Be wary of results before rushing in

JEFF Hoober has a message for men having PSA tests done: Get a second and third opinion before embarking on biopsies and treatment.
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The 69-year-old Maryborough man says surgery to remove his prostate five years ago left him impotent, partly incontinent and angry about the way he was treated.

He said a rising PSA reading around four caused him to have a biopsy, which diagnosed cancer with a Gleason score of six. This led doctors to recommend surgery without a full explanation of the risks.

''My urologist did not provide me with any proper counselling,'' Mr Hoober said. ''It wasn't stressed to me that the chance of nerves being damaged was greater than them not being damaged.''

In a terrible chain of events, Mr Hoober says he was told after the surgery that he did not have cancer after all.

''I couldn't believe it, it was devastating,'' he said.

While urologists say Mr Hoober's experience is very rare, they acknowledged Gleason scores can change between biopsy and pathology tests after the prostate has been removed, giving men a different estimate of how aggressive their cancer is likely to be. This level of accuracy depends on the pathologists' experience, they said.

While urologists said a man like Mr Hoober would be advised to take a surveillance approach with the knowledge they have today, he suspects some surgeons are too eager to operate.

''It begs the question of how the urologists' income has been going. I bet there's been an enormous increase in surgery since Sam Newman went public.''

Mr Hoober said he had mixed feelings about testing now and felt biopsies put men in a difficult position.

''We're so shit scared when we hear the word cancer. All you can think of is I need to get this out of my body,'' he said.Rather the risk than suffering a painful death

PROSTATE cancer has been an unfortunate family affair for Mark Sheehan who says testing and treatment will probably save his life.

All of the school principal's brothers, including AFL talent manager Kevin Sheehan, have been diagnosed with prostate cancer in recent years at ages 60, 61 and 63.

All of them had Gleason scores indicating high-risk cancer.

Mr Sheehan, 57, has suffered the same fate. Having been diagnosed with a high Gleason score of seven recently, he is now preparing to follow his brothers, who all had their prostates removed after a similar diagnosis.

While debate rages about the accuracy of testing and the damaging side effects of treatment, Mr Sheehan said he would much rather have his prostate removed and live with the risk of side effects from surgery than die the slow and painful death he heard stories about when he was growing up.

''If I had a lower Gleason score, I wouldn't be lining up for surgery and I would be keeping a watching brief. I can't say I'm gladly looking forward to August 15 [his surgery date], but I have to trust my GP and surgeon,'' he said.

''I also have the experience of my brothers who are are all out in the community and dry, so to speak. They are all living full lives and not dragging their feet around.''

Despite suggestions prostate cancer management has been influenced by commercial interests, Mr Sheehan said he felt as though he had adequate counselling at the Epworth Hospital to decide on robotic surgery at the private hospital.

''It's very personal, it will be different for everyone, but I feel medically very well informed,'' he said.

Mr Sheehan believes his family's experience of prostate cancer showed PSA testing was still valuable for picking up high-risk cancers early.

His recent diagnosis has caused him to urge men over 50 to take an annual test.

''Early detection and treatment are essential,'' he said.

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Swan songs and the quest for boomer cred in the heart of the Boss’ fan belt

WHAT DID Bruce Springsteen ever do to deserve this? Even Paul Keating had the decency to choose a composer already dead, Gustav Mahler, with whom to parade his cultural pretensions.
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But the unfortunate Springsteen is alive and due to tour Australia next year, his every concert burdened now with the knowledge that his most publicly ardent local fan is … oh, dear … Wayne Swan, federal Treasurer.

Swan, of course, is hardly the first politician to try to steal baby boomer cred from Springsteen, the lyrical, visionary and endlessly high-energy rock performer from New Jersey.

The Boss, as Springsteen is known, is 62, and he tends to cause middle-aged male politicians of all stripes to behave like schoolgirls confronted with Justin Bieber.

The Republican Governor of New Jersey, Chris Christie, has attended 126 Springsteen concerts and claims to know every word to every Springsteen song, despite the rock star refusing to even meet him.

It was national news in the US when Christie appeared to fall asleep at one of those concerts earlier this year, leading the Governor to angrily deny any such thing. He was enjoying, he said, ''a spiritual moment''.

The Democrat Governor of Maryland, Martin O'Malley, declares that Springsteen ''has been the soundtrack of my life'' and is much given to quoting his lyrics in speeches.

Even a former president, Ronald Reagan - possibly unaware that Springsteen could not stand his politics - declared in a 1984 election campaign speech that ''America's future rests in a thousand dreams inside your hearts. It rests in the message of hope in songs so many young Americans admire: New Jersey's own Bruce Springsteen.''

But Wayne Swan, 58, has very nearly outdone them all.

Not content with merely crafting his John Button Lecture as a form of fanzine (''the Boss was and remains my musical hero. And not just mine. He's the favourite musician of the Prime Minister.''), Swan released his own YouTube video to prove his devotee status.

There was Wayne in Eric Clapton T-shirt flicking through his Springsteen world tour '96 souvenir pamphlet, Wayne displaying his Springsteen record collection, a shot of his ''Springsteen Live at the Nassau Coliseum'' poster from 1980 (tickets: $12); Wayne flicking through speech notes while nodding to the beat of Born to Run; Wayne in shirt sleeves and tie trawling through Treasury papers with the soundtrack cranked to full blast; Wayne grooving to his son playing guitar and his daughter singing Dancing in the Dark.

And, mercy! A shot of Wayne as a long-haired university student from the early 1970s, complete with moustache. Weirdly, he's wearing a suit and tie. Born to run … for preselection.

Around the time that photograph was taken, the American music critic Jon Landau was about to create an enduring legend. ''I saw my rock'n'roll past flash before my eyes,'' he wrote of a concert he had attended. ''I saw something else: I saw rock'n'roll's future, and its name is Bruce Springsteen.''

Wayne Swan, pretty clearly, has seen his future flash before his eyes and, not wishing to give such a hideous vision a name, he is determined hope lies in the past, its name, Bruce Springsteen.

You would just about forgive the Boss if he tried to limit the damage by introducing his Australian concerts with a tune for Wayne - the cutting old Beatles song, Taxman:

''If you drive a car, I'll tax the street/If you try to sit, I'll tax your seat/If you get too cold I'll tax the heat/If you take a walk, I'll tax your feet.''

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Opposition sour notes on Springsteen as hero

THE opposition ridiculed Wayne Swan for invoking his hero Bruce Springsteen as he renewed his attack on mining billionaires, while Clive Palmer, one of the Treasurer's targets, took aim at his lack of musical patriotism.
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''It says everything about this government that it is guided by the principles of a rock singer, rather than any enduring philosophy that builds a stronger nation,'' shadow treasurer Joe Hockey said.

Describing Mr Swan's John Button lecture as a ''look-at-me speech'', he said: ''You have got the clown trying to run the circus.'' He said he saw rock music as entertainment, not ''as the benchmark of guiding principles for the destiny of a nation''. He was inspired by the likes of Adam Smith, John Stuart Mill or a Robert Menzies.

If Springsteen was the right benchmark ''then we might as well have Glenn A. Baker and Molly Meldrum running the country - and they would do a far better job than the current mob'', Mr Hockey said.

Mr Swan said in his speech - which cast Springsteen as a working class hero who had influenced him from the 1970s - that the only regret he had about his attacks in his Monthly essay on Mr Palmer, Gina Rinehart and Andrew Forrest was that he had not gone harder. In the essay he accused them of seeking to buy excessive influence in their own self-interest - he now says their subsequent actions have borne him out.

Opposition Leader Tony Abbott said he was ''not here to defend billionaires, billionaires can defend themselves''. ''What's important, though, is that the Treasurer's words attack billionaires but his policies attack middle Australian families.''

Mr Palmer tweeted that it was ''unpatriotic'' of Mr Swan to be quoting songs from a millionaire US rock star. ''I prefer Oz groups like Redgum and the Seekers.''

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Indonesians innocent of people smuggling

FREEDOM came and went in the blink of an eye yesterday for two Indonesians who have been incarcerated for the last 21 months, after a jury took less than five hours to find them not guilty of aggravated people smuggling.
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As soon as they had been escorted from the County Court into the sunshine of William Street, they were whisked into a van and taken to the Maribyrnong Immigration Detention Centre to await deportation.

The news was conveyed by Victoria Legal Aid's Sarah Westwood by phone to the remote village of Itterung in South Sulawesi, where the elder son of Sore, one of the accused, expressed the hope his father might be home in time for Eid al-Fitr, the holiday to mark the end of the Islamic month of Ramadan.

''They are the victims, not the perpetrators, and I'm pleased that the jury understood that,'' said Carolene Gwynn, the barrister who represented Sore, 42, a widower and farm worker who left school after grade five.

The pair are the first of 48 Indonesian boat crew to be tried in Victoria this year for aggravated people smuggling - an offence that carries a mandatory five-year prison term for those found guilty.

''This is a verdict that keeps our faith in the jury system,'' said Michael Cahill, who represented the younger accused, 24-year-old Rustam, whose only possessions were the jeans and T-shirt he was wearing when the boat was intercepted in November 2010 - and whose formal education ended in grade two.

It is also a verdict that raised questions about the costs of charging those with minor roles in transporting asylum seekers to Australia - and whether it is a help or a hindrance in bringing the ''Mr Bigs'' of people smuggling to justice and reducing the risk of deaths at sea.

More than 140 Indonesians are being prosecuted across Australia and 198 are serving prison terms after being convicted in other states. To prove guilt, the Crown must demonstrate beyond reasonable doubt that they knew their intended destination was Australia and that their passengers might not have a lawful right to enter the country.

Both men were described by their lawyers as members of a people smuggling ''B-team'', who were kept in the dark about their destination and left to care for the 59 passengers and face arrest when members of the ''A-team'' left after fixing the engine during the journey.

In an interview that was not admissible as evidence, Rustam had told immigration officials on Christmas Island that he thought their destination was an ''island'', and that he believed the trip was ''halal'', or legitimate, Mr Cahill said.

The pair's first reaction to the verdict was one of bewilderment, which later gave way to tears.

Ms Gwynn said she spent more than four hours trying to explain how the trial would unfold to Sore before it began a fortnight ago, but that both of the accused struggled to follow what was happening throughout.

Aside from the language barrier - and the fact there is no Indonesian word for ''jury'' - they were fasting for Ramadan and struggling with the cold, which made listening to the interpreter more difficult, she said.

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Dean Lotz, as Francois, gives a nuanced performance in a difficult role.FEW anti-heroes in cinema are as off-putting yet pitiful as Francois (Deon Lotz), the middle-aged sawmill owner at the centre of this second feature from the young South African director Oliver Hermanus.
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Married and outwardly conservative, Francois leads a double life that involves meeting up in a secret rural location for sex with other men.

None of these men identify as gay; on the contrary, open homosexuals are strictly excluded from proceedings, along with non-whites.

Beauty plays no part in these mechanical orgies, bluntly filmed by Hermanus in a way that suggests a parallel with the glimpses we get of Francois' business with its mainly black employees.

Lonely and isolated, Francois seems caught in a trap of his own making, while his wife (Michelle Scott) has found her own way of coping with a sexless marriage.

New possibilities come into focus when Francois discovers his ideal love object in the son of an old friend: Christian (Charlie Keegan), a handsome law student and part-time model. Eventually, Francois follows the younger man to Cape Town, where his obsession gets out of hand with disastrous consequences.

As a study of how repression and hypocrisy can lead to madness, the film has a universal meaning. But it also paints a picture of South Africa as a land where all the old prejudices are alive and well, whether they relate to class, race, sexuality or gender.

Hope lies with the free-spirited Christian and his ability to step across boundaries, which the film associates with the post-apartheid generation in general (it hardly matters if the character is gay or straight).

Lotz gives a nuanced performance in a very difficult role, and Hermanus is plainly a talented director. He uses point-of-view shots with careful economy, keeping us ''inside'' Francois' perspective while still letting us see his character as puzzling and alien.

Equal attention is given to the lighting. Many of the interior scenes are deliberately drab: when Francois arrives at his Cape Town hotel room and lets the sun shine through a window, there's an instant sense of relief.

For all its assurance, Beauty is not an enjoyable film to watch.

The schematic story offers limited rewards in terms of ideas, and some viewers will consider the gruelling climax too high a price to pay.

Still, if Hermanus can maintain his steady gaze at unpleasant realities, he has an interesting career ahead.

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