Auscast Medical

Soft tissue sarcomas are tumours that arise from connective tissue, fat, muscle, and blood vessels. They are distinct from epithelial malignancies (carcinomas) in both morphology and behaviour. Unfortunately, due to their rare occurrence, these tumours can be mistaken clinically and pathologically which affects patients management and prognosis. As part of sarcoma awareness month, we are doing a s...

Ethics, codes of conduct, and challenging decisions are universal constants in medicine. Difficult situations and trying to do the right thing are not always obvious particularly when these decisions involve lots of emotions, family members, and have life and death implications. Ethics, and ethics committees, can help to provide a clear and consensus path for clinicians, patients, and family membe...

Lipoprotein (a) (Lp(a)) was discovered in 1963 by a Norwegian geneticist by the name of Kåre Berg who studied particles that carried cholesterol in the blood. He found some patients had an additional protein on the low-density lipoprotein. Studies found that patients with elevated Lp(a) had increased risks of cardiovascular disease. However, the levels were not affected by diet, environmenta...

Skin has always told stories. For thousands of years, those whose skin behaved differently — scaling, thickening, inflaming — were feared, isolated, and misunderstood. Psoriasis was long lumped together with leprosy, its sufferers cast out rather than cared for. It would take centuries before medicine began to separate these conditions, and longer still before we understood what was re...

The Artful Dodger is a television series on Disney+ that is a historical medical drama set in 1850s Australia with Jack Dawkins, the Artful Dodger from the world of Oliver Twist. Jack is a former pick pocket now surgeon who is reacquainted with old partner in crime, Fagin, who is keen for Jack to resume old habits. The Artful Dodger takes pride in being one of the most historically accurate depict...

The complex symptomatology of hormonal diseases only started to be recognised in the 19th century as we learned about anatomy and physiology. When Doctor Robert Graves began piecing the hyperthyroid puzzle together when he saw patients with similar symptoms such as anxiousness, nervousness, aggitation, bulging eyes, and rapid/irregular heart rate. He realised this was a previously unknown con...

It has been well established in studies and articles that cholesterol lowering medications have significant heart morbidity and mortality benefits. However, high dosage trials did not show additional survival benefits but had increasing side-effects for patients. Therefore, the maximum dose for statins is not necessarily the best dose for patients. This is the story of statin dosing. Guest: Profes...

Crucifixion was a form of punishment, humiliation, and execution. Adopted by the Ancient Romans, crucifixion was used on the State’s worst criminals on lower classes and slaves. As common as it was though, we know very little about how people died on the cross. In this episode, we take a closer look at crucifixion through a medical lens. This image is not historically accurate. It was crafte...

Recreational use of steroids and testosterone to enhance image and performance is on the rise. Over the last 70 years, testosterone and testosterone-like substances have been used extensively to enhance performance particularly in elite sports. Nowadays, the use is more widespread and occurs in the general community with far more drugs available to people via the internet. Unfortunately, the evide...

Hypogonadism is a medical condition where the body does not produce enough testosterone. This can be primary (testicular failure) or secondary (pituitary or other condition). There are a number of conditions that doctors need to be aware of that can cause hypogonadism. This is the story of hypogonadism. Image ref:  https://www.sciencedirect.com/topics/agricultural-and-biological-sciences/hypo...

While testicular cancer is rare, it is the most common cancer in young men aged between 15 and 39 years. Like with every cancer, early detection is the key. Self-examination is important along with seeking medical attention if there are any concerns. Fortunately, overall survival is around 95%. This is the story of testicular cancer. Our special guests: Dr Nari Ahmadi who is a...

And we’re back – for another year – with more stories, more expert guests, more topics to discuss. Episodes released fortnightly. And we’ve also released an ebook with audio narrated by the masterful voice of Steve Davis for a general audience sharing some of the amazing stories of medicine. Chapter J provided in this episode. Our special guest: In this episo...

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Charles Dicken’s first novel has an adolescent boy named Joe who was overweight and always sleepy. He could fall asleep at any time, even during meals. The novel is known as the Pickwick Papers. Decades later, doctors began to recognise patients with the same symptoms. They called it Pickwickian syndrome. Obstructive sleep apnoea is a common condition in the general community. Risk factors i...

Willem J Kolff was an intern when he saw a 22 year old man die of kidney failure. He realised that the patient’s life could have been saved if his blood could have been detoxified. Willem set to work and developed the first ever dialysis machine (initially the ‘rotating drum kidney’). While dialysis is a lifesaving treatment, it is one that we hope to avoid for pat...

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 o...

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....

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 dis...

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 essenti...

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) sc...

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...

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...

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 3...

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 patien...

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...