Professor Tony Costello (School Captain, OX 1966)



Interview conducted by Alexander Armstrong and Aidan Batten of Year 12

Do you have any advice for Xavier students thinking about a career in Medicine?
It depends on what your interest in Medicine is predicated on. The best motivation is to be attracted to the human side of things: a fantastic and noble profession with many different facets, where what you do is help people.

Can you share with us any reflections on your time at Xavier?
I enjoyed my time at Xavier, both in the classroom and on the sports field; football was my greatest love. I had some memorable teachers: Bernard Fitzpatrick who taught me Maths (and it was my Maths results that got me into Medicine). He was a wonderful man and it was lovely to maintain contact with him as his doctor, as I looked after him for the last ten years of his life. Joseph O’Dwyer, an English teacher and poet who stretched us to think. He challenged us each day to find a word in the dictionary he didn’t know; I owe my love of words to him. My Headmaster was Father Keenan, a gentle and decent man. He taught me to understand the phrase “noblesse oblige”. From him we knew that we had to give back in terms of leadership and service. Fourteen of the graduates in my Year 12 year
went on to do Medicine.

Why did you choose Medicine and what led to your choice of speciality?
My father was a GP and his practice was in our house, so I saw a lot. In those days before so much specialisation he did everything: anaesthetics, surgery etc. As an eight or nine year old I was helping him testing urine for sugar and protein! I am one of four of his sons who did Medicine, all Xaverians. Of course my father began to practise in the days before antibiotics, where one could still die with something like tonsillitis.

I was attracted to Urology because it was increasingly technologically driven; the use of cameras, lenses, lasers and so on. I went to the USA to train in cancer surgery and felt that this was the way to go, treatments were revolutionary. When I joined the teaching staff at the University of Melbourne, I completed a Doctoral Thesis in Laser Physics. With the application of robotics, there has been so much success in improving survival rates in prostate cancer. Such developments are very exciting: using a 3-D vision system, having the surgeon’s hand movements digitized and reproduced internally in the patient, who can now go home so much earlier.

Was it difficult introducing robotics to the world of traditional medicine?
It was a controversial development and gave rise to a lot of criticism of me at the start. New technologies meant that one had to re-learn. Now eleven years later, robotics is established in a very wide range of surgical applications, although things were very fraught early on.

Beyond prostate cancer what are the major issues facing men’s health?
Prostate cancer is the most common male cancer, the treatments are dynamic and have become much better over time. Men however are generally pathetic advocates for their own health care (unlike in women’s health care where there is such a profile for breast cancer and cervical cancer). You’ll notice that there is no Royal Men’s Hospital. A thousand more men die each year from prostate cancer than do women from breast cancer. And there are such important health issues for men: risk taking behaviour; depression; diabetes; alcohol; obesity; smoking.

What is the best preparation for a patient about to undergo surgery for prostate cancer?
I often say that the ideal patient is a marathon runner, i.e. someone in good health and with no obesity! At the outset somethings can’t be immediately addressed in thirty days: obesity and smoking for example. It is a fact that smoking increases complications in medical treatments by about 30%.

Do you think a boys’ school should be addressing these health issues early?
It is important to understand men’s health from the earliest days in school. For example the age range for testicular cancer is from 17 to 35, and boys need to be aware of that. Also to address obesity, nutrition, smoking, risk taking with alcohol (which is more common in boys and men) – all of these would be a good start. Boys need to know that you simply don’t get a lot of cancers if you don’t smoke.

What are the exciting developments of the future in your field?
We are now taking patients’ cancer cells and tailoring a specific therapy for that mutation. This is far more precise than the ‘blunderbuss’ of chemotherapy. In targeting the genes, we are developing more personalized and more precise cancer medicine.

Whom do you think of as the great role models of your school days?
I recall Bob Santamaria, a political activist with a real agenda for social inclusion. As a boy, I was always impressed by Archbishop Mannix. Of course there was my father and also those surgeons who trained me at St Vincent’s, London and the USA.

Do you still think of yourself as a Xavier boy?
My education at Xavier was very important to me, but I also think of myself within a bigger picture that involves Newman College and the University of Melbourne. I don’t think of myself as a Xavier boy, rather I think of myself as a proud Xavier alumnus.

As an Old Xaverian, what does the College still mean to you?
Xavier was a place where I learnt the importance of social inclusion; where I developed an awareness of injustices that can occur in society. I learnt this both from Xavier and from my family. It was an awareness of injustices that one then had to do something about.