The Surest guide to prostate cancer
Prostate cancer is the second most common cancer in American men, according to The American Cancer Society. About one out of every eight men will be diagnosed with prostate cancer during his lifetime.
Prostate screening
A prostate-specific antigen (PSA) test measures the amount of PSA in your blood. PSA is released by a man’s prostate gland into his blood. A high PSA level may mean that you have an enlargement, infection or cancer of the prostate. A PSA level within the normal ranges does not mean that prostate cancer is not present. High levels don't always mean that prostate cancer is present.
Helpful general information
Many cancer-related procedures occur in a variety of settings, such as a doctor's office or outpatient center. Your cost for a procedure may depend on the way your doctor's team bills for the service. Keep in mind that sometimes what seems like an office visit may actually be considered “outpatient.” Ask your doctor's team how they will send the claim to Surest to understand your price for the procedure.
Surest is here to help.
A prostate cancer diagnosis can feel overwhelming. The Surest clinical team can help you understand your treatment choices and coordinate your care. We can also help you navigate coverage and cost for your cancer care.
If you’re a Surest member with questions about cancer, reach out to us. The Surest clinical team is here and ready to talk. We will contact you directly.
Prostate cancer information
What types of doctors might I see for prostate cancer?
Several types of doctors and clinical professionals may be involved in your care. The doctors you see will be specialists in your diagnosis and may include:
- Urologists specializing in the male urinary and reproductive systems
- Medical oncologists specializing in the diagnosis and treatment of cancer
- Radiation oncologists specializing in using radiation therapy to treat cancer
- Surgical oncologists who have special training in cancer surgery
Search the Surest app for a specialty or by a doctor's name to view the price of an office visit. You can share this information with your primary care doctor or oncologist to help guide you to quality, affordable specialists.
Can I get help making decisions about my prostate cancer treatments?
With an increasing number of cancer treatments available, it's normal to feel uncertain about your treatment plan or what is ahead of you. Surest can help. We have a clinical team available to help you navigate important decisions.
We can also help you find other doctors who specialize in your diagnosis. This is called a second opinion. Don't worry about offending your doctor. You are taking an active role in learning more about your condition. Most doctors expect and encourage second opinions. The Surest team is here for you.
Let us know when it’s most convenient to reach you. I'd like some help.
What types of tests might I need for prostate cancer?
Testing will usually be done to help diagnose and stage the cancer. Types of testing include the following:
Laboratory tests: Urine and blood tests
- Many routine in-network urine and blood tests are covered at $0 cost to you. Search for the test on the Surest app to find the price.
- The cost of most advanced laboratory tests can be found by searching the name of the test on the Surest app. If you can't find a specific test, call Member Services.
- If your labs are drawn during a doctor visit, there will be a cost for the doctor visit. This cost can be found on Surest app under the doctor's name.
Laboratory tests: Genetic testing
- Genetic testing is used to look for inherited gene mutations that might put someone at higher risk of getting prostate cancer or help determine treatments for cancer. Examples of genetic tests include the following: BRCA1/BRCA2, CHEK2/ATM/PALB2/RAD51D and ARV-7
- These tests need authorization before the test is done. Your doctor will initiate this authorization.
- Genetic testing prices will vary depending on the type of test and how it's done. Most in-network prices can be found on the Surest app under the name of the test.
Imaging tests
Imaging tests are used to look for cancer, find out how far it has spread, and to see if treatment is working. The prices for the tests below are based on where you choose to have the imaging test done. Search the Surest app for the test to compare and identify lower-cost options. Ask your doctor to send your imaging test orders to the place you choose.
- CT scan
- MRI
- PET scan
- Bone scan
The price for an in-network X-ray or transrectal ultrasound is $0 to you unless:
- The imaging is performed during a doctor's visit. Then you will pay the office visit price. Ask your doctor’s team if they plan for an office visit with the imaging.
- The imaging is considered an outpatient procedure by the facility and sent to Surest with that designation. Your cost will be the outpatient price. Ask the facility when you schedule the test how they will bill for the imaging.
Prostate biopsy
Core needle biopsy is the most common type of prostate biopsy. It is usually done by a urologist in the doctor’s office. The result of the biopsy will tell you if cancer is present and how fast it is likely to spread.
The biopsy will help determine if you have cancer and if so, the risk of the cancer spreading. For help understanding treatment options, review the resource for prostate cancer, low risk or prostate cancer, high risk. For help understanding treatment options review these resources or call the Surest clinical team and then talk with your doctor. The cost to you depends on whether the biopsy is considered outpatient or a doctor's office visit. Ask your doctor's team if the biopsy is considered an office visit or outpatient procedure. Search for the name of the biopsy on the Surest app to see the price.
What are common prostate cancer treatments?
Active surveillance
This treatment includes regular doctor visits, testing and imaging. Find the costs on the Surest app under the name of each service.
Surgery
The most common surgery for prostate cancer is called a radical prostatectomy. In this operation, the entire prostate is removed. Typically, you will stay in the hospital overnight after the surgery. If you need surgery, your in-network price will depend on the following:
- The type of surgery
- Whether you are admitted as inpatient or outpatient. You can ask the doctor or hospital about how you will be admitted before the surgery. You can then determine the price by looking on the Surest app. The price will cover the surgery and the hospital stay afterward.
You will find the cost of most surgeries by searching for the name of the surgery on the Surest app. You can compare prices between providers and locations. If your Surest plan requires activation of coverage for certain surgeries, you will not need to activate coverage if the surgery is to treat cancer. Please call Surest Member Services to make sure you have a clear understanding of this policy.
Most surgeries will require a pre-operative physical. This physical is usually done by your family doctor and the cost to you will be the price of the doctor’s office visit. This can be found on the Surest app under the doctor’s name.
Radiation treatment
Radiation therapy uses high-energy particles or waves to destroy or damage cancer cells. The most common types of radiation therapy for prostate cancer are:
- External beam radiation therapy (EBRT)
- Intensity modulated radiation therapy (IMRT)
- Brachytherapy (internal radiation)
Your in-network price for radiation therapy can be found on the Surest app by searching for the type of radiation therapy. There is typically a cost for each radiation visit. Some types of radiation therapy may need authorization. Your doctor will initiate this process.
Drug treatment
Drug treatment medicines may be used alone or in combination and can be given by infusion, injection or as pills. Types of drug treatments include:
- Hormone therapy to reduce levels of male hormones (androgens) to slow or stop the cancer growth
- Chemotherapy that travels throughout the body to reach the cancer cells
- Immunotherapy to stimulate your own immune system to destroy cancer cells
- Targeted therapy that attacks the cancer cells' inner workings
The cost for the treatment will depend on the type of drug and where you receive it. Call Member Services for specific information about your costs. Drugs may need authorization. Your doctor will initiate this process.
What other services might help during prostate cancer?
Dietitian
A dietitian visit can be helpful if you have problems related to food and digestion. This can be because of the cancer, or as a result of treatment. The price for this service will depend on the dietitian you see. Look on the Surest app for prices.
Home care
Home care (home health care) services are usually provided through a home health agency. They may offer different types of home care services using nurses, therapists, social workers, home care aides and medical equipment.
- If you need home care, your doctor will order the service. Talk with your doctor if you think this may help you.
- Find the cost for a home care visit on the Surest app by searching "home health service," then scrolling to the bottom and selecting location to find in-network agencies.
Acupuncture
Acupuncture applies needles, heat, pressure and other treatments to specific places on the skin, called acupoints. This can help control symptoms such as pain, fatigue, nausea or vomiting. The price for an acupuncture visit can be found on the Surest app by searching “acupuncture” or a provider name.
Palliative care
Palliative care can improve quality of life if you have a serious or life-threatening disease, such as cancer. Palliative care addresses symptoms and side effects of the disease and treatment, as well as any related psychological, social or spiritual problems. To find the price for palliative care on the Surest app, search “palliative care.” Palliative care does not include respite care or hospice services. Contact the Surest clinical team for help accessing those services.
Support for stress, anxiety and uncertainty
A cancer diagnosis often affects the emotional health of patients, families and caregivers. You are not alone. One in three people with cancer experience mental or emotional distress.
- You have benefits for both in-person and telehealth mental health care. Look on the Surest app more specific costs or reach out to our Surest clinical team.
Resources you may find helpful
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This content is not medical advice. You should always consult with your health care professional.