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.

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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.

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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.

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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.

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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.

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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.

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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.

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It is evident from paintings that Leonardo da Vinci and Michelangelo suffered some form of underlying hand pathologies. These have been the focus of discussions and journal articles amongst many academics. Our understanding of different disease processes involving the hand have come a long way. There are a lot of options for patients both medical and surgical that we discuss in this episode.

This is the story of hand pathology

Our special guest:

Dr Paul van Minnen is a plastic and reconstructive surgeon who runs his own private practice in Adelaide called ‘Grip surgery’.

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