A Growing Burden
More than 14 million people struggle with cancer every year, and according to the World Cancer Research Fund International (WCRF), that burden is growing. Researchers with the WCRF estimate that by 2025 cancer cases will reach 25 million – a figure that highlights the importance of getting the best cancer care possible.
However, oncologic diagnosis, support and treatment isn't cheap. The British cancer support group Macmillan estimates that most people will lose more than £500 per month during their fight with cancer due to both increased medical expenses as well as lost productivity at work. Some researchers have even developed a new statistical tool to measure the financial toxicity of cancer, demonstrating that those in the health care industry recognize the serious effect cancer can have upon a patient's fiscal livelihood.
The high cost of cancer to both health and finances highlights the importance of finding good, affordable care following a cancer diagnosis. Prostate cancer is the second most common cancer in men around the world and the leading cancer in men from the United Kingdom, Australia, New Zealand and Canada – some of the most represented nationalities within Hong Kong's expatriate community. What are the prostate cancer treatment options for expats in Hong Kong, and is it better to seek diagnostic and curative care abroad or back home?
If a man suspects he may have prostate cancer (noticing symptoms such as erectile dysfunction, blood in his urine and trouble urinating as normal), the first step will be a visit with a urologist or general practitioner, and to take a prostate-specific antigen (PSA) test. During this screening, blood is drawn from the patient and tested for PSA – an antibody produced by the prostate when cancer is present. In both Hong Kong and abroad, a PSA test is normally inexpensive and sometimes provided for free by health care practices or organizations such as the Hong Kong Cancer Fund.
However, discovery of PSA in a patient's blood does not prove definitively that prostate cancer has developed; more tests are needed. Following a high-PSA screening, the patient will normally attend a consultation with a urologist to understand his choices regarding follow up tests and care; then, the doctor will schedule a more accurate screening process to determine whether or not the patient does have prostate cancer. A post-PSA test consultation does cost money: in Hong Kong, it is normal to pay HK$1,600 to HK$2,000 (£121 to £152) to speak with a urologist about the test and future options following a screening that has revealed high PSA levels in the blood.
In the United Kingdom, a follow-up consultation is usually combined with further tests; for example, a urologist consultation along with a trans-rectal prostate ultrasound and biopsy (intended to provide detailed imaging of the prostate as well as extract a physical sample of the prostate gland to be examined) can be expected to cost £800 (HK$10,550). The cost of a biopsy alone in a private British hospital runs nearly £400 (HK$5,275), and a magnetic resonance imaging (MRI) scan separate from a biopsy normally costs just over £700 (HK$9,231).
Although the price of an initial prostate consultation in Hong Kong appears far cheaper than that at a UK clinic, further diagnostic care in Hong Kong comes at cost. Private urologists in Hong Kong typically charge HK$35,000 (£2,654) for a trans-rectal prostate biopsy, and around HK$15,000 (£1,137) for a diagnostic MRI scan of the prostate.
Location Location Location
Breaking down the prices, it's clear that private urology diagnosis and treatment for prostate cancer can be more expensive in Hong Kong than in the United Kingdom. Why the cost differential? Hong Kong's private medical sector is comprised of health care professionals, many expats themselves, with a high degree of education, training and experience, meaning that patients eager to seek their advice and care are willing to pay accordingly. Furthermore, private clinics in Hong Kong are generally outfitted with cutting edge medical technology – equipment that offers powerful and quick results, but will incur a higher price for patients.
In both Britain and Hong Kong, prices between doctors and their medical practices may vary. Before choosing a doctor and course of treatment, research into a clinic's policies, procedures, costs and references is recommended. Prostate cancer is extremely common, but luckily, it is curable. Surgery, radiology and hormone therapy are all treatment options, and most prostate cancer patients enjoy a 15-year (or longer) recovery survival rate. Early detection is key, as is finding the right doctor who can provide information and medical assistance, and expats should explore all options before settling on a preferred course of diagnosis and treatment.