This Medical Life

In July 2020 in the midst of a global pandemic, we released our first episode called ‘What is pathology?’ with This Pathological Life podcast. We hoped to create something that would entertain and education the audiencem and shed light on to some of the amazing stories and characters in medicine. In creating these podcasts, I am always thankful and appreciative to our guests who willingly give their time and expertise. If there is anyone who has excited our audience, been an inspiring teacher and a fantastic storyteller, it is Professor Graeme Suthers. He has been involved in the following episodes over the last four years: This Medical Life podcast: Ep 40 Carrier screening Ep 30 BRCA (Part 1) Ep 21 Marfan syndrome Ep 15 Lynch syndrome Ep 10 Familial Hypercholesterolaemia This Pathological Life podcast: Ep 45 Pharmacogenetics Ep 44 PKU and Cystic Fibrosis Ep 33 Fragile X Ep 13 Trisomy / Chromosomal abnormalities On the 30th of June 2023, Professor Graeme Suthers retired and we wanted to take some time to thank him, but also ask him some questions and reflect on his career. This is the story of Professor Graeme Suthers. This Medical Life podcast is available on all podcasting services and Spotify.See omnystudio.com/listener for privacy information.

On the 1st of November 2023, the Australian Government will release new guidelines for screening prostate cancer with the Prostate Specific Antigen (PSA) blood test. These guidelines are based upon the Clinical Practice Guidelines (CPG) published in 2016 with new items to be included in the Medicare schedule. These items are based upon the Prostate Cancer Foundation and the Cancer Council of Australia guidelines that have been endorsed by the NHMRC, RACGP, and USANZ. We speak to Professor Ken Sikaris who has been at the forefront of these new recommendations. Our special guest is Professor Ken Sikaris who is a chemical pathologist and Director of Chemical Pathology at Melbourne Pathology. This Medical Life podcast is available on all podcasting services and Spotify.See omnystudio.com/listener for privacy information.

We continue the second episode of this two part series on breast screening and mammograms focusing on the future. In this episode, we talk about the importance of breast density as a new risk factor, personalised breast cancer risk assessment (iPrevent developed by Peter MacCallum Cancer Centre https://www.petermac.org/iprevent), and discuss a personal account with Dr Sandy Minck. Special guests: Associate Professor Michelle Reintals is the Director of BreastScreen South Australia and an Australian trained radiologist with extensive and international experience in breast screening and mammography. Professor Kelly-Anne Phillips is a medical oncologist who cares for breast cancer patients and is a researcher at Peter MacCallum Cancer Centre that is internationally recognised in breast cancer genetics and treatment. Doctor Sandy Minck is a fellow of the Royal Australian College of General Practitioners and an advocate for breast density awareness and personalised risk assessments. She has personal experience in this area as both a doctor and a patient. This Medical Life podcast is freely available on all podcasting services and Spotify.See omnystudio.com/listener for privacy information.

A critical tool in the fight against breast cancer is population screening. Early detection, surgical intervention +/- further treatment has dramatically reduced advanced disease and mortality rates but it still remains the most common cancer worldwide. In this episode, we focus on the history of breast cancer, the development of mammograms and early detection with our understanding of the underlying pathology. Our special guests include: Associate Professor Michelle Reintals is the Director of BreastScreen South Australia and an Australian trained radiologist with extensive and international experience in breast screening and mammography. Associate Professor Wendy Raymond is a histopathologist who has specialised in breast pathology and cytology. A/Professor Raymond is a past president of the Australian Society of Breast Disease and co-edited the IAC Yokohama system for reporting breast FNA biopsies. This is the first part of a two-part series on breast screening, focusing on the present. The second part (coming soon) will focus on the future.See omnystudio.com/listener for privacy information.

Our understanding of the world today is constantly changing. What was once considered truths and facts can, in hindsight, be seen as misguided or wrong. It may be challenging to accept but becomes evident over time that the things we learn today may become irrelevant or superseded in the future and this is particularly relevant to medicine. Scientometrics is the quantitative study of science and the rate at which change occurs. Today, we discuss this topic with scientist and author Sam Arbesman, to ask the following question: what is the rate of change of facts in the field of medicine? Our special guest is Sam Arbesman who is a scientist and author of Overcomplicated: Technology at the Limits of Comprehension and The Half-Life of Facts.See omnystudio.com/listener for privacy information.

Vitamin D has been a controversial topic in recent times with the debate continuing over appropriate testing, adequate levels, and the evidence for treatment. We discussed the appropriateness of testing and chemical pathology component with Professor Ken Sikaris (Episode 25), but what does the research tell us about diseases associated with Vitamin D and the utility of replacement? We discuss this with Professor Scott Byrne from The University of Sydney. Our special guest is Professor Scott Byrne from the Westmead Institute for Medical Research. Professor Byrne is also Co-director of the Centre for Immunology and Allergy Research and Head of the Cellular Photo-immunology Group in the School of Medical Sciences at Sydney University. This is the second chapter in the story of Vitamin D.See omnystudio.com/listener for privacy information.

Nobel Prize winner Professor Peter Doherty discusses his research on distinguishing virus-infected cells from non-infected cells. He also talks about his advocacy for science communication, his experiences living in different cultures, challenges in veterinary education, the Dunning-Kruger effect, the complexities of immunology, T cells in cancer therapy, professionalism in the medical field, and a light-hearted Nobel Prize hoax.

The double helix structure of DNA was the discovery of the century. However, the story about the discovery is mired in controversy as one of the major contributors, Rosalind Franklin, was conspicuously absent from acknowledgements and died (and subsequently not named) before the Nobel Prize was awarded. In 1968, James Watson wrote the book ‘The Double Helix: A Personal Account of the Discovery of the Structure of DNA’ and reads more like a fictional detective novel than an autobiographical account with the portrayal of Franklin as a forceful, gruff and confrontational. Recently, an article in Nature shows an unpublished news article from 1953 (at the time of the discovery) that Franklin’s contribution was crucial to uncovering the structure of DNA. Today, we talk to one of the authors of the article in Nature, Nathaniel Comfort, who is Professor of the History of Medicine at John Hopkins University. Link to the article: https://www.nature.com/articles/d41586-023-01313-5 Our special guest is Professor Nathaniel Comfort from the John Hopkins University. His interest lies in the histories of genetics, eugenics, genomics and biomedicine. He has authored two books (The Tangled Field and The Science of Human Perfection), written for Nature, The Atlantic, The Nature as well as appeared on PBS, National Public Radio and the BBC. This is the story of the DNA double helix.See omnystudio.com/listener for privacy information.

Essentially every culture, modern or ancient, understood that health and faeces are inherently linked. The Ancient Chinese practiced ‘copromancy’ which was the assessment of health based upon the shape, size and texture of faeces. Today we have the Bristol Stool Chart that helps us to classify faeces/poo into seven different groups. As disconcerting as it may be, the state of our poo can tell us a lot about our own health and this is only going to increase as our knowledge about our faecal microbiome expands. The faecal microbiome is the composition of all the microorganisms within our faeces. We are learning that the composition not only affects our health but can also be contributory to diseases we experience. In some circumstances, this has also become a treatment with faecal transplantation to manage treatment resistant clostridium-difficile colitis. This is the story of the faecal microbiome. Our special guests: Dr Piers Mitchell, who is a hospital specialist consultant in the NHS and co-editor of the International Journal of Osteoarchaeology. Dr Mitchell has trained in paleopathology, osteoarchaeology, parasitology, medical history, and orthopaedic surgery. Dr Vincent Ho, who is a Gastroenterologist practicing in NSW, is an Associate Professor at Western Sydney University and head of a research laboratory. See omnystudio.com/listener for privacy information.

In 1891, Guido Werdnig documented two cases of brothers who had global progressive muscular weakness. In 1935, Dr Dorothy Anderson conducted an autopsy on a young child who had died from malnutrition due to suspected coeliac disease despite being on the upon treatment. In 1943, in inherited form of intellectual disability in boys was described by Martin and Bell. The diseases are Spinal Muscular Atrophy, Cystic Fibrosis, and Fragile X syndrome respectively. The learning curve for genetics in the last 100 years has been a steep one. Recessive genes circulate in the general community and for the most part, they are hidden and play no part in day-to-day life. Some may even have had a survival advantage in pre-modern times. However, if two parents each carry matching recessive genes, there is an increased chance that their children can have a severe or even life-threatening illness. Carrier screening provides a test for parents to assess this risk, however, it also requires an understanding of the testing paths, risks and cost from requesting doctors. This is the story of carrier screening Our special guest is Professor Graeme Suthers who is the Director of Sonic Genetics Australia. Additional information: Link to further information about reproductive carrier screening: https://www.sonicgenetics.com.au/patient/test-information/rcs/ Link to carrier screening online patient course: https://www.sonicgenetics.com.au/patient/test-information/rcs/carrier-screening-online-patient-course/See omnystudio.com/listener for privacy information.