Follow-up costs after external radiation for low risk prostate cancer

Purpose: Some routine follow-up costs for external radiation for prostate c ancer might not be justifiable. To study this possibility, we reviewed the follow-up costs and clinical course of 36 consecutive, unselected patients treated with external beam radiation (EBRT) for low-risk prostate cancer at the University of Washington. Methods and Materials: Thirty-six consecutive patients with Stage T1/T2 pro state cancer and pretreatment prostate specific antigen (PSA) < 10 ng/ml we re treated with EBRT with curative intent at the University of Washington f rom 1990 through 1996, All follow-up visits with each patient's urologist a nd radiation oncologist, and all laboratory tests were tabulated. Charges q uoted in this report are based on University of Washington billing. Results: A total of 8 patients demonstrated biochemical evidence of tumor p rogression/persistence. none of whom has had any therapeutic intervention f or progressive cancer. No patient had local disease progression by physical examination. One patient experienced a Radiation Therapy Oncology Group (R TOG) grade 3 bowel complication (obstruction), not detected on routine foll ow-up. The average combined PSA and physician follow-up charges for the fir st 2 years after therapy was $1,013, Conclusion: The data presented here suggests that for low-risk prostate can cer (PSA < 10 ng/ml), frequent follow-up by physical examinations and PSAs during the first 2 years after therapy is not warranted, (C) 1999 Elsevier Science Inc.