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The Costs of Breast Cancer

Breast cancer can come with a hefty price tag. Even when your doctor finds the cancer early, you could face a long road of surgery, radiation, chemotherapy, medications, doctor visits, and tests. And there may be expenses you never anticipated.

In one study, 1 in 3 women said the costs of care were more than they expected -- so much so that some avoided doctor visits. Even if they have good insurance, women with breast cancer find the costs can be front-loaded. Deductibles, co-pays, and co-insurance pile up in the first 2-3 months after diagnosis, before you hit your out-of-pocket maximum.

The best way to deal with the costs of breast cancer treatment is to address them head-on. Learn as much as you can about what expenses you'll have and plan carefully for them. That includes talking to your doctor about how much your treatments will cost.

Your oncologist can refer you to groups that help pay for medications and services like transportation and child care. Above all, don’t skip treatments or doctor visits because of money worries.

Your Treatment Plan

There's no one-size-fits-all approach to treating breast cancer. Your doctors will create a treatment plan based on your own situation. It may include a combination of:

Even after treatment, you may need:

  • Visits to an oncologist, every few months at first and then once a year after 5 years
  • Mammograms 6-12 months after a lumpectomy and then once a year. After a mastectomy, you'll need one annually for the remaining breast.
  • Pelvic exams annually if you take certain hormone drugs that raise risks of uterine cancer
  • Bone density tests if you take other hormone drugs
  • Medications to reduce the risk that your cancer will come back

Direct Medical Costs

So how much might treatment cost you? It depends on your insurance plan, what type and stage of cancer you have, where you live, and more. But a couple of studies shed some light on possible expenses.

One study looked at costs allowed by insurance companies for breast cancer surgery, chemo, radiation, medications, and certain other medical costs for women ages 18-64. It found costs were higher soon after diagnosis, when surgeries were common. They went down once the approach shifted to chemotherapy.

Specifically:

  • For women diagnosed with stage 0 breast cancer (small, localized tumors), these medical costs totaled $48,477, on average, 6 months after diagnosis. The total rose to $71,909 after 2 years.
  • For stages I and II (tumors had not grown deeply into nearby tissues), the range was $61,621-$97,066
  • For stage III (larger tumors that spread to nearby areas), $84,481-$159,442
  • For stage IV (affecting other parts of the body), $89,463-$182,655

The American Cancer Society looked at medical costs in a different way. In a case study, after one woman was diagnosed with stage I breast cancer, she had a lumpectomy and biopsy. Later, she had chemotherapy, radiation, daily hormone therapy pills, and regular visits to a primary care doctor and oncologists.

Her total health care costs in her first year of treatment were $144,193. Her expenses for co-pays and coinsurance, deductibles, and premiums would total:

  • $5,819 with employer-sponsored insurance
  • $10,114 with a health plan bought in the marketplace
  • $8,793 with Medicare

Indirect Expenses

You often need more than just a doctor's care when you have breast cancer.

  • You might need physical therapy for pain, tightness, and swelling in your arms after surgery. Many health plans cover physical therapy for cancer treatment. Check with your insurer.
  • Mental health therapy can help you deal with the stresses of cancer treatment. In the U.S., fees per session usually range from $100-$200.
  • Acupuncture can help relieve the nausea, fatigue, and other effects of chemo and radiation. Costs vary depending on where you live. But a first-time visit averages about $112 and follow-up visits around $80. Many insurers cover acupuncture for cancer treatment, so check with yours.
  • You might need a wig because of hair loss from chemo or radiation. Synthetic wigs cost anywhere from $30-$500, while a wig made from real hair could run more than $800. Some insurance companies will cover wigs if your doctor writes a prescription. It's worth asking your oncologist and your insurer.

You'll probably need to take some time off work, too. Research your employer's health leave policies, along with disability programs you may qualify for. Include any lost income in your financial calculations.

More Tips for Controlling Costs

  • Look into medication assistance programs offered by many drug companies.
  • Compare the price of your medications at different pharmacies and online.
  • Ask your doctor about taking part in a clinical trial. This lets you get state-of-the-art treatment while bringing down costs.

Take Charge of Your Recovery

The best way to manage your costs is to be proactive. Take steps to anticipate and manage the costs of your treatment.

Do your research. And don’t be shy about seeking help from doctors, hospitals, drug companies, and support groups. If you don't feel up to it, ask friends and relatives to help.

Taking charge of expenses will help you keep your focus where it belongs -- on your recovery.

WebMD Medical Reference

Sources

SOURCES:

CDC: "Breast Cancer Statistics," "Leading Cancer Cases and Deaths, All Races/Ethnicities, Female, 2017."

American Cancer Society: "Treating Breast Cancer," "The Costs of Cancer: Addressing Patient Costs," "Follow up Care After Breast Cancer Treatment," "Will My Insurance Cover Alternative and Complementary Therapies?"

National Cancer Institute: "For Some Women with Breast Cancer, Cost Influences Decision About Surgery."

Breastcancer.org: "Treatment and Side Effects," "Paying for Your Care," "Taking Time Off Work for Treatment, "Wigs," "Acupuncture," "Managing Your Health Insurance."

American Health & Drug Benefits: "Comparison of Treatment Costs for Breast Cancer, by Tumor Stage and Type of Service."

Breast Cancer Research and Treatment: "Medical costs associated with metastatic breast cancer in younger, midlife, and older women."

Integrative Cancer Therapies: "Barriers to Acupuncture Use Among Breast Cancer Survivors: A Cross-Sectional Analysis."

National University of Health Sciences: "5 Myths about Acupuncture Treatments and Their Effectiveness."

Journal of Integrative Medicine: "Acupuncture price in forty-one metropolitan regions in the United States: An out-of-pocket cost analysis based on OkCopay.com."

Cedars Sinai: "Physical Therapy – Breast Cancer."

Psychology Today: "How much does therapy cost?"

Journal of Oncology Practice: "Financial Costs and Burden Related to Decisions for Breast Cancer Surgery."

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