Update October 2006
Preamble: (a) During the course of the Hearing, Associate Professor GG and Mr O’Neill, in particular, introduced issues that did not relate to the Charges and their Particulars (as they stood) for the Hearing of 2006. Whilst there was objection made for some, for the most part, the speakers were allowed to address the issues, because there was some point in letting them have an uninterrupted address so that the Panel should be able to hear their views and assess their credibility, reasonableness, knowledge and bias. What was said under prompting by Mr O’Neill was essentially defamation under privilege. There was little point arguing the issues, because those espousing them were either too rigid and biased or, in the case of Professor Fox, he had the issues presented to him with him not being told much of the relevant clinical background and clinical significance for fruitful discussion to occur. There was no separate time provided for the Applicant to address these issues in defence. This section addresses most of the points.
(b) In the Submission of 15/2/2006 (Exhibit A) the Applicant noted that the Board had reported the outcome of the Hearing of 2005, that there was an appeal to the VCAT, and that there were conditions placed upon the Applicant by Orders of the VCAT. The Applicant was concerned at this public display whilst the application was sub judice. During the preparation of this Submission (July 2006) the Applicant obtained via the Board’s website, not only the summary given above, but the entire Findings and Determination of the Panel of 2005. Not only is this not restricted merely to the medical subscribers to the Board, but it is available to the entire public of the world, which includes all the witnesses. In a Review that seems relevant (although dealing with criminal cases and juries), there is still the basic issue of adverse influences concerning an accused who is before an Hearing and the influence that the media reports may have (directly or indirectly) on all the other participants, such as witnesses. Reading or hearing of such reports can be expected to have had a profound firming of the views of Associate Professor GG and Professor Peters in particular. The Applicant is concerned that the Testimony given by Professor Fox and Dr Scarlett may have been influenced also. This could be at the subliminal level. Surprisingly, the author quotes from a reporter’s guide to the law drawn up by Minter Ellison, the Board’s current legal firm ! From this reference two matters that should not be published (out of nine) leap out of the page :
i. The (criminal*) record of the accused and,
ii. Publications which may affect witnesses or potential witnesses or the evaluation by the jury* (the VCAT Judges*) of the evidence. (*Modified by MAT as indicated)
Reporters are the “watchdogs” of the public, gathering information and news as they can. They are (for the most part) not parties to the judicial processes. In the case of the Applicant, the Board, a party to the legal proceedings has acted as a publishing house, disseminating adverse accounts and the Panel’s biased views far and wide whilst the dispute is sub judice, apparently oblivious to law, the Minter Ellison reporters’ code and common decency.
The Applicant submits that the actions of the Board, in broadcasting such a mass of adverse information relating to the Applicant and to the Hearing of 2005 to the public and the medical profession whilst the legal process was/is sub judice, has prejudiced, to a significant degree, the ability of the Applicant to have a fair hearing. The Board has pursued a relentless course of defamation against the Applicant which, historically, may be unparalleled: and the President of the Board was excused from attending the VCAT Hearing and answering questions !
Associate Professor GG.
In order to understand the issue, the reader needs to consider the philosophy behind cytotoxic chemotherapy. There are two aims in medical oncology treatment (ie non-surgical and non-adjuvant) :
a) “Potentially curative” therapy, for conditions such as leukaemia, lymphoma, seminoma, Wilm’s tumour, small cell lung cancer and ovarian cancer. Leukaemia and lymphoma are relatively infrequent. Their treatments are intensive, with the aim to obtain the maximum benefit from the maximum doses that the body can stand before the mortality rate becomes excessive (>10%). The aim is to obtain a “cure” as may be defined.
b) “Palliative care” therapy (which is for most cancers that have metastasized), where the aim of the therapy is to induce the maximum benefit consistent with the minimum in side effects. That is because the quality of remaining life is the main consideration.
Dr Roy Bean FRACP, a more recent mentor of the Applicant, was a medical Consultant Physician and Oncologist/Haematologist, who experienced the medical and scientific developments from about 1960 through to his death in 1990. He assumed a senior role in the Heidelberg Repatriation Hospital before his retirement, and was a keen observer of patients, their reactions and responses. He published and read papers, some prepared in collaboration with the Applicant, whose association went back to 1965. Roy studied patients with stomach cancer in particular, because (after surgery) there was no other treatment available, other doctors were happy to refer them and there was a quick turnover, of assistance in statistical assessments.
He felt strongly about the use of “potentially curative” treatments (see above) in patients who were clearly in the incurable class, a view repeated recently by Dr Ron Bova (RB1, Tab 127; TRA.002.0230) “It is important to temper overzealous enthusiasm to ‘cure’ the patient and to consider treatment aimed at achieving the best quality of life for the individual and his or her family.” (Roy Bean referred to one Oncology unit of Melbourne as the “charnel house,” quipping “Killing patients is alright, provided you use standard protocols.” He would say, when any patient chose to attend that clinic, “You watch, he/she will be dead in x weeks” [x being a small number]. He was usually right !)
In his private practice in Dandenong, where most of his patients were in the incurable category, he applied forms of cytotoxic chemotherapy that he had developed over the years for this purpose. One of these was his VMF regime, with Vincristine, Methotrexate and 5-FU. Whilst this may have been trialled initially on patients with stomach cancer, he applied it to virtually all patients with blood group “O” (he considered that the glycoprotein lectins of the cell membranes influenced the banding &/or access of drugs into the cancer cells, and accounted, in part, to the variability of responses between patients with the same types of tumours). When a patient had a cancer with small nuclei (based upon his own photomicrography and sub-classifications), he would add to the group etoposide, irrespective of whether the cancer was in the “small cell” (neuro-ectodermal) group or not.
The major features of this regime are :
i. None of the agents is an alkylating agent (he used to use Cyclophosphamide in earlier years, but abandoned it because it was “too toxic” – it causes sterility and the hair falls out. It is the C in CAV- the “gold standard” regimen before carboplatin and etoposide for Small Cell Lung Cancer).
ii. Methotrexate and 5-FU are anti-metabolites, blocking metabolic pathways. They cause considerably less toxic symptoms, and are more appropriate in the “palliative care” setting. (Like GBA + UHF.)
iii. Vincristine augments the action of Methotrexate, and Methotrexate augments the action of 5-FU (see references)
In the case of small cell lung cancer, not all the cancers are “pure” – some have large cell components, so that a drug such as 5-FU provides a broader spectrum.
In choosing this regime for Ms SO, the Applicant considered the following points :
i. The overriding, primary and paramount aim, was to re-establish treatment with
ii. Assuming that the modern anti-emetic drug(s) had been used in Gippsland (and they were),
there needed to be another explanation for the (stated) intolerable side effects,
iii. Carboplatin was assumed to be the agent responsible for the (stated) side effects. (Before the
more modern anti-emetics, patients could be guaranteed to be vomiting within one hour
of the infusion). Accordingly, carboplatin was best eliminated in the planned
reintroduction of cytotoxic chemotherapy.
iv. Vincristine (the V in CAV) and etoposide were established effective treatments for small cell
v. The other drugs have been used in the past, and are listed as second line agents (see
vi. The combination is not first choice (the “first choice” – the combination she had just received,
seemed inappropriate in the circumstances), but there seemed a greater need to re-
establish some form of cytotoxic chemotherapy, than none at all.
vii. The aim was to re-introduce the Carboplatin later, assuming acceptance of the principle of
cytotoxic chemotherapy treatment.
viii. Ms SO was blood group “O,” meaning that the regime fitted into Roy Bean’s tested application.
With that blood group, the view of Roy Bean was that Doxorubicin (“Adriamycin” – the
A in CAV) was less effective (and it also had symptomatic side effects, loss of hair etc.).
ix. This regime had been used by the Applicant on many occasions over the years, he was
conversant with it, understood it, and it had been trouble-free.
x. The Applicant would have only one chance to “get it right” in trying to re-establish cytotoxic
chemotherapy – any problem, and she would refuse to have more, which would seem to
be an irretrievable situation.
xi. The cytotoxic chemotherapy had to be toxicity free, irrespective of all other considerations.
Those, like Associate Professor GG, who choose to criticize this regimen :
a. Have not provided a satisfactory, low toxicity and effective alternative,
b. Have not realized that the regime was not a cocktail thrown together in a moment of
disorganized confusion and ignorance by the Applicant.
c. Seem to have forgotten that Methotrexate penetrates the brain better than many other
medications. This would have been relevant, given the almost certain presence of
micro-metastases there in October 2000.
d. Have criticized a low toxicity regime established for “palliative care” patients by Dr Roy Bean, who had expertise, experience, position and original work in the area far more extensive and sound than that of Associate Professor GG’s claimed expertise, experience, position and original work. The management of Ms SO at the Peter MacCallum Cancer Institute, under Associate Professor GG would seem to highlight the concerns of Dr Bova and Roy Bean. GG made her “as sick as a dog,” when she was clearly incurable. If Associate Professor GG has a problem with the VMF regimen, then he has a problem with Roy Bean’s qualifications, experience and status. Based upon the trenchant criticisms and defamation of the Applicant made under privilege, for a treatment the Applicant had only considered and not applied, Mr O’Neill was able to persuade Senior Member Davis to issue orders that the Applicant was not to administer chemotherapy to patients, an order which was then disbursed widely by a publication of the Board, when the matter was sub judice with the VCAT. This had the effect of maximizing throughout the body of medical practitioners of Victoria, including those who may have considered referring patients to the Applicant, Associate Professor GG’ defamatory claims, made when under privilege.
i. The final payout from ComSuper was $13,379-59. It was deposited into her account on
ii. She withdrew $12,000 on 20/10/2000. David Spall was in the Bank in Fairfield, apparently by
chance (witnessed by Nurse F) at the same time, so she handed the $6,750 as per quote over to
him. That left her with $5,250 in cash. She withdrew $500 the same day in Endeavour Hills. She
withdrew $100 on 23/10/2000, and $750 on 24/10/2000.
iii. She had moved $6,600 out of her account over 5 days. Where it went is, of course, unknown,
but it was in her possession or under her control after the Applicant had been paid.
iv. She and her daughter went for a holiday in Tasmania in December, before she attended Dr
Worboys 20/1/2001 for the referral to the Peter MacCallum Cancer Institute.
On this basis, Ms SO cannot be seen to have been“stripped of her life’s savings” by the Applicant. A more likely explanation was that she moved the funds to areas not easily tracked, so she could act the pauper and that Associate Professor GG was to claim she was. Associate Professor GG was either deceived by Ms SO or, more likely, a collaborator in the deception.
(“The lady doth protest too much, methinks” a trans-gender reference to Associate Professor GG.)
Whilst the banal uric acid issue is irritating in the extreme, it brings some important points, especially because :
i. The Particular containing it was not made out by the Panel of 2005, meaning that it is simply not an issue in the current Hearing, so why is there the emphasis and repeated presentations ?
ii. As a medical issue, it is ridiculously trivial and banal
iii. It represents one of the aspects that can be regarded as clinical pathology, where pathology testing is being determined and the results applied in the clinic by a pathologist.
iv. It is reasonably well documented, from the alleged account by Ms SO which slipped through, to the final version where the possibility that it could be used as a test for cancer was dismissed because we all have levels of uric acid.
Throughout the last 16 years there have been repeated attempts to present the Applicant, as he practises as a clinical pathologist in the clinics, as a blithering idiot, whose only place should be in the laboratory: by this thinking, pathologists have no place in the clinics (recall Professor Peters’ fiat). Here we have all parties (except Ms SO initially – until she was coached better) ridiculing the use of the uric acid tests, distorting the reason for doing them and the interpretations to be drawn from them in the clinical setting. The hit team were all performing according to plan ! The agent for the team (Minter Ellison) has been doing its bit too – by repeatedly bringing to the Panels’ attention the reminders that the Applicant in the clinic was clearly incompetent and should crawl back into his laboratory cave and return to being a good little troglodyte, leaving clinical medicine to clinicians and the laboratories to be served by laboratory lackeys (him, rightfully, being one).
The most important aspect of this shameful hounding and hassling by the Board, Minter Ellison and Associate Professor GG, is that it demonstrates, using a most trivial medical pathology issue, just how the team has manipulated statements, meanings, justifications and interpretations in order to achieve its ends. There is then the logical question: if this demonstrates what can be done with a trivial issue that, fortunately, has been well documented, how many times, and to what degree has the team done these sorts of distortions with all the other points, Charges and Particulars ?
The Evolution of the Uric Acid Account
The giant slide
SO's account asResponse
Alleged by GG
in complaint to Board
SO’s accountTumour Marker
According to Dr Middleton
(for the Board)
GG under cross-? Cancer ?
Examination 2005 (diagnostic)
This issue would seem to have involved the Office of the Board, now known to be corrupted by Mr John Smith, Exhibit B, TB2, Tab 128; TRA.002.0344, and also the input of Minter Ellison (Ibid.), with a track record of deceptions. Associate Professor GG, in his inexpert state, suggested that a recent meal of Soy bean or fish could be responsible. (Soy bean contains protein, but not much purine. Shell-fish may contain purines, but given the cost and that Ms SO was a vegetarian, would make these desperation guesses unlikely. His earlier guesses in 2005 included gout, and a recent meal of meat. During the Hearing in 2005, the Applicant tested the issue on himself by buying 1 kg of Herr Aldi’s mince steak, boiling up 250 g and removing 35 g of (dry) fat, leaving 215 g of lean meat and juice. He consumed only that – meat and juice - for breakfast and measured his blood and serum uric acid during the day. The rise in the serum uric acid was in the first 4 h, and was so slight that the specimens had to be run in triplicate to obtain a reasonable average level showing a change (Exhibit D, RB2, Tab 127; TRA.002.0204.). The urine output peaked at about 4.5 h. When the high/low urine levels were presented on the graph from Ms SO (Ibid., TRA.002.0205) the relative increase shown by her’s across the high/low lines, can be seen.) Associate Professor GG’s “explanations” might be applicable for a single outlier point on the graphs. However, the graphs showed steady rising points after the start of UHF treatment, meaning that, if Ms SO had an exogenous source of purines, she was consuming it at a progressively increasing level over the relevant time, to a level which would have occupied most of her eating during the day. Also, the pattern shown can be explained by the initial disappointing response to the chemotherapy, followed then by the steady rise when receiving the UHF, which fitted-in with the X-ray evidence of ~stable disease (cell multiplication and apoptosis were increasingly active, but in approximate balance). The suggestions by Associate Professor GG are, in context, without sound medical and scientific basis. Naturally, Mr O’Neill provoked those he asked, like Associate Professor GG, into defamatory comments under privilege. Once again Mr O’Neill was mischievous.
(On 13/9/2006, both Channel 2 and Channel 9 presented a report on a trial of the use of PET scans for assessing the responses to cancer treatments, conducted at the Peter MacCallum Cancer Institute over the last five years. No-one would want cheap and simple measures of responses, such as measuring uric acid, as suggested by a Pathologist to undermine the major research project run by Radiotherapists !)
The Applicant is grateful for the Board and Minter Ellison calling Associate Professor GG to the witness stand. This has enabled the Panel of the VCAT not only to hear his views and opinions, (which have been examined above), but allowed the Panel to assess those less easily described and quantified attributes which may affect credibility (if relevant), such as intransigence, arrogance, unreasonableness, rudeness, falsehood and intrigue.
The Panel of the VCAT should now be in a better position to understand how difficult it was for the Applicant to explain to Associate Professor GG, after he had made his hostile telephone call on 8/12/2001, that the heating involved bringing theorganelles of tumours to about 42oC and that the means of delivery of the UHF was general, and did not require beaming, as is used in radiotherapy. (The Applicant notes the account given by David Spall [Exhibit G; RB2, Tab 128; TRA.002.0416-7] of the German engineer who volunteered to be a normal control, but showed the resonance effect. An X-ray of his chest shortly afterwards revealed a mediastinal mass ! This illustrates the ability of the UHF to penetrate deep into the chest at least.)
Professor Richard Fox.
1. The choice of cytotoxic chemotherapy. When Mr O’Neill asked professor Fox about the choice of cytotoxic chemotherapy, and what could replace Carboplatin, Professor Fox, without being fully informed of the clinical problem, suggested Doxorubicin (“Adriamycin”). This would be natural, because Doxorubicin was the A in the CAV regime used before the Carboplatin and Etoposide combination became the “gold standard.”. However, examination of the responses to monotherapy with this agent as presented [in DeVita p989] 25% and [Holland & Frei p1274] 27%, shows little difference compared to Methotrexate, in [Holland & Frei] 27%. 5-FU is also reported to have a response in previously treated patients of 12%. Roy Bean concluded that the results of Doxorubicin use for patients with blood group “O” was disappointing (p86, Table 9.3), and felt that the toxicities may well outweigh the benefits. In the circumstances, there were sound reasons for not choosing Doxorubicin. Once again, Mr O’Neill has been mischievous.
2. The use of Uric Acid determinations to monitor the tumour as a marker. Again, Professor Fox was not fully informed of the background. This issue, in fact a non-issue, but dragged into prominence by Mr O’Neill to prompt a defamatory statement from Professor Fox, should never have been raised (see above, in relation to Associate Professor GG). Once again, Mr O’Neill has been mischievous.
1. Uric acid is not a marker. Who said it was ? The same myth again ! Mr O’Neill could not leave it out ! See under Professor Peters elsewhere
2. Lithium as an anticancer medication. This myth recurred frequently, as though the observer might forget what had been said, despite various explanations debunking it by the Applicant. The Applicant suspects a prior understanding.
3. Whole Body Hyperthermia. The myth of the heating episode being called treatment.
4. She had a 20% chance of a cure and was potentially curable. This issue was dropped from the Charges and Particulars. Accordingly, the re-introduction of it represents Defamation under Privilege. The Applicant concludes that the Board has received advice that she was not “potentially curable” and that this claim is yet another myth (as the Applicant had claimed). This issue was the big emotive point for the Civil Court action – “a 44 year old single mother robbed of her life and her life’s savings . . . etc.” UMP ran for cover and was happy to pay up (especially with assistance from the Federal Government). (The validity of the Civil Settlement may now be questioned.)
The Board, Minter Ellison and the Lithium Saga (See: The Dark Side, for details - Above)
The Lithium Issue
 Clarke, Ceri. “Can the media affect an individual’s right to a fair and unbiased trial ?” (2003)
 Held by the VCAT. See attached photocopy
 A PubMed search of “Small Cell Lung Cancer” AND Uric acid produced some 16 “hits.” These do not count the Text Book accounts of the Tumour Lysis Syndrome. Associate Professor GG was wrong.
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