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Association between the US Medicare program and localized prostate cancer among elderly men

On September 13th, on JAMA Oncology, the Surveillance, Epidemiology, and End Results (SEER)—Medicare study analyzed the costs to the US Medicare program from the diagnosis and treatment of localized prostate cancer among elderly men.

Prostate cancer is the most common malignancy among elderly men. Due to increasing life expectancy and the introduction of prostate-specific antigen (PSA) screening, a rising number of elderly men are diagnosed with prostate cancer. Each year, the diagnosis of prostate cancer in men ages 70 and older led to Medicare costs in excess of $1.2 billion over the ensuing 3 years… and some people are wondering: are older prostate cancer patients overtreated?

The main objective of this study was to quantify the costs to the Medicare program associated with the detection and treatment of prostate cancer among elderly men in the United States. National Medicare costs were estimated using per-person costs, stage-adjusted prostate cancer incidence rates by age from SEER 2007 through 2011, and 2010 Census population estimates by age.

The investigations included 49 692 men aged 70 years or older, diagnosed with localized prostate cancer between 2004 and 2007. The median per-patient cost related to diagnosis and workup, treatment, follow-up, and morbidity management was $14 453 within 3 years after diagnosis; for those with a Gleason score of 6 or lower, who received no active treatment within 1 year of diagnosis, the median cost was $1914.

The majority of the costs are related to treatment. Reducing the provision of low-value health care services among this patient population represents a potential source of significant cost savings for the U.S. Medicare program. Age, clinical-stage, PSA level, histological grade, and comorbidities should be carefully balanced before making a treatment decision, especially in elderly men suffering from prostate cancer.

Ronald Chen, MD, MPH, of the University of North Carolina at Chapel Hill, and colleagues reported: “Elderly patients, especially those with comorbidities, are unlikely to die of prostate cancer or benefit from screening”.

A study by the Defense Center for Prostate Disease Research indicated that the percentage of men older than 65 years diagnosed with prostate cancer decreased from 53% in 1990 to 27.8% in 1996 and remained stable thereafter. Besides PSA and Gleason score, age is considered a key prognostic factor in treatment decision making.

More and more prostate cancers are also diagnosed in younger men who want a treatment that does not compromise their quality of life, take time away from work, or cause worrisome side effects. Robotic prostate surgery is a promising new treatment option for men diagnosed with prostate cancer. This surgery is the only prostate cancer treatment that definitely removes the cancerous prostate and gives men the lifelong assurance of a nearly undetectable PSA level.

Many patients are able to return to work and regular activity in just 2-3 weeks after Dr. Samadi’s SMART prostate cancer treatment. Within 4-6 weeks, the majority of patients feel comfortable resuming most activities.

Dr. David B. Samadi helps men of all ages achieve complete recovery from prostate cancer while preserving the highest possible quality of life after surgery. Widely regarded for excellence in robotic surgery innovation, clinical care, and research, Dr. Samadi has performed more than 7,000+ successful robotic prostate surgeries, using his own Samadi Modified Advanced Robotic Technique (SMART) surgery.

Here, you can read one of David Samadi’s patient testimonials, Larry P., a 64-year-old patient who underwent robotic prostate surgery. He goes into every detail about his prostate cancer journey.

Do you have any questions about prostate cancer? Please feel free to contact us NOW! Thank you!

Dr. David Samadi | Robotic Prostate Surgeon

About is a resource created by Dr. David Samadi in order to raise awareness and get more men to receive prostate cancer treatment. The information is strictly general and you should always discuss with your doctor issues concerning your health.


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