[MOL] I find this articile irratating...Androgen vs. Orchiectomy.... [00899] Medicine On Line


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[MOL] I find this articile irratating...Androgen vs. Orchiectomy....




ANDROGEN SUPPRESSION: THE ORCHIECTOMY FACTOR
------------------------------------------------------------------------
HONOLULU--Clinicians treating advanced prostate cancer should be aware that
orchiectomy may be a bargain.
  
A University of Hawaii team, writing in the January Journal of Urology,
said that if physicians don’t consider cost when making treatment
decisions, other forces will.
  
And in that case, the decisions will be made by "relatively uninformed
and often crude market, medical industrial, and political forces,"
said Dr. Albert J. Mariani and colleagues of the University of Hawaii.
 
His group reported that in a cohort of 96 patients, androgen
suppression was a less-expensive approach only if patients were not
expected to live 2.7 to 5.3 months. That’s the time it took for the price
of LHRH agonists to surpass that of surgery.
 
According to the researchers the tab for LHRH treatment exceeded that
of orchiectomy by 10.7 to 13.5 times, and LHRH agonists with nonsteroidal
antiandrogens are 17.3 to 20.9 times more expensive.
 
LHRH agonist therapy became more expensive than surgery after 4.2 to
5.3 months, and for LHRH agonists combined with nonsteroidal
antiandrogens it was after 2.7 to 3.4 months.
  
The researchers said that their data underestimated the orchiectomy
savings because about 15% of the patients in the study were still alive
at its end and will continue therapy for the rest of their lives.
  
A study from the University of Toronto published in the Nov. 1
Journal of the National Cancer Institute also found that orchiectomy
is significantly less expensive than other methods of androgen
suppression.
 
 
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