Cost of Radiation Therapy for Breast Cancer: Factors Affecting Price

Key Factors affecting the cost of radiation therapy

Here are some of the key factors that are affecting the cost of the radiation for breast cancer.

Type of radiation therapy

Not all radiation therapies are equal and the same. In some cases, more advanced technologies cost more than usual types of treatments. Basic external beam radiation therapy (EBRT) uses the standard beams, which often tends to cost less than highly conformal or image-guided techniques. 

There are techniques such as Intensity-modulated radiation therapy (IMRT), image-guided radiation therapy (IGRT), stereotactic body radiotherapy (SBRT), proton therapy, and add significant cost. For example in India: IMRT costs ranges are approximately reported between INR 1,50,000 to 2,85,000. IGMRT costs are reported between 3,00,000 to 5,00,000 rupees.

Number of radiation therapy sessions

Radiation therapy for breast cancer might involve daily fractions (e.g., 25 to 30 sessions) or less depending on the treatment protocol. The more therapy sessions you might need, the higher the costs it can get. If there is a boost dose or extra targeted drug fields, including lymph nodes and chest wall, it adds to the time, resources, and cost.

Stage and complexity of the breast cancer

An early-stage breast cancer might require simpler fields and less complex treatment planning vs. advanced treatment planning with extensive nodal involvement (post-mastectomy chest wall irradiation).

A higher stage or more complex anatomy might often lead to a higher cost. If other organs at risk, such as the heart and lungs, might require more advanced treatment planning to spare them, this adds cost.

Hospital and location of the facility type

Private cancer centers in major metropolitan cities in India generally charge more than usual. The cost of living, facilities and equipment, staffing, and the healthcare team can affect the cost of your treatments.

While in small cities or at government facilities/charitable organizations, it can cost significantly less than in tier 1 cities. Additionally, the hospital's accreditation, status, and brand name can add to the cost.

Pre & Post treatment costs

The radiation treatments costs for imaging for planning (CT/MRI) often include specialist consultation, immobilization devices, quality assurance, follow-ups, and management of side effects. Additionally, post-treatment care, a potential hospital stay if there are any complications, supportive medications for patients, and additional scans add to the total expenses.

Insurance coverage and Financial support

Your insurance plan (government and private) usually covers radiation treatments and how much it affects your out-of-pocket expenses. Advanced treatment methods might not be covered or might require an extra payment as well. Negotiation, bundled packages vs. per-session billing, and international travel also influence the overall cost.

Patient support

A patient's overall health conditions, along with comorbidities such as heart and lung issues, can make treatments more complex and hence more expensive. Additionally, age and body habits, often including large size, need more complex treatment planning. Prior treatments (if re-radiation is often needed) and patient choices, like hospital, type of room, extra services, etc, can add to the cost.

How to approach the cost conversion

Here are some of the practical tips that can be used for patients and caregivers to manage and plan for radiation treatment costs for breast cancer.

Ask for a detailed cost breakdown: Ask your healthcare coordinator, "What is the number of sessions, and what technique is being used?" What is included, such as follow-up scans and follow-up check-ups?

Clarify the billing structure:Try to check whether it's a bundled package or per session. What technique is being used? What are the extra bills per fraction plus add-ons?

Check the insurance and reimbursement details: Always ask questions such as, "What does your treatment plan cover?" Are there any caps on newer treatments? Etc.

Compare facilities: If you have an option for a hospital and cancer centres, then compare the costs of the hospital and facilities choices.  

Ask about alternative treatments: Ask your healthcare team if there is any advanced technique, for example, IMRT, recommended. Ask if any simpler alternative techniques are available while consulting your oncologist and what trade-offs exist.

Plan for non-therapy costs: If your hospital is from a faraway place, then travel and accommodation, hospital stay, and follow-up scans can add up to your hidden costs.

Negotiate your treatment costs: In some cases, some hospitals might offer a discount or payment plan.

Financial counseling: Many cancer hospitals in India have a financial counselor, who can often advise on subsidies and insurance claims.