Prostate Cancer: Costs For Diagnosis, Treatment, And Care

Being diagnosed with prostate cancer is life-changing. Soon, you'll have to choose your preferred initial treatment and healthcare provider.  

Knowing what you can be expected to pay for prostate cancer care and treatment can help you feel in control.  According to a 2019 study¹ a typical prostate cancer treatment costs around $2,800 per month. However, this can be lower or higher depending on:

• Whether you have health insurance 

• The type of government assistance you receive 

• The type of specialized care you need 

• Your location 

• The facility type

• The type, stage, and grade of your prostate cancer

• Your age, weight, and overall health 

• Previous medical history 

In all, consider the following costs:

Doctors appointments

Typically, you'll need regular follow-ups and screenings to check how the cancer is developing after a prostate cancer diagnosis. A PSA test is usually about $20. And you may incur additional appointment costs ranging between $25 and $100.

While your healthcare insurance is likely to cover most of your doctor's visits, you may need to cover copays. In the same 2019 study above, the average copayment after prostate cancer diagnosis was $37 per month. After ten months, this went down to $31. 

If you can’t afford regular appointments, make sure to discuss this with your doctor. They may be able to set up a payment schedule or offer other types of financial flexibility. 

Treatments and procedures

The costs of prostate cancer treatment vary from one procedure to another. 

Specific procedures like radiotherapy require daily visits to your doctor for a set period. During these appointments, you're responsible for fees like coinsurance. 

If you need to take unpaid leave to undergo treatment, you should also factor the lost wages into the total treatment cost. 

Here's a quick overview of some prostate cancer treatments and their costs.  

Active surveillance (or watchful waiting)

Active surveillance is usually recommended for patients with existing health conditions, where surgery or other therapy wouldn’t be appropriate. 

According to the American Cancer Society², treatment via watchful waiting costs about $4,270 initially and $9,130 over five years. 

Surgery 

Surgery is usually recommended for early-stage prostate cancer. According to the American Cancer Society, prostate cancer surgery costs around $15,197 initially and about $19,214 over five years. 

Prostate cancer surgery costs vary depending on:

• The type of technology used (robotic, laser, or laparoscopic)

• The type and location of the incision

• The type of procedure (minimally invasive or open)

Here are some surgery cost estimates³ in the United States:

• Enlarged prostate surgery costs between $6,000 and $20,000

• Robotic prostate surgery costs between $7,200 and $35,500 

• Radical prostatectomy⁴ (laser) costs: $16,891 to $17,560 

• Transurethral Resection of the prostate (TURP) costs approximately $11,500  

Chemotherapy

Chemotherapy is recommended when other treatments have failed or when the cancer is widespread. It costs about $5,500. 

Radiation therapy

If surgery has failed to eliminate the tumor, radiation therapy can be used. Its cost ranges between $12,000 and $40,000. 

Hormone therapy

Hormone therapy is recommended when prostate cancer has spread. According to the American Cancer Society, it costs $17,474 initially and about $25,097 over five years. If the cancer is advanced, the cost can exceed $100,000. 

Hidden costs

Many treatments come with additional out-of-pocket costs, like the cost of drugs, supplements, vitamins, and alternative therapies. 

Added to that are expenses related to managing possible side effects of prostate cancer and its treatments, like bowel function, impaired urinary function, and impotence. 

Out-of-network costs 

When you go to a medical professional or hospital not covered by your insurance, you must pay out-of-network costs. 

Transportation and travel

Travel costs, especially if your healthcare provider is miles away, can add up. It’s a good idea to factor in the price of gas, parking, and accommodation if needed. 

Legal costs

There may be additional costs if you need guidance on financial, legal, or employment issues relating to your diagnosis. Think of issues involving: 

• Learning about your rights as an employee

• Addressing lost wages 

• Factoring in medical expenses when tax filling, and 

• Writing a will 

Caregiving (at-home and long-term care)

If you need extra help: someone to fix meals, assist with personal care, or drive you to follow-up clinic visits; consider the associated costs. 

Health insurance coverage vs. out-of-pocket payment

Prostate cancer costs can be covered by your healthcare provider or be paid out-of-pocket. 

Health insurance coverage 

Different Medicare parts⁵ cover different treatments, as outlined below. 

Medicare Part A (inpatient hospital insurance) 

This insurance covers:

• Inpatient hospital admissions (plus the treatment received in your stay at the hospital)

• Nursing care at a skilled nursing facility after a 3-day stay in the hospital

• Specialized nursing care or home health care (like physical therapy)

• Blood work

• Hospice care 

• Eligible clinical trials 

There are situations when a hospital stay is regarded as outpatient care. Always ask your healthcare provider for clarification before your treatment. 

Medicare Part B (outpatient care)

This covers:

• Doctors visits 

• Radiation treatments that are done in a clinic 

• CT scans and X-ray tests 

• Outpatient surgical procedures 

• Durable medical equipment (walkers and wheelchairs) 

• Intravenous chemotherapy drugs administered in a clinic or doctor's office 

• Some clinical trials  

• A mental health treatment that's received in a doctor's office, clinic, hospital outpatient department, or therapist's office 

• Preventive services for persons considered at risk of prostate cancer 

• Some second or even third opinions for non-emergency surgery 

Screenings

Medicare covers screenings for the early detection of prostate cancer. Tests covered include prostate-specific antigen (PSA) tests and digital rectal exams (DRE).

PSA and DRE screenings are covered annually for men over 50 years. 

Prostate cancer screening costs 

DRE

• 20% coinsurance 

• Relevant deductibles 

• Copayment if screening occurs in an outpatient setting

PSA

If your healthcare provider accepts Medicare, you won't pay a dime for your annual PSA blood test. If they do not, you'll be required to pay for doctor services – but not the test. 

Prescription drugs

If outpatient care does not cover the cost of cancer drugs, part D of healthcare insurance may cover it instead.

Private insurance carriers administer prescription drug plan (PDP) policies. It’s best to check with your carrier to ensure their policies include your prescribed medication(s). 

PDP usually cover the following drugs:

• Anti-nausea medication

• Oral chemotherapy drugs

• Pain medication 

Out-of-pocket expenses

Coinsurance, copayments, or deductibles may apply to your treatments. These costs vary depending on:

• Whether your healthcare professional accepts assignment 

• The type of facility 

• The location of the healthcare provider 

• Whether you have an insurance policy 

Discuss with the medical staff upfront to understand how they charge for prostate cancer-related services. 

Exclusions

Medicare does not cover the following expenses:

• Adult daycare

• Room and board at an assisted living facility 

• Long-term care in a specialized nursing home 

• Nutritional supplements or medical food

• Assisted living services like eating and bathing 

Money-saving resources 

There are a number of resources you can use to offset the costs of prostate cancer. 

For example, most hospitals offer up to 30% discounts to uninsured patients or those paying in cash. Also, some states have programs like the IMPACT Program that provide free or discounted treatment for eligible uninsured patients. 

Besides discounts, you can also benefit from shopping around for better rates. Take advantage of resources like the American Society of Clinical Oncology oncologist locator to search for a skilled prostate cancer specialist. Or the National Cancer Institute search tool to locate NCI-designated cancer centers. Or even the NCI guide to finding a reputable healthcare provider or treatment facility.

Find even more resources for prostate cancer patients, family, friends, and caregivers.