One doctor’s case from 1901 changed how we understand memory loss. Auguste Deter was 51 when her husband Carl brought her to see Dr Alois Alzheimer in Frankfurt, worried by memory lapses that had turned into paranoia and confusion. When Auguste died five years later, Alzheimer examined her brain and found two things under the microscope: amyloid plaques between nerve cells and neurofibrillary tangles within them. His 1906 presentation to a room of psychiatrists drew no questions at all. It was not until 1910, when Emil Kraepelin included the case in his Handbook of Psychiatry, that the term Alzheimer’s disease appeared in print for the first time.

Dr Liam Mulcahy, physician trainee and author of Beyond the White Coat, traces that discovery in detail, then Dr Travis Brown turns to two guests for where the disease stands in 2026.

Dr Daniel Clarke, consultant neurologist at Sir Charles Gairdner Hospital and director of clinical trials at Alzheimer’s Research Australia, covers how Alzheimer’s actually presents (often nothing like the stereotype), why history remains the most important diagnostic tool, and why non-pharmacological measures such as exercise and vascular risk control come before medication. He also explains why family history is often overrated, and why he does not recommend routine APOE4 gene testing.

Dr Gemma Daley, consultant chemical pathologist at Sullivan Nicolaides Pathology, explains what the new p-tau181 and p-tau217 blood tests can and cannot tell a GP, who should and should not be referred for them, and why they are adjunctive tests rather than standalone diagnostic tools.

What to listen for: the presenting features that separate Alzheimer’s from ordinary age-related forgetfulness, and what a negative or positive p-tau result actually means for a patient in front of you.

This is the story of Alzheimer’s disease.

Useful links:

Dementia Australia: https://www.dementia.org.au/

Alzheimer’s Research Australia: https://alzheimersresearch.org.au/

Our Special Guests:

Dr Liam Mulcahy is a physician trainee with an interest in neurology and author of Beyond the White Coat

Dr Daniel Clarke is a consultant neurologist and director of clinical trials at Alzheimer’s Research Australia

Dr Gemma Daley is a consultant chemical pathologist at Sullivan Nicolaides Pathology

Listen:

This Medical Life podcast is available on all podcasting services, Apple Podcasts, YouTube, and Spotify. Members of the RACGP are able to log the hours as CPD (Education) that they listen to the episodes under self record via Quick log. We invite you to help support us on our donation page.

See omnystudio.com/listener for privacy information.

Two teenage patients, thirty years apart, changed how bone sarcomas are treated. In 1890, seventeen-year-old Bessie Dashiell saw New York surgeon William Coley with a painful hand. Despite an amputation, she died of metastatic cancer ten weeks later. Coley’s search for a better answer led him to Coley’s toxin, a bacterial treatment now recognised as an early form of immunotherapy.

In 1921, pathologist James Ewing treated a fourteen-year-old girl with a wrist tumour he believed was osteosarcoma. Coley’s toxin failed. Radiotherapy, tried next, worked, even though osteosarcoma is classically radiotherapy-resistant. The tumour turned out to be a different disease entirely, now known as Ewing sarcoma, accounting for around 15 percent of bone sarcomas.

Dr Travis Brown traces both stories in detail, then turns to two guests for the clinical picture in 2026.

Dr Liz Connolly, medical oncologist at Peter MacCallum Cancer Centre and oncology research fellow at ProCan Children’s Medical Research Institute, covers staging (localised versus advanced), chemotherapy regimens for osteosarcoma and Ewing sarcoma, targeted therapies, and why immunotherapy has so far shown limited benefit in these cancers. She also discusses five-year survival, which sits around 70 percent for localised osteosarcoma or Ewing sarcoma, and why chondrosarcoma remains difficult to treat with drugs.

Professor Angela Hong, clinical professor at the University of Sydney and radiation oncologist at Royal Prince Alfred Hospital, explains why Ewing sarcoma responds so well to radiotherapy while osteosarcoma and chondrosarcoma do not, how multidisciplinary teams decide between surgery and radiotherapy, current dosing and an active Australian phase III trial, and why early referral to a sarcoma centre matters regardless of where a patient lives.

What to listen for: the diagnostic overlap between early bone sarcoma symptoms and everyday musculoskeletal complaints, and what that means for when to consider imaging and referral.

This is the story of Bone Sarcoma Part 2. Find Part 1 here.

Useful links:

Australia and New Zealand Sarcoma Association: https://sarcoma.org.au/

Find a sarcoma specialist: https://sarcoma.org.au/pages/about-sarcoma/find-a-sarcoma-specialist

Sarcoma guidelines: https://sarcoma.org.au/pages/sarcoma-guidelines

Seeking a second opinion: https://sarcoma.org.au/pages/about-sarcoma/seeking-second-opinion

Useful patient information: https://sarcoma.org.au/pages/about-sarcoma/patient-and-carer-sarcoma-information

Our Special Guests:

Dr Liz Connolly is a medical oncologist who specialises in treating and researching sarcomas

Professor Angela Hong is a radiation oncologist and clinical professor at the University of Sydney

Listen:

This Medical Life podcast is available on all podcasting services, Apple Podcasts, YouTube, and Spotify. Members of the RACGP are able to log the hours as CPD (Education) that they listen to the episodes under self record via Quick log. We invite you to help support us on our donation page.

See omnystudio.com/listener for privacy information.

Bone sarcomas are rare, accounting for 0.2% of all cancer diagnoses, with around 200 cases diagnosed in Australia each year. The three main types differ by age and site: osteosarcoma (around 30 to 35% of cases, often in the arms, legs and pelvis, with peaks in adolescence and again in the seventies and eighties), chondrosarcoma (around 30% of cases, typically in adults over 40), and Ewing sarcoma (around 15% of cases, most common in children).

Professor Fiona Maclean, an anatomical pathologist, describes bone sarcoma diagnosis as a pattern-recognition challenge made harder by rarity, noting that tumour type and stage are the two most useful pieces of information for a GP reading a pathology report.

A/Professor Richard Boyle, an orthopaedic oncological surgeon, outlines the red flags, including unexplained deep bone pain and night pain, and the diagnostic pathway from X-ray through biopsy to multidisciplinary review.

This is the story of Bone Sarcoma Part 1.

Useful links:

Australia and New Zealand Sarcoma Association: https://sarcoma.org.au/

Find a sarcoma specialist: https://sarcoma.org.au/pages/about-sarcoma/find-a-sarcoma-specialist

Sarcoma guidelines: https://sarcoma.org.au/pages/sarcoma-guidelines

Seeking a second opinion: https://sarcoma.org.au/pages/about-sarcoma/seeking-second-opinion

Useful patient information: https://sarcoma.org.au/pages/about-sarcoma/patient-and-carer-sarcoma-information

Our Special Guests:

A/Professor Richard Boyle who is a Sydney-based orthopaedic oncological surgeon and head of the NSW Sarcoma unit.

Professor Fiona Maclean who is an anatomical pathologist and professor from Macquarie University.

Listen:

This Medical Life podcast is available on all podcasting services and Spotify. Members of the RACGP are able to log the hours as CPD (Education) that they listen to the episodes under self record via Quick log. We invite you to help support us on our donation page.

See omnystudio.com/listener for privacy information.