Among the three most common types of prostate cancer treatment, external beam radiation therapy is the most toxic and costly, according to a Cleveland Clinic researcher.
Dr. Jay Ciezki and colleagues analyzed the Medicare records of more than 137,000 men who received one of three prostate cancer treatments — external beam radiation therapy; prostatectomy, or removal of the prostate; and brachytherapy, a procedure that involves implanting radioactive seeds in the body.
The three treatments are equally effective in treating patients diagnosed with low- and intermediate-risk disease, “so it comes down to quality of life and cost,” Ciezki told WebMD. According to the researchers’ analysis, that means that brachytherapy is the best option, Ciezki said.
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Toxicity rates were nearly 8.8 percent for patients receiving external beam therapy treatment, 6.9 percent for prostatectomy and 3.7 percent for brachytherapy.
In terms of cost, external beam therapy was the most expensive of the three treatment options, at $6,412 annually. Average cost per patient per year was $3,205 for prostatectomy and $2,557 for brachytherapy, according to the study.
Ciezki told The Plain Dealer that some high-risk patients can benefit from external beam therapy. But for the 80 percent of patients diagnosed with low- and intermediate-risk prostate cancer, the other two methods may be more preferable options than previously thought by doctors.
One type of radiation therapy called proton therapy has come under increasing scrutiny as critics question whether it’s worth the expense. Former White House adviser and oncologist Ezekial Emanuel coauthored a New York Times editorial last month that decried the rush to build proton centers as a quintessential example of what’s wrong with American healthcare.
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Like more conventional cancer treatment methods, proton therapy uses radiation. The difference is that protons do the bulk of their work beneath the skin where a tumor is located, unlike X-rays, which tend to lose power and cause collateral damage as they penetrate the body’s tissues. In theory, that means proton therapy allows for the more precise targeting of tumors and a reduction in collateral damage.
It’s worth noting that Cleveland Clinic’s top local rival, University Hospitals Case Medical Center, last year announced plans to construct a $30 million proton beam center.