann Karmanos Cancer Center, told Reuters Health that it's imperative to find out whether the pricier treatments are worth it.

"We don't have unlimited dollars or resources to pay for expensive treatments that may have a marginal benefit," Konski said. "If the outcomes were improved, the costs were worth it."

The $350 million increase Nguyen found is an estimation of all men diagnosed with prostate cancer in 2005, not just men with Medicare insurance.

The National Institutes of Health estimates that prostate cancer treatments cost about $12 billion each year. According to the Centers for Disease Control and Prevention, more than 200,000 men are diagnosed with prostate cancer each year and nearly 30,000 die.

Nguyen's study was funded by the Department of Defense and Harvard Medical School.

Konski wrote an editorial about the study in the Journal of Clinical Oncology, where the research was published. He said that technology is being adopted in hospitals and doctors' offices faster than researchers can track whether the advantages balance the additional costs.

"It's a new paradigm that we have nowadays," Konski said, "and we have to look at cost, unfortunately."