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The Australian
7 days ago
- Business
- The Australian
New treatment allows cancer patients to avoid going under the knife
You can now listen to The Australian's articles. Give us your feedback. You can now listen to The Australian's articles. Australian hospitals have adopted a new combination chemotherapy for bladder cancer that has brought remission rates to 60 per cent, taking patients out from under the knife. A blend of the drugs Gemcitabine and Docetaxel has seen patients sidestep side effects while cutting rates of surgical bladder removal since being trialled at Monash Health in 2023, with the treatment now available to hospitals. Hailed as a means to 'change the whole protocol for the treatment of bladder cancer', the combination takes medications already made affordable by the Pharmaceutical Benefits Scheme to an eligible population of thousands of patients. The drugs are referred to collectively as Gem-Doce. It represents the first non-surgical alternative in bladder cancer treatment since the decades-old introduction of tuberculosis drug Bacillus Calmette-Guerin, for which supply is volatile. Retired teacher Alan Feher, 72, was a successful recipient of the combination therapy after he was diagnosed with aggressive bladder cancer. He had been late to catch his cancer, given he is colour blind and missed the most obvious symptom of blood in his urine. He was also misdiagnosed with an enlarged prostate in 2018 before landing on the true cause of his symptoms. 'It's quite by accident that the process started because I was mainly concerned about prostate cancer, and didn't have much idea about bladder cancer,' he said. 'The biopsy showed two things: that it was a non-invasive bladder cancer, and it was also high grade. 'The urologist said it was normal to remove the bladder and the prostate … that's looking at quite radical surgery, which would have meant having some kind of a bag hanging off of my body, where the kidneys redirected outside of my body … I nearly fainted when I heard that.' Facing the prospect of surgery, his entrance into the 2023 drug trial led him into remission. Urological Society of Australia and New Zealand president Damien Bolton welcomed the successful combination therapy, pointing to rising death rates from bladder cancer as an indication of how necessary new treatments were. Its lethality has risen in line with Australia's ageing population. Weranja Ranasinghe. Picture: Monash Health Urological Society of Australia and New Zealand president Damien Bolton. 'One way we can hold back and hopefully cure bladder cancer is not by having a big operation to remove your bladder and give you a stoma, or by having chemotherapy and radiation which have serious toxicities, but by putting different anti-cancer agents into the bladder, and this combination … Gem-Doce, is a huge step forward for that,' he said. 'Since the time of Covid, there's been a shortage worldwide of BCG … in Australia, like many countries around the world, we've had to ration our use. 'Now with Gem-Doce, you've got the ability to reserve BCG for when it's most needed, and you've got another viable alternative.' Professor Bolton said he hoped, pending the therapy's success, it would be adopted into recommended treatment guidelines. Annually, more than 3000 Australians are diagnosed with bladder cancer, most aged over 50. An aggressive cancer, it disproportionately affects men. In isolation, Gemcitabine and Docetaxel are poor treatments for bladder cancer; when administered together, 60-69 per cent of patients respond positively. A simultaneous European study has reported a 79 per cent high-grade disease-free survival rate and 73 per cent overall disease-free survival rate. Monash Health study lead Weranja Ranasinghe said the therapy would take patients out of palliative care. 'This new treatment provides an excellent alternative for these patients with good tolerance and durability. The other advantage is that these agents are widely available and affordable,' Associate Professor Ranasinghe said. 'The new treatment, Gem-Doce, is (using) established chemotherapy medicines and administering them sequentially into the bladder is shown to be effective in about 60 to 69 per cent of patients who don't respond to BCG treatment or who want to preserve their bladder.' Read related topics: HealthVaccinations
The Age
14-05-2025
- The Age
Tip manager tells Erin Patterson mushroom murder trial of dehydrator found in e-waste bin
'He then called me back and sent me a photo. He said it kind of looked like a microwave dehydrator, but wasn't quite sure because he did not get it out of the bin,' Canty said. Photographs shown to the court showed a black Sunbeam dehydrator inside an e-waste bin. Canty said a search of the site's business records had shown the e-waste deposit was paid for at 11.35am using eftpos. Erin Patterson is accused of murdering her parents-in-law, Don and Gail Patterson, and Gail's sister, Heather Wilkinson, by serving them poisonous mushrooms in a beef Wellington she cooked at her Leongatha home on July 29, 2023. The Pattersons and Heather Wilkinson died in the days after the meal from the effects of mushroom poisoning. Heather's husband, Ian, survived after weeks in hospital. Erin Patterson has pleaded not guilty to three charges of murder and one of attempted murder. Her lawyers have said the deaths were a terrible accident. No evidence Erin Patterson suffered cancer or poisoning: doctor The final witness on Wednesday afternoon was Professor Andrew Bersten, an intensive care specialist. Bersten told the court he had examined Erin Patterson's medical records, including those from during her time at Leongatha and Monash hospitals in late July and early August 2023. He found that her presentation was consistent with someone having a diarrheal illness. He said he had not been shown any evidence that showed she had suffered from toxic poisoning, or cancer, during this same time. When examining the results of the accused woman's fecal specimen taken on July 31, 2023, he found no pathogens were detected. The court heard Erin Patterson was released from hospital about 2.45pm on August 1, 2023. Expert kept leftovers in home fridge after testing meal, court told Earlier on Wednesday, a fungi expert from Melbourne's Royal Botanic Gardens said she had kept the leftovers from the beef Wellington meal in her refrigerator at home after testing the food for toxic mushrooms. Mycologist Camille Truong told the court she had been working at the Royal Botanic Gardens when she had received a call to help identify mushrooms in the leftovers. Truong said that on July 31, 2023, she received an email from toxicologist Laura Muldoon at Monash Health but was unable to identify the type of mushroom from the attached pictures, which were also shown to the jury. 'Usually with toxicologists when we discuss the case, we ask several questions that can help us identify the mushroom based on where it was found. So I asked her if she knew what the source of the mushroom was, where it was found, if the person who cooked it remembers the colour before it was cooked,' she told the jury. 'I then told her that based on this photograph, I wouldn't be able to give her an identification. '[Muldoon] said they had been bought from a supermarket. And a Chinese shop, I believe. 'I did indicate to her if the mushrooms were coming from a shop or supermarket, it's … impossible to be death cap mushrooms, as they only grow in the wild.' Due to a misunderstanding, the court heard that Truong had left work early for the day before receiving a message from a receptionist telling her that a parcel of leftovers had arrived for her at her office. She then asked a colleague to drop the leftovers at her home. Truong said the leftovers had been in a large zip-lock bag when they arrived at her home, and she set up a small microscope in her house to look at the meal. She said she did not see any death cap mushrooms inside, and she put the lunch leftovers in her fridge at home. She took the leftovers back to her workplace and tested them again later the next day. She told the jury the only mushrooms she could identify were field mushrooms, typically found in supermarkets. 'I was told all the mushrooms were coming from … a shop or supermarket. No foraging activity,' she said. The leftovers were then collected by the Department of Health about 1pm on August 2, 2023, she said. Dried death caps emit 'very unpleasant' smell: expert Identifying specific mushroom species is a difficult process and can often be confirmed only in a laboratory rather than out in the field, a mushroom expert told the trial. On Wednesday morning, mushroom expert Tom May was asked about an article he had co-authored about the accuracy of mushroom identification tools. While under cross-examination by defence barrister Sophie Stafford, the mycologist agreed that accurately identifying fungi was a challenging process that often required testing under a microscope. He said there was no obvious odour from death cap mushrooms when they were freshly picked, although they did emanate a strong smell when dried. 'My experience with death cap mushrooms is when they are first collected, there's no particular smell, slightly sweet perhaps. I have dried death caps on a number of occasions, and I find the smell to be very unpleasant,' May said. May agreed that in an article Stafford was asking about, he had written that only 62 of the 78 mushroom photographs he had analysed as part of his report could be confidently identified as a particular species. He agreed there was a possibility the 62 could also have been identified by error as the study looked at photographs of mushrooms supplied to the poisons hotline, and not captured by the authors live in the wild. May was taken through a series of photographs of mushrooms that had grown in Victoria, including in Gippsland. He was also taken through screenshots of other mushroom images uploaded on the iNaturalist website, the state's most popular citizen scientist website of its kind. The images were shown to the jury on Wednesday as May was asked questions from the defence about identifying different types of mushrooms using features including the top, stem and gills of fungi. He agreed some posts to the page were 'research-grade' verified – where a number of people have supported the identification – while others, including some from the Gippsland area, were unverified observations. In another post shown to the jury, a suspected Oudemansiella gigaspora was posted in Narbethong, north-east of Melbourne. May agreed it had similar features to death cap mushrooms – brownish and with a smooth cap, white stem and gills. He also agreed Oudemansiella gigaspora was known to grow in the Gippsland area and not known to be poisonous to humans. The court heard that in May 2024, a woman died in Victoria after consuming death cap mushrooms she had picked from her front garden and cooked into a meal with her son. May agreed the coroner's office later recommended additional public awareness about the dangers of eating wild mushrooms.
Sydney Morning Herald
14-05-2025
- Sydney Morning Herald
Expert kept leftovers in home fridge after testing beef Wellington meal, court told
A fungi expert from Melbourne's Royal Botanic Gardens has told Erin Patterson's murder trial that she kept the leftovers from a beef Wellington meal linked to the illness of four people in her refrigerator at home after testing the food for toxic mushrooms. Mycologist Camille Truong told the Supreme Court in Morwell that she had been working at the Royal Botanic Gardens when she received a call to help identify mushrooms in the leftovers. On July 31, 2023, Truong said she received an email from toxicologist Laura Muldoon at Monash Health but was unable to identify the type of mushroom from the pictures, which were also shown to the jury. 'Usually with toxicologists when we discuss the case we ask several questions that can help us identify the mushroom based on where it was found. So I asked her if she knew what the source of the mushroom was, where it was found. If the person who cooked it remembers the colour before it was cooked. 'I then told her that based on this photograph I wouldn't be able to give her an identification. '[Muldoon] said they had been bought from a supermarket. And a Chinese shop, I believe. 'I did indicate to her if the mushrooms were coming from a shop or supermarket, it's ... impossible to be death cap mushrooms as they only grow in the wild.' Through a misunderstanding, the court heard that Truong had left work early for the day before receiving a message from a receptionist telling her that a parcel of leftovers had arrived for her at her office. She then asked a colleague to drop the leftovers at her home.
The Age
14-05-2025
- The Age
Expert kept leftovers in home fridge after testing beef Wellington meal, court told
A fungi expert from Melbourne's Royal Botanic Gardens has told Erin Patterson's murder trial that she kept the leftovers from a beef Wellington meal linked to the illness of four people in her refrigerator at home after testing the food for toxic mushrooms. Mycologist Camille Truong told the Supreme Court in Morwell that she had been working at the Royal Botanic Gardens when she received a call to help identify mushrooms in the leftovers. On July 31, 2023, Truong said she received an email from toxicologist Laura Muldoon at Monash Health but was unable to identify the type of mushroom from the pictures, which were also shown to the jury. 'Usually with toxicologists when we discuss the case we ask several questions that can help us identify the mushroom based on where it was found. So I asked her if she knew what the source of the mushroom was, where it was found. If the person who cooked it remembers the colour before it was cooked. 'I then told her that based on this photograph I wouldn't be able to give her an identification. '[Muldoon] said they had been bought from a supermarket. And a Chinese shop, I believe. 'I did indicate to her if the mushrooms were coming from a shop or supermarket, it's ... impossible to be death cap mushrooms as they only grow in the wild.' Through a misunderstanding, the court heard that Truong had left work early for the day before receiving a message from a receptionist telling her that a parcel of leftovers had arrived for her at her office. She then asked a colleague to drop the leftovers at her home.
NZ Herald
13-05-2025
- NZ Herald
Erin Patterson trial: Health expert links death cap mushrooms to fatal lunch
He said the sprouting body of the fungus was most commonly found in April and May but had also been observed in summer and winter months after a period of 'decent rainfall'. Once sprouted, he said, the body of the mushroom would last up to a few weeks, while the mycelium below ground could live for decades or even centuries. May described the cap of the mushroom as typically 'greenish or yellowish but may be whitish or brownish'. In Victoria, the mycologist said death cap mushrooms were observed most frequently in the metropolitan Melbourne region, particularly in the east. In the East Gippsland region, May said there had been three reports of death cap mushrooms, one historical record in Morwell and two in April and May 2023 in Outtrim and Loch that were posted to citizen science website iNaturalist. Questioning also turned to a post made by May on iNaturalist where he identified death cap mushrooms in the locality of Outtrim in the afternoon of May 21, 2023. May said he was in town to give a presentation to a local community group about fungi when he spotted the growth nearby while walking. Posting under the name of funkeytom, May said he geolocated the sighting on iNaturalist to within 20m. 'It was in Outtrim and I believe it would have been Neilson St in Outtrim,' he said. Prosecutors allege the next day, Patterson's mobile data 'suggests' she travelled to Outtrim about 11am before returning to her Leongatha home. As defence barrister Sophie Stafford cross-examined May, she took him through 10 photographs of possible death cap mushrooms with the expert offering his opinion on whether he was confident he could classify each as such. He agreed that even for an expert, positively identifying mushrooms 'is challenging'. Quizzed on the possibility of misidentification, May agreed that was why the majority of mushroom poisonings occurred. Stafford took the witness to a research paper he had co-authored in 2023 that examined the use of phone applications to identify mushrooms and concluded their use for the identification of poisonous species was poor. He told the jury there was no simple rule that was 'totally reliable' to distinguish toxic mushrooms from edible ones. 'After the first fatality of amanita phalloides three decades ago, I was saying 'just don't eat wild mushrooms',' he said. 'Over the years... I would now advocate for this slow mushrooming apprenticeship.' May told the court calls to the Victorian Poisons Information Centre had risen in recent years and it appears there was an increasing number of people interested in foraging for mushrooms. 'In general, that appears to be the case,' he said. 'The number of calls does seem to be rising but the population of Melbourne is also growing.' May will continue giving evidence when the trial resumes on Wednesday. Monash Health director of public health of infections diseases Rhonda Stuart was called to give evidence on Tuesday about her interactions with Patterson on July 31, 2023, two days after the fatal lunch. She told the court that she was questioned by Patterson on why she was interviewing her, responding: 'If the mushrooms she bought were causing a public health issue I'd need to know about it.' Stuart said Patterson told her that she used two types of mushrooms, fresh from Woolworths and dried from an 'Asian grocer', when preparing the beef Wellington lunch. 'She said they were in a sealed packet but she opened the packet and put them in another container,' Stuart said. 'She said she made a paste, and when I asked her about the dried mushrooms, she said she'd used the entire lot so there was nothing left over.' Stuart told the court Patterson told her that 'she ate about half of the meal'. Called to give evidence on Tuesday, Monash Health emergency registrar Laura Muldoon told the jury there was no 'clinical evidence' Patterson experienced mushroom poisoning on August 1. According to Muldoon, Patterson had 'chapped lips but otherwise she looked perfectly well' and was discharged from hospital later that evening. Patterson was transferred to Monash Health's emergency department after self-presenting to Leongatha Hospital on July 31 and complaining of diarrhoea and abdominal cramping. Quizzed by prosecutor Sarah Lenthall on whether there was any clinical evidence for amanita phalloides poisoning or any other toxin, Muldoon responded 'no'. She told the court that she was tasked with sending remnants of the beef Wellington meal, retrieved from Patterson's bin, to a mycologist at the Royal Botanical Gardens. The court was shown a photo depicting pastry with a small amount of brown material separated from the rest of the dish. Another doctor at Monash Health, Varuna Ruggoo, said Muldoon's notes said there were 'no concerns' about poisoning. 'She wrote in her notes there were no concerns about that kind of poisoning because liver tests were all in normal limits,' she said. Jurors in the weeks-long trial were told on Thursday last week by trial judge Justice Christopher Beale that they'd be getting a long weekend as a measure expected to save time. 'I've just been having a discussion with counsel about the way the case is progressing and the way that we can save some time and we can best achieve that by not sitting on Monday,' he said. 'There are things happening behind the scenes to try and condense the material that will be presented to you and if Monday is devoted to that rather than you sitting here in court listening to some evidence, I expect the case will conclude earlier.' Patterson is facing trial after pleading not guilty to three counts of murder and one count of attempted murder relating to a fatal lunch she hosted at her home in Leongatha, a small dairy town in Victoria, on July 29, 2023. Her husband's parents Don and Gail Patterson, both 70, and Gail's sister Heather Wilkinson, 66, died after consuming death cap mushrooms inside a beef Wellington that Patterson served. Wilkinson's husband Ian Wilkinson, 71, survived after a long stint in hospital. Patterson's defence counsel says she did not intentionally or deliberately poison anyone, calling the deaths a tragic accident, and that she too fell sick after eating the lunch. The trial, now in its third week, continues.
