Breast Cancer Therapy and Costs

About half of newly biopsied breast cancer patients always ask for detailed cost estimates for treatment.  (The luckier half simply say, "Just give me the best".)  It doesn't seem to matter whether they have insurance or not if their account is held by a local company. 

Costs. They nearly always frown when I say, "It depends".  That's understandable, I guess.  It seems that naming a figure gives comfort– but how can an oncologist honestly box a disease so heterogenous into simple numbers from the outset?  I have to bite my lip when told that, "Dr So-and-So says it costs only this much…"  No comment.  Even when a patient is wise enough to give you a working budget, one still has to wade through the variables to get the loudest bang for her buck.  Its tragic when a metastatic breast cancer patient comes to the Center, still on the Tamoxifen started after primary surgery, only to test negative for the hormone receptors on her mastectomy specimen.

This isn't the flu.  For breast malignancies, the positive biopsy is merely a first step.  Other than announcing the existence of the problem, it does little else on its own, & a responsible oncologist from any of the subspecialties still wouldn't be able to formulate a decent cancer treatment plan. 

Sadly, there's a persistent notion that the crucial remedy is a radical operation up front… that all else is extra or bonus.   Now, what impact would that have on a patient with liver metastases?  Shouldn't the money have been spent on something else? 

Paul Outerbridge, c.1937
Breast Cancer = "Multidisciplinary Management".

To all Shoppers:  Do yourself a favor and see a certified specialist.  Would you allow a general surgeon to excise a brain aneurysm?!  Cost is not the same as Value, and the best way to reconcile these two factors is to consult the specialists whose business is to do little else besides.

I wish all life were simple too.

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