Cost Of Hormone Therapy For Breast Cancer

Costs Of Breast Cancer Endocrine Agents

The drug-specific costs of the adjuvant endocrine agents most commonly used for early stage breast cancer are presented for 2007, 2010, and 2011 .2). Four drugs are of interest, specifically, the three FDA-approved AI agents and tamoxifen. Only tamoxifen was available in generic formulation on the CMS website during 200710, but generic agents were available for each of the AI agents during 2011. All states had one or more plans providing coverage for each of these medications typically, all plans in a state provided coverage for each medication.

Surgery To Stop The Ovaries From Working

This is also a type of ovarian ablation. You might choose to have an operation to remove your ovaries instead of having drug treatment to stop them working. You have this operation as keyhole surgery. It is called laparoscopic oophorectomy and you have it under general anaesthetic . You usually stay in hospital overnight.

The surgeon makes a number of small cuts into your tummy . They put a long bendy tube called a laparoscope into one of the cuts. The laparoscope connects to a video screen.

The surgeon puts small instruments through the other cuts to carry out the operation and remove the ovaries. They close the cuts with stitches and cover them with small dressings.

Removing your ovaries causes you to have a sudden menopause. The symptoms include hot flushes, sweating and mood swings.

Ovarian Ablation Or Suppression

For women who havent gone through menopause, ovarian ablation may be an option. This can be done medically or surgically. Either method stops estrogen production, which can help inhibit the growth of cancer.

Surgical ablation is done by removing the ovaries. Without production of estrogen from the ovaries, you will enter permanent menopause.

Symptoms of menopause may include:

• hot flashes
• vaginal dryness
• changes in sex drive

Serious complications after surgical ablation are rare, but you may be more prone to complications if you have diabetes or obesity, or smoke cigarettes.

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Breast Cancer: Will Treatment Costs Outpace Effectiveness

Stanton R. MehrEvidence-Based Oncology

Breast cancer was one of the first disorders to profit from the successful application of targeted therapy, and its treatment has changed dramatically from 20 years ago. Despite these advances, breast cancer is responsible for 14% of cancer deaths among women, second only to lung cancer.1

Table 1

The death rate has decreased since 1990 however, it is projected that about 40,000 will die in 2012 due to the disease ,1 with the most deaths occurring among African Americans, followed by Caucasians .2 The overall 5-year survival for 2002 to 2008 was 89%, with the longest survival rate in patients having localized disease and a much lower survival for those with metastasized disease .2

An estimated 227,000 new cases will be diagnosed in 2012, and it is the most frequently diagnosed cancer in women. The incidence of breast cancer had declined by the year 2000 and has since remained stabilized.1 The highest incidence is seen in Caucasians, followed by African Americans.2 Breast cancer remains a cancer that is most often diagnosed in older women about onefourth of the cases will be diagnosed in women between the ages of 55 and 64 years, followed closely by women between the ages of 65 and 74 years.2

Factors responsible for the reduction in deaths are reduced utilization of hormone replacement therapy for menopausal women, earlier tumor detection, and improved therapies.1

High Incidence Results in Significant Economic Burden

Table 2

What Is The Cost Of Breast Cancer Treatment By Stage In India

Your oncologist will come up with a plan, which is best suited for your stage of cancer. So it is important that you must also know the overall cost of breast cancer treatment by stage in India.

A. Cost of Stage 0 Breast cancer treatment

As we have covered all the aspects of treatment, lets shift our attention to what role a hospital plays in breast cancer treatment.

We have listed the detailed cost comparison between a private hospital and a government hospital.

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What Is The Cost Of Various Breast Cancer Surgeries In India

Surgery is the primary treatment needed for breast cancer. In almost all cases of early-stage breast cancer, surgery is done. Depending upon the stage of the patients breast cancer, the method of surgery will differ. The breast removal surgery cost in India varies depending on several factors, but on average, it costs $4000. The cost of tumor removal surgery in India starts from 1,56,300 and goes up to 2,13,800. The cost of surgery is determined by various other factors, including the choice of hospital, location of the treatment etc. For example, mastectomy costs in India are roughly $3000. But in the UK and USA, it ranges approximately from $8000 to $13000.

To make it convenient for you, we have listed the breast cancer surgery cost in India –

Now that we have covered all the treatment options in detail, lets bring our attention to stage-wise breast cancer treatment as the stage with which you are being diagnosed with determines the treatment plan and hence the cost of that treatment.

Unanswered Questions And Future Research

In our study protocol we did not prespecify analyses relating to cancer stage or tumour type because these lay outside the main question of interest. Although information on risk related to individual progestogens could be improved, previous studies have shown that the associated risks between HRT and tumour types might differ, with higher risks of developing oestrogen receptor positive tumours and lobular tumours.11 Knowing the cancer stage could also address the question of risk differences between women of various body weights, to clarify whether systematic differences might exist in diagnostic delay. Other unknowns include questions about breast cancer survival rates and all cause mortality in women using HRT.13

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What Are The Pre And Post

A. Pre-Breast cancer treatment:

The oncologist will prescribe certain tests for you to undergo, the results will determine what treatment is best suited to your condition. But even these tests will make an impact on your overall treatment bill.

Mammogram: It is an x-ray image of your breast. It can be used to check for a lump or any other indication of breast cancer. It can be also done to examine breast cancer in women who have no signs or symptoms of the condition.Cost: 1,000 2,000

Breast Ultrasound: It can be used to check for a lump or any other indication of breast cancer. It can be also done to examine for breast It’s usually done as a follow-up examination following an irregular finding on a mammogram In Ultrasound imaging of the breast, sound waves are used to create pictures of the internal structures of the breastCost:Around 1500

Biopsy report: It is a test that extracts tissue from the breast. After that, the extracted cells are observed beneath a microscope and are further examined to confirm the diagnosis of breast cancer.Cost:Around 13000

B. Post-Treatment cost:

There may be some follow-ups recommended by the hospital after your treatment. These procedures put the extra cost onto your bill, and hence, considering all of this is very important because it directly affects the overall breast cancer treatment cost in India.

It Will Also Be Important In The Future To Differentiate Prior To Treatment Patients Who Are At High Risk Of Relapse From Those At Lower Risk In Order To Tailor Hormone Treatment This May Be Done To Avoid Escalation Of Anti

The CANTO cohort comprises 12,000 women with breast cancer treated in 26 French centres. It is sponsored by Unicancer and directed by Professor Fabrice André, specialist breast cancer oncologist at Gustave Roussy, Inserm research director and responsible of the lab Predictive Biomarkers and Novel Therapeutic Strategies in Oncology . Its objective is to describe adverse effects associated with treatment, to identify the populations at risk of developing them and to adjust therapy accordingly, so as to afford a better quality of life following cancer.

Watch the video on YouTube :

J Clin Oncol. 2019 Feb 10 37:423-438 : https://doi.org/10.1200/JCO.18.01160

TO CITE THIS POST :

1INSERM Unit 981, Gustave Roussy, Cancer Campus, Villejuif, France

2Breast Unit, Champalimaud Clinical Center, Champalimaud Foundation, Lisbon, Portugal

3Medical Oncology, Gustave Roussy, Cancer Campus, Villejuif

4Department of Supportive Care, Gustave Roussy, Cancer Campus, Villejuif

5Medical Oncology, Centre François Baclesse Caen, Caen

6Unicancer, Paris, France

7Department of Medical Oncology, U.O.C. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genova

8Department of Internal Medicine and Medical Specialties , School of Medicine, University of Genova, Genova, Italy

9Surgical Oncology, Centre Georges-François Leclerc, Dijon

10Medical Oncology, Institut Curie, Paris

14Surgical Oncology, C.R.L.C Val dAurelle, Montpellier

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How Much Hormone Therapy Costs

The cost of hormone therapy depends on:

• the types of hormone therapy you receive
• how long and how often you receive hormone therapy
• the part of the country where you live

Talk with your health insurance company about what services it will pay for. Most insurance plans pay for hormone therapy for their members. To learn more, talk with the business office where you go for treatment. You can also go to the National Cancer Institute database, Organizations that Offer Support Services and search “financial assistance.” Or call toll-free 1-800-4-CANCER to ask for help.

Coping With Hormone Therapy Side

Coping with a diagnosis of breast cancer is never easy, and the added stress of an early menopause brought on by treatment can make this particularly difficult.

You may find that going through the menopause prematurely can create feelings of loss, and you may even feel isolated from women your own age.

Some women may find it difficult to come to terms with the fact that they will not be able to start a family or have more children. Whatever your feelings, remember that you do not have to cope on your own. Your cancer specialist and breast care nurse are there to provide information and support to you and your family.

You might find it easier to share your feelings with someone who has had a similar experience to you.

Our Survivor Support programme can put you in touch with a trained volunteer who has been through a breast cancer diagnosis. Our trained volunteers are available to provide emotional and practical support to anyone going through or finished with their treatment.

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Less Common Types Of Hormone Therapy

Some other types of hormone therapy that were used more often in the past, but are rarely given now include:

• Megestrol acetate , a progesterone-like drug
• Androgens , like testosterone

These might be options if other forms of hormone therapy are no longer working, but they can often cause side effects.

Take Charge Of Your Recovery

The best way to manage your costs is to be proactive. Take steps to anticipate and manage the costs of your treatment.

Do your research. And donât be shy about seeking help from doctors, hospitals, drug companies, and support groups. If you don’t feel up to it, ask friends and relatives to help.

Taking charge of expenses will help you keep your focus where it belongs — on your recovery.

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Possible Side Effects Of Hormone Therapy

Some side effects are common to all methods of hormone therapy and are due to the reduced levels of oestrogen.

These include:

• Mood changes.

Tamoxifen and aromatase inhibitors also produce some different side effects. You may experience some of the side effects listed, but are unlikely to experience them all.

For most people who are recommended to take hormone therapy for breast cancer, the risks of treatment are outweighed by the benefits.

Here is a list of possible side effects that might be experienced on tamoxifen and aromatase inhibitors:

How Are Aromatase Inhibitors Taken

Aromatase inhibitors are pills. You take one pill every day.

Postmenopausal women with hormone receptor-positive breast cancer can:

• Begin hormone therapy with an aromatase inhibitor
• Begin hormone therapy with tamoxifen and then after a few years, switch to an aromatase inhibitor

When an aromatase inhibitor is the only hormone therapy given, its taken for 5-10 years.

When an aromatase inhibitor is taken after tamoxifen, the drugs are taken for a combined total of 5-10 years.

Talk with your health care provider about how long you should take an aromatase inhibitor.

Find a list of questions on hormone therapy you may want to ask your health care provider.

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Strengths And Weaknesses Of This Study

Some limitations of this study arise from inevitable shortfalls in completeness and accuracy within any routinely collected dataset. A small proportion of women had missing information on smoking status, alcohol consumption, and BMI, but these were dealt with by multiple imputation. As we did not have reliable data for age at onset of menopause for all women, we estimated onset from the first menopause specific record before the earliest HRT prescription. For women with no such record we assumed onset within the most common age range of 50 to 54 years. We did not investigate the differences between continuous and sequential HRT because these regimens are prescribed at different times after menopause. As our cases and controls were matched by age, they would likely have been prescribed similar regimens, making a comparison infeasible. Our primary focus, anyway, was recent long term exposure.

What Are The Factors Affecting Breast Cancer Treatment Costs In India

We will try to touch upon these factors, so you will get a better idea of why there is a variation in the overall cost of breast cancer treatment in India.

Stage of Cancer: There are various stages in cancer and depending upon the complexity of cancer, the treatment differs. Hence, each stage brings variations in the final cost of treatment.

Treatments that are given: The treatment is finalized by the oncological team. Every cancer treatment will have a different cost, therefore, if the number of treatments increases, greater will be the cost.

Place of the Treatment: The place where you decide to get your treatment for breast cancer in India will also play a huge role in the overall price. Private hospitals will cost you more than what you pay at a government hospital. The city where the hospital is located also affects the cost of your treatment, that is, the higher the cost of living, the greater will be the expenditure. If you want to see the finest cancer hospitals in India, then click on this list.

The number of Sessions and Cycles: Systemic treatments like Chemotherapy, hormone therapy and immunotherapy are given in cycles. Therefore, the number of cycles prescribed by the medical team will affect the cost of your treatment.

Medicines associated with the treatment: Usually, the medicines required in breast cancer treatment are costly. So this factor also increases the overall cost of your treatment.

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For The Population Studied As A Whole There Was An Overall Deterioration In The Quality Of Life At Two Years From Diagnosis This Deterioration Was Greater In Patients Who Had Received Hormone Therapy Especially After The Menopause By Contrast Chemotherapy Had A Bigger Effect On Quality Of Life In Non

It is important in the future that we are able to predict which women are going to develop severe symptoms with anti-hormonal treatment so that we can support them, added Dr Vaz-Luis. While it has been shown that hormone therapy provides a real benefit in reducing the relapse rate of hormone-dependent cancers which represent 75% of all breast cancers, the deterioration in quality of life may also have a negative effect on patient adherence to treatment. It is, therefore, important to offer them symptomatic treatment, in particular for menopausal symptoms, musculoskeletal pain, depression, severe fatigue and cognitive dysfunction and to combine this with supportive measures such as physical exercise and cognitive behaviour therapy.

Hormone Therapy After Surgery For Breast Cancer

After surgery, hormone therapy can be given to reduce the risk of the cancer coming back. Taking an AI, either alone or after tamoxifen, has been shown to work better than taking just tamoxifen for 5 years.

These hormone therapy schedules are known to be helpful for women who are post-menopausal when diagnosed:

• Tamoxifen for 2 to 3 years, followed by an AI for 2 to 3 years
• Tamoxifen for 2 to 3 years, followed by an AI for 5 years
• Tamoxifen for 4½ to 6 years, followed by an AI for 5 years
• Tamoxifen for 5 to 10 years
• An AI for 5 to 10 years
• An AI for 2 to 3 years, followed by tamoxifen for 2 to 3 years
• For women who are unable to take an AI, tamoxifen for 5 to 10 years is an option

For most post-menopausal women whose cancers are hormone receptor-positive, most doctors recommend taking an AI at some point during adjuvant therapy. Standard treatment is to take these drugs for about 5 years, or to take in sequence with tamoxifen for 5 to 10 years. For women at a higher risk of recurrence, hormone treatment for longer than 5 years may be recommended. Tamoxifen is an option for some women who cannot take an AI. Taking tamoxifen for 10 years is considered more effective than taking it for 5 years, but you and your doctor will decide the best schedule of treatment for you.

These therapy schedules are known to be helpful forwomen who are pre-menopausal when diagnosed:

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