Researchers from the University of Michigan Comprehensive Cancer Center in Ann Arbor presented evidence at the Breast Cancer Symposium in San Francisco last week that the number of treatments, and their costs, vary widely from one radiation oncology delivery method to the next.
The investigators used regional Medicare reimbursement codes to examine compensation associated with seven different radiation treatment scenarios for cancer that has spread to the bone. This included the number of treatments given, the setting of either freestanding center or hospital-based center and the use of one of three different radiation technologies: Accuray’s CyberKnife, stereotactic radiosurgery and conventional radiation.
According to the authors, costs can range from around $1,700 for a single treatment with conventional radiation techniques to more than $16,000 for four treatments using the CyberKnife.
"Some of the technologies that have been shown to be safe and effective, but have not been shown to be superior, can cost up to 10 times what a single dose of conventionally delivered radiation costs," said David D. Howell, MD, assistant professor of radiation oncology at the University of Michigan Medical School and medical director of radiation oncology at the Norval K. Morey Cancer Center in Mt. Pleasant, Mich.
Research has shown a single treatment with standard radiation can be equally effective as 10 treatments of standard radiation when it comes to relieving pain associated with cancer that has spread to the bone. Fewer treatments also spare patients and their caregivers from more trips to the radiation oncology department.
However, Howell reported that some doctors believe that delivering radiation using more recently developed technologies, such as stereotactic radiosurgery or the Cyberknife, will yield better pain control or fewer side effects for certain patients. Studies to date have not unequivocally confirmed these views, and research is ongoing.
Most radiation oncologists will consider a variety of factors in choosing a treatment strategy, such as the location and type of cancer, how well it may respond to radiation, as well as the patient's previous and current cancer treatment.
"In considering the big picture of patient care and treatments for cancer, safety, efficacy, side effects, the patient's time commitment and comfort all should enter into the mix. Cost is another parameter that should be considered," Howell said.