Tissue-agnostic therapies may be a godsend for people with rare cancers and cancers of unknown origin, but regulatory and funding frameworks haven’t kept up with the scientific revolution.

Genomics has allowed increasingly rapid development highly-targeted cancer drugs and unprecedented improvements in outcomes for patients with more common cancers. Now, patients with rare cancers also have some hope in the form of tissue-agnostic therapies.

A previously-well patient presents with progressive weakness in the proximal lower limbs and trunk and a generalized change to the skin. There are many differential diagnoses to be considered.

A patient admitted for worsening breathlessness and a productive cough experiences rapidly progressive respiratory failure. His workup involves a battery of investigations and interventions from the respiratory medicine textbook.

Thrombolysis can buy valuable time for patients who experience acute ischaemic stroke but two thirds of them present outside the recommended window. A recently published study shows that tenecteplase improves outcomes in selected patients even if administered up to 24 hours from onset of a large vessel occlusion.

A man presenting with a 3-month history of diarrhoea has a complex range of accompanying symptoms and investigative results.

NSW is on track to meet the state and federal targets for the elimination of hepatitis C. But an adaptable approach to surveillance and intervention is required, particularly in correctional settings which have high rates of transmission.

In this “reality audio” podcast we get a taste of the daily tasks and responsibilities of an advanced trainee in nuclear medicine. There is a broad mix of cases and professional collaborations.

Today’s IMJ paper describes the validation and of a prognostic algorithm for predicting the likelihood of 30 day readmissions, and how this can be implemented to improve practice.

This podcast follows the case of a patient with acute myeloid leukaemia who developed neurological symptoms after initiating chaemotherapy.