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A word from the Principal Medical Adviser
How DVA handles claims of child abuse in the ADF
In June 2016, the Royal Commission into Insti-
tutional Responses to Child Sexual Abuse held a
public hearing to inquire into the experiences of
men and women who were sexually abused as chil-
dren in the ADF.
DVA has considered the issues raised. In assess-
ing claims, it will look at all the available evidence
and, depending on the particular circumstances,
can determine that an incident of abuse occurred
based on a statutory declaration alone.
How to make a claim
DVA takes the issue of abuse very seriously and has
put in place arrangements to make sure claims for
such abuse are managed with sensitivity.
DVA has a dedicated team that manages all new
claims relating to sexual and other forms of abuse.
Members of this team have been trained by Phoe-
nix Australia – Centre for Posttraumatic Mental
A social worker provides advice and acts as a sin-
gle point of contact between clients and claims
assessors, where this is the client’s preference.
Any survivor of child abuse in the ADF can
lodge a claim for compensation with DVA.
To apply for compensation, call 133 254 (or
1800 555 254 for regional callers).
More information is available on DVA’s website
How to get support
DVA’s priority is to provide immediate support to
abuse survivors and so has put in place arrange-
ments to make sure claims for such abuse are
managed with sensitivity.
Under a measure announced in the 2016–17
Budget, anyone who has served full-time in the
ADF, even for a single day, can access treatment for
post-traumatic stress disorder, depression, anxiety,
alcohol misuse and substance misuse, without hav-
ing to claim that the condition is related to service.
To access treatment, call on 133 254 or 1800 555 254
if you are in a regional area, or email firstname.lastname@example.org.
Support to abuse survivors is also available via
the Veterans and Veterans Families Counselling
Service (VVCS). VVCS provides specialist free, con-
fidential counselling, case management and group
programs to around 20,000 current and former ADF
members and their families each year.
VVCS is available at any time and any day of the
week to provide support on 1800 011 046.
Get good advice before having prostate cancer surgery
In recent months, I
have been contacted
by middle-aged vet-
erans worried about
the very common, life-
long implications of
their planned surgery
for prostate cancer.
These men were fit, well and sexually active and,
while wanting to be treated for their prostate cancer,
were very concerned about the risks of surgery, includ-
ing the almost unavoidable side effects of permanent
impotence and long-term urinary incontinence.
In every case, I asked the veteran whether they had
fully discussed all the treatment options with their
GP, and whether they had obtained an independent
second opinion from an appropriate specialist, such
as a radiation oncologist, who had no financial inter-
est in them having surgery.
Alarmingly, very few had been told of any treat-
ment options other than immediate surgery. And in
the rare case where the veteran had asked the uro-
logical surgeon to whom they’d been referred about
other options, such as localised radiation treatment,
they reported that they’d been told in effect that ‘if
you have radiation treatment then you won’t be able
to subsequently have surgery’. This statement is 100
per cent wrong!
In most men, prostate cancer is a very slow-growing
condition that is strongly associated with age. There
are many causes of prostate cancer including: certain
genetic factors such as the BRCA2 gene (the same
gene associated with breast cancer); family history;
alcohol consumption; smoking; obesity; high animal
fat consumption; and exposure to some chemicals
such as dioxins.
Many prostate cancers do not need active treat-
ment. In fact, ‘watchful waiting’ has five-year clinical
outcomes that are just as good as many active treat-
ments for men with cancer that remains within the
However, there are more aggressive prostate
cancers that definitely DO need active treatment.
Treatments can include: hormonal treatment (such
as androgen deprivation therapy); definitive external
beam radiotherapy; brachytherapy (locally implanted
‘seed’ pellets of radiation); and, of course, surgery for
the removal of the prostate.
But prior to embarking on any of these treatments,
I would strongly recommend that men and the peo-
ple who love them ensure they get advice from their
GP regarding all the options and that they get at
least two specialist opinions – including from a non-
surgical specialist. Only then will the veteran and his
partner be able to make a fully informed decision as
to what treatment (if any) is right for him at that time.
In addition to the issue of treatment is that of
diagnosis. The PSA blood test is a commonly used
method of detecting the possible presence of cancer
in the prostate. However, it is not entirely reliable. I
encourage you to discuss with your GP the various
additional means of diagnosing the condition. A mag-
netic resonance imaging (MRI) scan, for instance, is
an effective way of identifying whether and precisely
where cancer is present. This information can also be
of use for subsequent biopsies as well as treatments.
There are some excellent evidence-based internet
resources that may help veterans research all their
treatment options and ensure they ask the right
questions of their treating doctors.
Australian websites include: eviQ Cancer Treat-
ments Online (www.eviq.org.au). Full access to this
site requires free registration, and includes informa-
tion for treatment providers, patients and carers.
However, an excellent two-page pamphlet entitled
‘Prostate Cancer Treatment Options’ can be down-
loaded from this website without registration.
Another very good cancer information site is the
NSW Cancer Institute (www.cancerinstitute.org.au).
There’s also the Faculty of Radiation Oncology’s
‘Targeting Cancer’ website (www.targetingcancer.
com.au), which includes information about treatment
of a variety of cancers (including prostate) with radi-
ation. Most of the radiation oncology services in
Australia are provided through the public health sys-
tem, so there’s little direct financial benefit to these
See also the Prostate Cancer Foundation of Aus-
tralia website (www.prostate.org.au), which focuses
mainly on the surgical treatment of prostate cancer.
Finally, it may be difficult in some parts of Aus-
tralia to find treating specialists who will accept a
DVA Health Card as full payment for prostate cancer
treatment, so it is important to ask around. The fees
charged for prostate surgery in Australia vary from
about $3,500 to nearly $25,000! There is no evidence
that paying a higher fee will result in better surgery
or outcomes for prostate surgery.
It is critically important to find out well in advance
of any planned surgical treatment whether your
treatment provider will accept your DVA Health Card
as full payment for the proposed surgery, otherwise
you may be significantly out of pocket. DVA does
have limited scope to consider higher than usual fees
through our Prior Approval process, but this is rarely
necessary and dependent on there being additional
clinical needs that justify the higher fees.
The relevant form is D1328, which your treatment-
provider should complete and submit to DVA. They
can access it on the DVA website (www.dva.gov.au
and use the search engine).
DVA can also arrange free transport to the nearest
appropriate treatment provider if one isn’t available
to you locally.
In summary, prior to undergoing any major sur-
gery such as prostate cancer surgery, make sure that
you discuss fully with your treating doctors all of
the possible treatment options to identify the best
treatment for your needs. It is your right to ask for a
second specialist opinion – and make sure that the
person providing this opinion is completely inde-
pendent and has no direct financial interests in the
Prof Ian R Gardner
Principal Medical Adviser
Department of Veterans’ Affairs
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