The cost of cancer treatment

Aug. 14, 2017
Hi, Tracy.
I thought it might be informative to share what cancer screening and treatment has cost over the years. I don't have all the figures, but I've got a pile of documents dating back to 2005, when I had my first biopsy based on an elevated PSA. By searching through all the documents I've accumulated, I have a rough idea of what my treatment has cost. Because of the complexity of the records, I don't vouch for the accuracy or completeness of the figures here, but this will serve as a tight synopsis showing many of the costs involved:

• Insurance: I pay Aflac about $13 a calendar quarter for supplemental insurance to help cover out-of-pocket costs for cancer treatment. This mirrors a policy that yielded a payment following your mother's death in 2002 following her stem cell transplant for lymphoma.
• 2005: first discovered elevated PSA, followed by biopsy with negative results. two more biopsies follow over the years, along with regular blood tests; cost figures not immediately available.
• 2010 Biopsy; 50 samples taken, paperwork unavailable.
• 2012 Periodic six-month blood test for PSA: $88
• Feb 2016: Lab work: $66; Bladder function test; doctor visit: $480;  PSA has shot up to 16; 21% chance of high grade prostate cancer. 62% chance biopsy is negative for cancer.
• June 2016: Doctor visit, Lab work, Pharmacy services, MRI procedure, MRI of pelvis, $2,364
• June 2016: Surgery (biopsy -- 20 samples) anesthesia, lab work, etc: $8,109. cancer detected
• July 2016: Irrigate bladder (prior to catheter removal): $313
• Bone scan, radiation, doctor visit: $1,649 
• October 2016: Lupron hormone blocker: $5,633
• November 2016: Implant gold (target) beads in prostate and scan to check placement: $1,675
• Dec 2016: Pelvis MRI $2,972
• January 2017: Calculating radiation dose, MRI, radiation treatments: $11,285
• Feb 2017: Bicalutimide hormone blocker, for month: $18.55
• Feb 2017: Second Lupron shot: $5,671
• Feb 2017: Beginning of 39 radiation treatments at $1,159 per treatment: $45,201
• Feb 2017: Radiation-related services: CT Guided: $388 x ?; physician's services: $626 x ?; QA: $267 x ?; x-ray guided target: $253 x ?;  There are a lot of these charges and I didn't tally them all.

You get the idea, Kiddo. I think that, so far, I've pushed well past $100,000, considering the items not tallied and for some not even listed. Old age ain't for sissies, and cancer ain't for the uninsured.

Love,

Dad

Another UTI

UPDATE:  Monday, Aug. 7

The UTI has been serious enough that I was called in for an intervenous injecton of antibiotics. I was also told to start taking my temperature to check for any fever. And surprisingly, a hot flash does not register as a fever. They are different phenomena. I do not have the name of the medication in the i.v. that I received this evening; tomorrow (Aug 8) I will take one dose of Monurol, which I mix with four ounces of water. That ends the treatment. The cause of this UTI isn't clear; I am instructed to drink lots of water to flush out any infection.

Addendum, Aug 9: This UTI involves an  "Extended Spectrum Beta Lactamase producing (ESBL)
gram negative organism." Details: Bacteria that produce enzymes called extended-spectrum beta-lactamases ( ESBLs ) are resistant to many penicillin and cephalosporin antibiotics and often to other types of antibiotic. The 2 main bacteria that produce ESBLs are Escherichia coli ( E. coli ) and Klebsiella species....Urinary tract infection (UTI) caused by resistant bacteria is becoming more prevalent.

At this writing the UTI seems to be in remission. The Monurol was followed by diarrhea, and that seems to have run its course as well.

Original post, Aug. 5, 2017

Hi, Tracy.
I think it was Wednesday, Aug. 2, when I noticed it stung a little bit when I peed. On Thursday it burned a lot. On Friday I sent an e-mail to my PA in oncology at Kaiser Permanente (KP) before heading south to have lunch with a friend.

Red face

I stopped at the Federal Way library to look up dining places, and while there I felt the urge to use the restroom. It was urgent, but not painful. I glanced at the mirror and realized my face was very dark pink. I'd never seen it that pink; it was another hot flash and the sweat was just pouring off me.

At lunch I fielded a call and learned that I could leave a specimen at the Federal Way KP facility. I told the nurse who had called me that the burning sensation had subsided, but I still left a specimen, just to be sure, with the outcome to be known by Monday.

Incontinence

Today, Saturday, I went to the rental property to remove some dangerous limbs from the broad-leaf maple tree. It was hot and I was having hot flashes, and feeling quite tired. I had to pee several times without much production. The stinging was starting to return. I wondered whether the night sweats had dehydrated me due to limited liquid generation, so I drank some water at Barb's and took ice water in a pape cup on the way home.

When I parked the car near the condo and got out, it hit. Not only just anurge to pee, but an uncontrollable urge, wich a bladder fully primed. There was no stopping it. I made it to the apartment without encountering anyone who might have noticed my pantleg was soaked. I took off my socks and glasses and stepped fully clothed into the shower, rinsing my clothing in the process. Then I placed an absorbent adhesive pad in my underwear. I walked to the car after a while to retrieve my new glasses, and again experienced an accident. Later, around 10:30 p.m. I had the urge to pee come on so strong that I barely made it in time.

No question: I have a UTI. How that infection got there is anybody's guess; good reason to revive the theory of spontaneous generation.  It will be Monday before I can have an antibiotic prescribed. Tomorrow I purchase some depends to replace the pads, which are not sufficient.

Love,
Dad