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.
