Jay_C I'm not a fan, but my thoughts and prayers are with him, hope he pulls through!

Michael Merritt Having cancer is never good, but better it be at an early stage than a late one. My thoughts are with him and his family.

c3 I apologize for doing this up front, but it needs to be brought out (and I should state that majority of men, if they live into their elder years will experience prostate cancer) If I understand correctly Sen. Dodd has early stage prostate cancer. I suspect he has cancer confined to the prostate gland, Stage I. As part of the healthcare reform initiatives, we've heard a lot about a potential federal agency that would review outcomes data to determine which treatments truly make a difference. The model for this is the UK's, National Institute for Clinical Evidence (NICE. Here's their quick reference guide for providers on prostate cancer (pdf warning). If you peruse it you'll see that "active surveillance" is their recommended treatment. Senator Dodd has chosen surgery. He will likely get a radical prostatectomy. That is an option under the NICE guidelines. Doing some quick searching on the Internet the cost of the radical prostatectomy is over $15,000. The costs for the biopsies involved with the active surveillance options are likely less than $5000. The outcomes in terms of quality of life and longevity may be the same (and given the issues of erectile dysfunction and incontinence the active surveillance arm may provide a better quality of life.) A large study is presently going on to effectively compare these options. Here's a nice review article outlining these outcomes. A few numbers to consider also: over 220,000 new prostate cancer's are diagnosed each year in the US. Less than 30,000 men die annually from prostate cancer. (Most men with prostate cancer die of something else.) If half of those newly diagnosed prostate cancer were early stage detected by a PSA blood test (as I believe Sen. Dodd's was) then the annual difference in expenditures would be about $1,100,000,000 (or 1.1 billion)

c3 In my searching for the above comment I found a nice, quick review of the outcomes research/"ineffective" treatments debate here.

Jason Arvak Based on my experience with my wife''s cancer treatments, I would say that the cost numbers you are reporting are probably dramatically low. It is likely that you are counting only the single surgical cost and are overlooking the MASSIVE cost of testing, especially the various radiological scans that check for metastasis and other cancers (a necessary step before stage 1 can even be confirmed in the first place). A single MRI scan can cost thousands and that doesn't count the CT scans, nor any of the follow-up scans that continue over time. Furthermore, in a single-payer system envisioned by some (including Dodd), the up-front expense of these scanning machines combined with the year-to-year budgeting process limitations of government payment systems could combine to dramatically decrease the overall availability of MRI and CT scans due to lack of available equipment to meet demand. Thus, the "active surveillance" option may become viable only on paper due to heavy rationing under a poorly designed, ideologically predetermined "reform" health care system. Of course, you can forget about receiving a civil response to such issues from reform advocates. Anyone who would even raise these issues in the first place is an evil, "ill-informed Republican" or "conservative Blue Dog" who is just a "creep" that deserves "contempt". :)

c3 Thanks Jason; I should have stated that I had assumed that post treatment follow up would be the same. a big assumption done for the sake of the argument. So I'll ask the difficult question againg: If evidence shows that the less expensive, less invasive but seemingly "less difinitive" therapy has equal outcomes to the much more expensive, highly invasive "curative" treatment, what responsibility does the payor (government or private) have to pay for the more costly intervention?

Jason Arvak If evidence shows equal outcomes, then by definition, it is not less definitive.