How much does prostate surgery cost in the US?

I am a 52 year-old American working in Japan, recently married, just diagnosed with prostate cancer. My PSA is 6, Gleason score is 6, pattern 3+3.

Two urologist surgeons in Japan told me that at my age, I should go back to the US if I want nerve-sparing surgery done. In Japan, it is still new. I am considering returning to the United States to have a da Vinci robotic, or laparascopic, prostatectomy done. I am wondering if I can afford it.

Question: Can anyone give me a general idea of how much either one of these surgeries might cost “out the door”, including all the hospital, doctor, and anesthesiologist’s fees? I need to get an idea if this is even remotely possible for me. I may get little, or no, reimbursement from my overseas medical insurance.

KJN

Hello KJN

I had open surgery and spent 4 full days in the hospital, I think the "total" total including everyone and everything was close to 70,000 USD, for everything that was associated with the surgery and aftermath.

That figure does not include the Salvage Radiation I just completed.

David in SC

I just looked up the surgery costs in my On-Line Health Record -- very convenient. Not sure if everything is covered there but here are the charges for a routine open Surgery at a local regional hospital (not in Boston) -- in early 2009 (in USDollars).

Anesthesia: 1386 + 924
SemiPrivateRoom: 350+2250
Surgery (2 docs): 139+2659+315
Labs: 250+290
Total: 8563.

I will check the actual paper copies that I have at home and update if necessary.

But bottom line, a lot of people seem to be getting ripped off by super high charges!!

Same here, Sephie, I put down the official 'list prices" that were charged.

KJN,
Although you know the situation in Japan far better than I, it would be surprising that given the excellent medical care available there, that was the case so far as nerve sparing surgery went. You may have just struck a couple of docs who cannot do it. It is most certainly available in both Singapore and Thailand. It might be worthwhile investigating the expertise of other urologists in Japan. Although unaware of the cost for an uninsured patient in the U.S., in Sydney (Australia) for example nerve sparing robotic will set you back just over $20,000 for hospital stay and doctors fees (for non citizens with no insurance). But in these other places you are faced with additional costs as pre-consultations, accommodation and follow up care.
Bill

i BELIEVE it costs $64000 (that's what I was told by Dr. Menon's team).

I'm fortunate to have excellent insurance. It will cost me about $1200 for everything, including all consultations, pre-op, etc. Much of that is because of my 2010 deductible.

Mel

Thanks to all of you for the figures. Wow! Those prices are as bad as I had feared. Doing it in the US may not be possible for me. I'll keep looking around. I've heard that it may be possible to negotiate with some hospitals for the insurance company price. I'll see what I can come up with.

I had my biopsy done in Bangkok (my wife is Thai). They took 24 cores. The right lobe showed no cancer, and the left showed cancer in 9 out of 12, but I don't know the percentage in each. The slides just arrived at Johns Hopkins yesterday for a second opinion.

The urologist surgeon in Bangkok who did my biopsy does robotic assisted surgeries. He's done 180. He is supposed to have done the most in Thailand, and he says he's got more than the leader in Singapore. I'm hearing that over 250 is a better bet. When I read of surgeons doing 1800 in the US, it sounds much better to me.

Prostate cancer is less common among Asian men living in Asia. I talked with two urologists in Japan, both at university hospitals, in Kyoto and Osaka. I was told that laparascopic is what's used here, now, but that most patients are older and not so worried about ED. Both of them told me that at my age, I ought to go to the US where surgeons have much more experience with all types of prostatectomies. The guy in Osaka said he had done 150 laparascopic and he was one of the leaders in the Osaka area. He also said that robot assisted surgery is still experimental surgery here. This is not surprising to me. I have lived here 10 years. The medical care here varies from modern high tech to archaic and downright scary. Japan is known as the land of opposites.

That price of $20,000 in Australia - was that in US, or Australian, dollars?

KJN,
That cost in Australia was in Oz dollars (currently Au$1-00= US$92c). Then again, robotic is not as prominent here as it is in the U.S so experienced urologists will charge a premium for robotic surgery and open is quite a deal lower in cost. Although I had robotic I would not be too hung up on it. open surgery with a well experienced doc will deliver equivalent results as far as continence and nerve preservation are concerned.......it is most certainly not the second best choice. Many members here have had open surgery with great results........and there are some advantages to open. I am not a fan of straight out laproscopic surgery as all I've read suggested it takes quite a bit of skill (hand movements are the reverse of the instrument movement) with the field of view somewhat restricted. Given the complexity of a prostatectomy, who needs extra hurdles. As "Worried Guy" says, "if Colin45" from Bangkok is about ( he had similar stats to yourself) he may be able to give you details on his to date successful open surgery there.
Bill

Post Edited (BillyMac) : 1/16/2010 4:28:25 PM (GMT-7)

Great info. Thanks again.

Ohio State: I’ll check out Dr. Bahn for overseas referrals.

Worried Guy: Hajimemacrape. Yoroshiku. What type of surgery did you have in Rochester? May I ask the names of the hospital and your surgeon? My sister lives in near NYC so NY is one of the easier states for me to visit for treatment. I’m looking at all of my options here. $20,000 after negotiations is doable. $50, 000 isn’t.

BillyMac: Thanks, US and Oz $ about the same. Again, $20,000 beats $50,000, though. I understand, too, going to a country I am not familiar with adds to the expense, and difficulty. I do have friends from Australia though, so I may run it by them.

Colin45: May I ask who the surgeons were in Bangkok? Which type of surgery did you have, and at what hospital? The guy who did my biopsy at Bumrungrad is usually at the government hospital and does robotic surgery there. Maybe the guy you talked to?

I actually have insurance in Thailand (BUPA), but it pays nothing for care in the US. As a general rule, here too, it seems like you may get what you pay for. It sounds like you got great results. How much experience did he have? It seems that I might get spectacular results from a low experience surgeon, but maybe not. That is what scares me and makes me want to bite the bullet, spend the money, and go for a more highly experienced surgeon in the US, or elsewhere.

Too much information, too many choices, too many decisions to be made.

Thanks again, all.

Hey KJN,
I went to Univ of Roch Medical Center and had DaVinci by Dr Jean Joseph. I've got all my bills and billing paperwork and do not mind opening my kimono if you need a peek. You've got my email through this site. I noticed someone else here had the same surgery, by the same doc , at the same hospital but at a much higher price. Clearly there is something whacked with the health care system - or at least the billing.
Ja, mo ii. Ano mondai wa shikattaganai.

(Oh, you probably noticed this site has an automatic profanity filter. It looks at character strings and converts them into less offensive words. It sure makes Japanese ridiculous. That's why I inserted spaces "incorrectly" in the Nihongo.)

By the way, given the chance to do it all again, I'd seriously be thinking about calling Colin. He's on the beach wearing a Speedo, while I'm in my kitchen wearing a pee pad.
You found a great site. Glad we can help.

Moshi shi_tsumon ga arimasu, zehi emairushi_te kudasai.
Ja mata
Jeff

Hi Colin45

Thanks. Any idea how many open surgeries Dr. Chodchoy has done? Which hospital did you do your surgery at? Great news about your continence and no ED!

Yes, I had my biopsy done by Dr. Sittipawn. I figured that if I did do it with him, my wife would have to be my translator at the government hospital. But I also was concerned with the number of surgeries he has done with robotic assistance. He says he has done around 200 laparascopic, but only 180 robotic.

Colin45

Thanks. I've found him on the net and will find out more about him.

Good point about translating the medical terms!

Colin45

Thanks.

You say in your bio that you lost one nerve bundle. Was that because of the location of the tumor? Did you have any idea that would be the case before you had the operation? That's great that you have no ED, regardless!