Tacky Tim misleads men and offends everybody

Tim Mathieson sure put his foot in it at a state reception at the Lodge this week.  But the real victims weren’t asian women.

Tim Mathieson is Australia’s “First Bloke”.  As such, he gets to host official functions and receptions, and gets to make speeches of importance.  People listen to Tim … well, as much as anyone listens to politicians or their partners.

Tim is also the patron of the Australian Mens Shed Association, whose aims are to provide “a safe and friendly environment where men are able to work on meaningful projects at their own pace in their own time in the company of other men. A major objective is to advance the well-being and health of their male members.” [1]

So, as a prominent Aussie man who is looking to promote good health to other Aussie men, he tried to encourage what he thought was a good health habit in a jocular manner which men would understand.

He said, “We can get a blood test for it, but the digital examination is the only true way to get a correct reading on your prostate, and perhaps look for a small Asian, female doctor is probably the best way.” [2]

In making this statement, the Prime Minister’s partner was both ignorant and insensitive.

The Adelaide Now labelled him “tacky”.  Hmmm … perhaps.  He certainly wasn’t tactful.  I understand what he was trying to say.  I’ve often joked to colleagues that gynaecologists should have long skinny fingers.  Mr Mathieson’s comedic compass was pointed in a similar direction, but while asian females may have fingers of a smaller diameter, actually referring to them in his joke drew the attention away from the pun and pricked the most sensitive of subjects.

In the pub over a beer with your mates, joking about doctors with skinny fingers may have been a winner.  But for Tim, it simply highlighted the ridiculous standard for sexist remarks which the Prime Minister set when she redefined misogyny as simply disagreeing with women.  If the same benchmarks were used for Mr Mathieson’s remarks, the media should be all over him for being sexist (and probably racist too).

It also highlighted the absurdity and excessively authoritarian nature of Gillard’s proposed anti-discrimination laws which seeks to criminalise any speech which is considered by anyone to be offensive or insulting.   George Brandis may have been a little hysterical when he said Mr Mathieson would be taken to “a re-education camp by the thought police” if Gillard’s laws were in place.  But Mr Mathieson would certainly be sued or arrested if the precedent set by England’s equivalent law was followed here (where a man was arrested by UK police because he called a police horse “gay” – http://www.youtube.com/watch?v=gciegyiLYtY from about 1:10).

As the editorial in the Australian said today, “WHILE his partner Julia Gillard might not thank him for it, the man affectionately known as the first bloke has done the nation a great favour. Tim Mathieson’s tasteless joke – complete with mildly racial and sexist undertones – has exposed the cant of the Prime Minister’s misogynist campaign against Tony Abbott, and even underlined the absurdity of the government’s proposal to further impinge on free speech through new anti-discrimination laws.” [3]

I’m thankful Mr Mathieson’s statement did something, because it certainly wasn’t of any educational or health-promotional value.

Unfortunately, prostate cancer is an enigma.  There is a myth that is still perpetuated by the media and male role models trying to make a token promotion of mens health – that prostate exams save lots of lives.  The lay public believe that prostate exams are the equivalent of pap smears for women.  In actual fact, they are poles apart.

Pap smears are the best screening test in the history of medicine.  Women hate them and I can understand why.  But as far as the accuracy, cost and effectiveness of the test goes, the pap smear is the gold standard for disease prevention through early detection.

Compared to pap smears, prostate testing in its current form is like an inbred third cousin.  Even combining both the PSA (the “prostate blood test”) and the infamous digital rectal examination does not improve the early detection rate or survivability of prostate cancer.

From the “Red Book”, which is the official guidelines for preventative activity in General Practice in Australia, published by the Royal Australian College of General Practitioners:

“Routine screening for prostate cancer with DRE, PSA or transabdominal ultrasound is not recommended.  DRE has poor ability to detect prostate disease.”
and
“Even if we were to conclude there was a survival benefit (from current or future trial data), this survival would need to be balanced against the harms of cancer overdetection and treatment.” [4]

In other words, not only is screening for prostate cancer pointless, but it is also potential harmful.

Men whose lives “were saved” by prostate screening, and whose stories are published by the media to further perpetuate the heroic prostate screening myth, were either really lucky, or whose prostate cancer was never destined to be fatal.  Prostate cancer seems to be either slow and indolent, and eminently non-lethal, or so aggressive that it becomes untreatable before symptoms become apparent and screening can detect it.

Rather than our political leaders and mens health advocates pushing men into unnecessary and potentially harmful screening tests, they should be lobbying the government to fund research into better methods of detection, or better treatments to better manage even the most aggressive prostate cancers.  That is the only way the survival rate from prostate cancer will improve.

Tim Mathieson sure put his foot in it at a state reception at the Lodge this week.  To asian females, sure.  But when he failed to check his facts, and then missed the opportunity to lobby for better health for future Australian men, that was the real tragedy.

[1] http://www.mensshed.org/what-is-a-men’s-shed/.aspx

[2] http://www.adelaidenow.com.au/tim-was-tacky-but-was-he-offensive/story-e6frea6u-1226564538077

[3] http://www.theaustralian.com.au/opinion/editorials/ask-not-who-points-the-finger-as-it-points-at-you/story-e6frg71x-1226564558412

[4] http://www.racgp.org.au/download/Documents/Guidelines/Redbook8/redbook8.pdf p72

POST SCRIPT: I understand that my discussion on prostate screening may be confusing for some people, and may seem to be contrary to advice that you have have previously received or have heard of.  Ultimately, the question of whether a man is screened or not screened for prostate cancer is between him and his doctor.  If you wish to proceed with prostate screening, or if you have any questions, the best place to start is your GP.  Find out about the risks of prostate screening as well as the potential benefits.  If you decide you want to go ahead, I would recommend both a blood test AND a rectal examination.  Tacking a PSA to some other blood tests is not adequate screening.

It should also be noted that screening of healthy men without symptoms is different to testing for cancer in men who believe that they have symptoms.  Symptoms of prostate cancer include:

  • Difficulties starting and stopping urination
  • Pain or a burning sensation when passing urine
  • Urinating more often than usual, particularly at night
  • The feeling that the bladder can’t be fully emptied
  • Dribbling urine
  • Blood in the urine or semen
  • Pain during ejaculation.

Unfortunately, all of these symptoms can be caused by conditions other than prostate cancer.  Or prostate cancer may have no symptoms at all.  But if you believe that you have symptoms of prostate cancer, or you are not sure, then you should see your GP as soon as you can.

For more information on prostate cancer: http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Prostate_cancer

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