Surgery ranks as the most cost-effective type of treatment for prostate cancer, according to a comprehensive new analysis of several hundred studies of various therapies’ costs and benefits.
The analysis, published in the British Journal of Urology International, compared how the major types of prostate cancer treatments stack up to one another in terms of saving lives and cost effectiveness.
University of California-San Francisco researchers analyzed 232 reports published in the last decade on clinical studies of patients with low-, intermediate-, and high-risk forms of prostate cancer who were treated with surgery, radiation therapy, hormones, and brachytherapy.
The results showed that for men with low-risk prostate cancer, the various forms of treatment vary only slightly in terms of survival — nearly 100 percent of patients surviving at least five years regardless of which therapy they received. But the cost of radiation is significantly more expensive than surgery for low-risk prostate cancer, they found.
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The findings also indicated that for intermediate- and high-risk cancer patients, surgery was the better option, when it comes to both survival and costs. But the analysis showed a combination of external-beam radiation and brachytherapy — in which radioactive “seeds” or other sources are placed in or near the tumor in the body — was comparable in terms of survival for high-risk prostate cancer.
"Our findings support a greater role for surgery for high-risk disease than we have generally seen it used in most practice settings," said urologist Matthew Cooperberg, M.D., a UCSF professor of urology who led the research.
Localized prostate cancer — involving tumors that have not spread to other parts of the body — accounts for about 81 percent of the quarter-million cases diagnosed in the United States every year, according to the National Cancer Institute.
It is typically treated with surgery (open, laparoscopic, or robot-assisted); radiation; hormone therapies; and combinations of each of these. Many men with low-risk prostate cancer may not need any of these treatments, and can be safely observed, at least initially.
Treatment can vary dramatically from one treatment center to another.
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The new study was the most comprehensive cost analysis ever and found treatment can range from $19,901 for robot-assisted prostatectomy to treat low-risk disease to $50,276 for combined radiation therapy for high-risk disease.
The study was funded, in part, by the National Cancer Institute of the National Institutes of Health.