This Medical Life

One in 10 Australians over the age of 18 years are living with signs of Chronic Kidney Disease (CKD) with the number of patients needing treatment for kidney failure has doubled in the last 20 years. Early detection and intervention can slow the progression of CKD by up to 15 years or longer. Our understanding of kidney disease can be traced back to Dr Richard Bright, one of the founding fathers of nephrology. He noted that heating a patient’s urine with kidney disease could form a precipitate – nowadays we’d call this albuminuria (albumin in the urine) and it is a marker of kidney damage. Today, there are a range of conditions that can reduce kidney function, cause kidney damage, and can cause significant morbidity and early mortality in patients. By screening patients, we can reduce the progression of CKD and significantly affect the health of patients in the long term. This is the story of Chronic Kidney Disease (Part 1). Our special guests: Maddie Williams who is a Registered Nurse with Kidney Health Australia who was diagnosed with kidney disease at the age of 17 requiring haemodialysis, peritoneal dialysis, and received a renal transplant. Dr Richard Phoon who is the Senior Medical Advisor at Westmead Hospital and has worked full-time as a Nephrologist at Westmead and Blacktown Hospitals since 2007. Useful links: CKD Management in Primary Care handbook (KHA) Link: https://kidney.org.au/health-professionals/ckd-management-handbook Kidney Health 4 Life: Kidney Health 4 Life – Better kidney health, for life Health professional webinar here: Kidney Health 4 Life Healthcare Professional Webinar – YouTube For health professionals looking for printed posters and brochures for their clinic or unit: Kidney Health 4 Life Print Materials Or contact the Kidney Health Australia Helpline on 1800 454 363 Listen: This Medical Life podcast is available on all podcasting services and Spotify. Help support us on our donation page.See omnystudio.com/listener for privacy information.

The statistics of Intimate Partner Violence (IPV) and Domestic Violence prevalence are staggering. 1 in 6 adult women and 1 in 16 adult men have experience physical or sexual abuse at the hands of their partner. Approximately 2.5 million Australians (13%) experienced abuse during their childhood. However, IPV is a topic that is rarely discussed. As healthcare professionals, we need to change this. A recent study by our guests on this episode, Timelines of psychological, physical and sexual intimate partner violence among a nationally representative sample of Australian women, studied the timeline of psychological, physical, and sexual intimate partner violence. They highlighted that early warning signs of an abusive partner include isolation, controlling behaviour, and intense jealously. We discuss these important findings and other take home messages of this study and how we can apply it to everyday practice. This is the story about intimate partner violence. Our special guests: Dr Elizabeth McLindon is a Research Fellow in the Department of General Practice and works in the Sexual Abuse and Family Violence (SAFE) program. Elizabeth is the Deputy Director of the Centre for Family Violence Prevention at the Royal Women’s Hospital in Melbourne. Professor Kelsey Hegarty is an academic general practitioner who holds the joint Chair in Family Violence Prevention at the University of Melbourne and the Royal Women’s Hospital. She also leads the Safer Families Centre. Listen: This Medical Life podcast is available on all podcasting services and Spotify. Help support us on our donation page.See omnystudio.com/listener for privacy information.

Oral cancer was a fatal disease even into the twentieth century. Patients required extensive surgery and often had a painful recovery or went into palliative care but the result was the same. Modern medicine has thankfully provided much to our understanding, the treatment and management of patients with oral cancer. In recent times, patients have been able to be stratified into two general but distinct categories: the first are older with a strong history of heavy smoking and/or alcohol use; the second are younger and have a history of multiple sexual partners. The distinction is important as the treatment and management are different between the two groups with the second group having a much better prognosis. This is the story of oral cancer. Our special guests: Dr Rebecca Morrow is an anatomical pathologist and deputy head of department at the Royal Adelaide Hospital with SA Pathology. Dr Rowan Valentine is a paediatric and adult Ear, Nose and Throat Surgeon. Listen: This Medical Life podcast is available on all podcasting services and Spotify. Help support us on our donation page.See omnystudio.com/listener for privacy information.

The first medical description of pernicious anaemia is from 1821. It is written by Dr James Combe and describes a previously well 47 year old corn-merchant who presented with pallor, weakness, and neurological symptoms. It would take over a hundred years before we would know how to treat this condition, and another decade after that to understand why the treatment worked. Vitamin B12 is an essential component of our diet and only found in animal products. Deficiency in vitamin B12 can present with fatigue, anaemia (macrocytic), and neurological symptoms. The most at risk from a dietary perspective are vegetarians, vegans, and the elderly. Patients may also have an autoimmune condition (pernicious anaemia) that interferes with gastric parietal cells and intrinsic factor; the way our body can absorb vitamin B12 from our diet. This is the story of vitamin B12. Our special guest: Our special guest is Professor Ken Sikaris who is a chemical pathologist and Director of Chemical Pathology at Dorevitch Pathology.See omnystudio.com/listener for privacy information.

One of the most difficult cancers to detect early has been lung cancer. Patients often present with advanced disease that and can often be fatal. In April 2025, a new National Lung Cancer Screening program has been rolled out in Australia to detect asymptomatic patients with a significant smoking history (30 Pack-Year). Suitable patients are eligible for a free low-dose CT (computer tomography) scan on their lungs to identify any potential lesions suspicious for cancer. This is the story of lung cancer screening. Our special guests: A/Professor Nicole Rankin is Head of the Evaluation and Implementation Science Unit in Melbourne School of Population and Global Health (University of Melbourne) and led the team that developed the Australian National Lung Cancer Screening Program Guidelines. Dr Julie Teague is an Anatomical Pathologist with an interest in thoracic and gastrointestinal pathology.See omnystudio.com/listener for privacy information.

In 1966, the Chief of Urology asked the Chief of Pathology at the Minneapolis VA Hospital to develop a system to communicate the results of prostate cancer to researchers. The Chief of Pathology was Donald Gleason and he developed a system that would revolutionise our understanding of prostate cancer. Today, every prostate cancer worldwide is classified using the Gleason score, named after Donald Gleason. Prostate cancer is one of the most common cancers worldwide and accounts for 15% of all male cancers. Its incidence of prostate cancer is estimated to double by 2040. This is the story of prostate cancer. Our special guests: Professor Fiona Maclean is a Clinical Professor, Anatomical Pathologist, author, past President of the Australasian Division of the International Academy of Pathology (IAP), and advisor in Pathology Artificial Intelligence. Dr Joanna Olphert is a urologist and robotic surgeon involved in genitourinary reconstructive surgery, robotic uro-oncology, and open complex peritoneal surgery. Dr Carole Harris is a medical oncologist, senior lecturer, and senior research fellow.See omnystudio.com/listener for privacy information.

Over the last 100 years, numerous types of implants (i.e. ivory, glass, wool) and injections (i.e. epoxy resin, beeswax, paraffin) have been used in an attempt for breast augmentation but the results were poor. In 1962, the first operation using silicone implants was performed and it revolutionised breast surgery. Breast augmentation surgery (cosmetic and reconstructive) is one of the most common cosmetic surgeries in Australia, United States, and the United Kingdom. As one of the most common cosmetic surgeries, it is important for doctors and patients to know about the risks and myths of this procedure. In this episode, we discuss breast augmentation surgery and our discussion includes common complications, risks, and breast implantation illness. This is the story of breast augmentation Our special guest: Our special guest is plastic surgeon Dr Andrew Campbell-Lloyd from ACL Plastic surgery in Adelaide.See omnystudio.com/listener for privacy information.

The interplay between genetics and medications is important but complex. Pharmacogenomic testing provides doctors with information about how individual patients may respond to certain medications (ie. fast and slow metabolisers). The RCPA recently released guidelines for doctors about requesting patient pharmacogenomic testing before prescribing some medications. These guidelines have identified 35 medications into three pharmacogenomics testing categories: recommend, consider, and no consensus. We discuss this testing with our guest today. This is the story of pharmacogenomics. RCPA guidelines: https://www.rcpa.edu.au/Library/Practising-Pathology/Pharmacogenomic-Indications-in-Australia Our special guest: Our special guest is Professor Luke Hessen who is the manager of the Genetics Department at Douglass Hanly Moir and co-Chair of the RCPA Pharmaogenetic Advisory Group.See omnystudio.com/listener for privacy information.

In 1924, a surgeon and a pathologist had a conversation about some patients with multiple bowel polyps. The pathologist, Dr Cuthbert Dukes, and the surgeon, Mr JP Lockhart-Mummery, noted that patients had a family history of bowel cancer and could have hundreds of colonic polyps. They, with the help of HRJ Bussey, set up the Polyposis Registry. The registry collected information about these patients and the families from 1918 to 1954. They found that patients developed polyps in childhood, the risk of affected children was 50%, and cancer took 15 years to develop from first diagnosis. This was clearly a familial disease. Today, we know this a Familial Adenomatous Polyposis or FAP. The genetic basis for this condition was identified in the 1980s and 1990s. Professor Sir Walter Bodmer led a team to map the location of the Adenomatous Polyposis Coli (APC) gene involved. This is the story of Familial Adenomatous Polyposis (FAP) Our special guests: Professor Sir Walter Bodmer is a professor of the Cancer and Genetics laboratory and Department of Oncology at Oxford University. Areas of research include: HLA, population genetics, Human Genome Project, and mapped the APC gene. He was knighted in 1986. Dr Tristan Rutland is an Anatomical Pathologists, recipient of the Konrad Muller RCPA Outstanding Teaching Award (2020), and recipient of the Resident Advocate Award from the College of American Pathologists. Dr Emelia Ip is a trained medical oncologist, staff specialist in cancer genetics, and co-chair of EviQ Adult Cancer Genetics Reference Committee. Help support us on our donation page.See omnystudio.com/listener for privacy information.

We have come a long way in our understanding of epilepsy and seizures. Historically, epilepsy was associated with possession and demonic forces. Modern medicine has helped us to understand that epilepsy is an electrical disorder of the brain that can affect an area or the entire brain itself. Unfortunately, a lot of stigma and misinformation remains about epilepsy and it is an important condition to be aware of. This is the story of epilepsy. Our special guest: Professor Mark Cook who is the Director of Neurology and Chair of Medicine at St Vincent’s Hospital in Melbourne. He was awarded the Order of Australia in 2023. Help support us on our donation page.See omnystudio.com/listener for privacy information.