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Prostheses (Prosthetics)
In cancer care, implants and prostheses (also known as prosthetics) play a crucial role in helping people recover and maintain their quality of life.
What is a prosthesis?
A prosthesis is the general term for a device, implant, or other item that replaces a body part or function. This can also include other items like ostomy supplies, catheters, and even wigs.
Other terms to know:
- The plural of prosthesis is prostheses.
- You might also hear these called prosthetics.
- Prostheses that are surgically placed inside the body are known as implants.
Why do some people with cancer get a prosthesis?
Sometimes, a person gets a prosthesis because a part of their body is removed to treat or prevent cancer. A person might also get a prosthesis when a body part is still there but doesn’t look or function the same way as it did before.
Surgeries for cancer treatment
Many types of cancer surgery require removing one or more parts of the body because cancer is there. Some examples include:
- Mastectomy (one or both breasts)
- Prostatectomy (all or part of the prostate)
- Laryngectomy (all or part of the larynx — voice box)
Surgeries for cancer prevention
Some people choose to proactively have a body part removed to prevent cancer from developing. For example, someone who is very high risk for breast cancer might choose to have a prophylactic double mastectomy (to preventatively remove both breasts).
Certain side effects of cancer treatment
Side effects like hair loss (alopecia) can be especially traumatic for many people. Wigs and other hair pieces are sometimes called cranial prostheses.
People often choose to get prostheses to help them function better, physically or emotionally. Many people find that a good prosthesis helps with both.
Does insurance cover prosthetics for cancer?
Many insurance plans cover some or all of the cost of a prosthesis.
The Affordable Care Act (ACA) requires all small group insurance plans to cover essential benefits, including prosthetics. But in reality, insurance coverage varies depending on what insurance plan you have and what prostheses you need.
If and how much of the cost is actually covered often depends on whether or not the prosthesis is considered “medically necessary.” There isn’t a standard definition of what is medically necessary, so coverage varies among insurance providers.
Medicare Part B
Most prosthetics that replace a body part or function are covered under Medicare Part B as Durable Medical Equipment (DME). However, if they aren’t considered medically necessary, they might not be covered. (For example, Medicare doesn’t consider cranial prostheses (wigs) for hair loss to be medically necessary.)
Prostheses related to a mastectomy
Prostheses related to a mastectomy are required to be covered by commercial insurance under the Women’s Health and Cancer Rights Act. This includes people who have prophylactic mastectomies to prevent cancer.
Maximizing insurance coverage for your prosthesis
If you are looking into insurance coverage for a prosthesis, there are a few ways you can increase your chances of being approved and getting the maximum benefit possible.
Talk to an insurance representative beforehand
It's a good idea to talk to someone at your insurance company before you get your prosthesis. Knowing certain information ahead of time can speed up the process and help you make the most of your benefits.
Here are some questions to ask your insurance provider:
- Do you require pre-authorization or pre-approval?
- What information or documentation do you need for approval?
- Is there any specific terminology the doctor should include?
- If approved, how much do you cover?
- Do you cover a certain number of prostheses or supplies per year or lifetime?
- Are there any requirements about the type of prosthesis I can get? (For example, Medicare plans only cover prosthetics and supplies from a Medicare-enrolled supplier.)
Check your current policy status
Consider any remaining deductibles, coinsurance, and coverage limitations or caps. These can increase or decrease your final out-of-pocket expenses.
Learn more about managing insurance and cancer-related expenses.
Communicate with a prosthetist
If you’re working with a prosthetist, give them as much information as possible about your insurance coverage. They might be able to recommend certain prosthetics that meet your needs while keeping your out-of-pocket-costs as low as possible.
Types of prostheses
There are many different types of prostheses. Some are worn on the outside of the body and can be put on and taken off (such as a breast form or leg prosthetic). Others are internal and often placed surgically (such as implants in the breast or penis).
Breast implants are placed inside your body, with surgery. A breast prosthesis (or breast form) is worn outside your body.
Whether you use a breast prosthesis or an implant will depend on the type of breast surgery you have, other cancer treatments you might need, the risks and benefits of each, and your own personal preferences.
Breast implants
- Your surgeon might place your implant during the initial surgery to remove your breast cancer. Or it might be placed during a separate surgery.
- Breast implants come in different shapes and sizes. They are made of either silicone gel or saline water. Many people prefer silicone implants because they feel softer and more natural.
Breast prostheses
A breast prosthesis (or breast form) is placed and worn inside a bra or other support garment. They are often made of silicone, foam, or cotton. Here are some tips when choosing and getting fitted for a breast prosthesis:
- If you’ve had a smaller portion of your breast tissue removed, small prostheses (equalizers) are also available.
- Nipple prostheses can be added during surgery when the nipple can’t be saved. Breast forms are available with and without nipples.
- Wear a fitted top when you shop for a prosthesis so you can see how it looks when you move.
- Try different options. Prostheses vary in shape, weight, and consistency. Ask about custom options if needed.
- Prostheses may feel heavy, but a good prosthesis should stay in place and feel comfortable when you move. It should also look and feel similar to your natural shape.
- Some breast prothesis have an air pump so you can adjust the size to your preference.
- Make your breast prothesis last as long as possible. Follow directions for cleaning. Body oils and sweat can wear out the materials.
Learn more about breast implants, prostheses, and options for reconstruction.
Some cancer treatments can cause temporary or permanent hair loss (alopecia). Wigs and certain hair pieces used for medical-induced hair loss are called cranial prostheses. This means they might be partially or fully covered by your insurance.
Ask your insurance company what documents are needed to approve your cranial prosthetic. This might include a letter or prescription from your doctor. If you’ve already paid out-of-pocket, you might be able to submit for reimbursement.
Learn about hair loss and wigs.
Treatment for head and neck cancer almost always includes some type of surgery to remove the tumor and sometimes the area around it. Many of these surgeries result in changes to how different parts of your face look or function.
Reconstructive surgeries might use a prosthesis or implant to help with appearance, chewing and swallowing, speaking, or smelling. Prosthetic specialists work with your surgeon to make custom prostheses and implants based on the size and shape of the part that’s removed.
Learn more:
Certain types of cancer require removing the eye (called enucleation). This is often part of cancer treatment for ocular (eye) cancers, such as ocular melanoma, ocular lymphoma, and retinoblastoma. In these cases, you might be offered an artificial eye (ocular prosthesis or implant).
Artificial eyes are usually made of silicone or hydroxyapatite (a bone-like material). An ocularist is a doctor who specializes in eye prostheses. They work with you and your cancer care team to find the best option. Prosthetics can be custom-made to match your eye size and color.
Prosthetic techniques have come a long way. It’s often difficult or impossible to tell a prosthetic apart from a natural eye. Certain surgeries allow the surgeon to attach the prosthetic eye to your eye muscles, so it even moves the same way as your natural eye did.
Learn more:
Physical and activity limits are the most significant changes most people deal with after amputation (surgery to remove part or all of a limb). Before surgery that will affect a limb (arm, leg, foot, or hand), ask about prosthesis options, risks, benefits, and how your prosthesis will be fitted.
- Sometimes a bone implant is attached to an external prosthesis.
- Targeted muscle reinnervation (TMR) might also be used. This helps make the prosthesis more stable and easier to control.
- Depending on the limb affected and how much needs to be removed, a temporary limb prosthesis might be fitted during the first surgery and a permanent prosthesis can be fitted after you are stronger.
- Be sure you know how to care for the surgical site and the prosthesis.
Learn more: Amputee Coalition has local resources and information about limb prostheses.
You might choose to get a penile implant (internal) or use a penile prosthesis (external) after surgery for penile or prostate cancer, or if other cancers or cancer treatments affect your ability to have an erection.
- Penile prostheses are external and worn outside the body. They are often attached with a strap.
- Penile implants are internal. They are placed after recovery from cancer surgery.
- You might want to discuss the possibility of a prosthesis or implant with your partner.
- Counseling sessions could help with making a decision.
- Different types, sizes, and shapes of penile prostheses and implants are available.
- Talk to your cancer care team and your partner about your options and what type is best for you.
- Talk to your insurance company about coverage.
Learn more: Sexuality for the Man With Cancer.
A testicular implant can be placed in your scrotum. This is done either during surgery to remove the testicle with cancer (orchiectomy), or in a separate surgery. Before surgery, talk to your cancer care team about whether you want a testicular implant.
Learn more: Sexuality for the Man With Cancer
Living with a prosthesis
Depending on the type of prosthesis, you might have follow-up care and appointments. It’s important to tell your health care team how you’re doing with your prosthesis. This includes any problems, concerns, or questions you might have.
Sometimes rehabilitation (rehab) or therapy is recommended for people with cancer who are learning to live with a new prosthesis. Rehab and therapy can improve your function, comfort, and quality of life. Examples are physical therapy, occupational therapy, or speech therapy.
Cancer rehab (or rehabilitation) is another example.
Cancer rehab is a supportive health care program that can help if you have physical or mental side effects caused by cancer or cancer treatment. This includes learning how to do daily activities with your new prosthesis. It also includes learning how to cope with both the physical and emotional effects of living with a prosthesis.
Learn more about cancer rehab.
- Written by
- References
The American Cancer Society medical and editorial content team
Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as editors and translators with extensive experience in medical writing.
Centers for Medicare and Medicaid Services. Medicare Coverage of Durable Medical Equipment & Other Devices. U.S. Department of Health & Human Services. January 2024. Accessed August 8, 2024. https://www.medicare.gov/media/publication/11045-medicare-coverage-of-dme-and-other-devices.pdf
Filis P, Varvarousis D, Ntritsos G, et al. Prosthetic reconstruction following resection of lower extremity bone neoplasms: A systematic review and meta-analysis. J Bone Oncol.36(100452):1-9. Accessed August 9, 2024. doi.org/10.1016/j.jbo.2022.100452
Haddad RI & Limaye S. Overview of approach to long-term survivors of head and neck cancer. In: UpToDate, Nekhlyudov, L (Ed), Wolters Kluwer. Accessed August 8, 2024.
Medicare.gov. Prosthetic Devices. Medicare.gov. Accessed August 2, 2024. https://www.medicare.gov/coverage/prosthetic-devices
Quadri MFA, Alamir AWH, John T, Nayeem M, Jessani A, Tadakamadla SK. Effect of prosthetic rehabilitation on oral health-related quality of life of patients with head and neck cancer: a systematic review. Transl Cancer Res. 2020;9(4):3107-3118. doi:10.21037/tcr.2019.12.48.
Last Revised: August 30, 2024
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