August 2010
New cancer buddies - ready to give support
The two-day training course held in July was a resounding suc-
cess and was oversubscribed, so People Living With Cancer are
hoping to arrange another course later in the year.
The Donald Gordon Medical Centre hosted the course and
provided lunch on Saturday and their Oncology unit provided
more refreshments during the two days.,
The DGMC Nursing Manager Mrs Nancy Tsele welcomed par-
ticipants and the course was facilitated by Linda Greeff of
People Living With Cancer, Cape Town, and guest speakers
were Deirdre Dimbleby (Hospice), Dr Adam Nosworthy
(DGMC Oncologist), Bev du Toit (Cancer Coping Kit) and
Bernice Lass (DGMC Oncology Unit Manager).
The following is an excerpt from MD Anderson Medical
Centre’s e-newsletter, “Network” and illustrates the service
People Living with Cancer is setting up in South Africa :
In a preparatory meeting before surgery to insert his chemo-
therapy port, the middle-aged man had become agitated, then
had burst into tears and said, “I’m going to die anyway. Why
should I do this?”
Sarabia Cerda, a physician assistant in MD Anderson’s
Department of Surgery, remembered the AndersonNetwork
Patient and Caregiver Telephone Support Line, which connects
patients with survivors who share their diagnosis and, if possi-
ble, treatment history. She called the senior administrative
assistant for the Anderson Network who quickly searched the
database of nearly 1,200 telephone support volunteers to find
one with a similar diagnosis and treatment plan.
Within 15 minutes, Sarabia Cerda recalls, the patient’s cell
phone rang. On the other end of the line was a Tennessee man
who had survived the same diagnosis, metastasis and surgery.
The men spoke for several minutes, then the reassured patient
decided to go ahead with surgery.
More than a year later, he is doing well.
“He was a tough guy, but he was frightened and desperate.We
(health care professionals) are sympathetic, but we haven’t
walked in patients’ shoes,” Sarabia Cerda says. “It was great to
be able to connect him with someone who understood exact-
ly what he was feeling.”
So if you, or a friend or relative, have been diagnosed with
cancer and need to talk to someone who has been through
it, please give our Johannesburg helpline a call on
073 975 1452 or our national helpline 0861-ASK-NOW.
 THE VIEW FROM THE OTHER SIDE -
The irony of
patient
autonomy
One of the cornerstones of medical ethics is the concept of patient
autonomy. MedicineNet.com provides a succinct definition: “The
right of patients to make decisions about their medical care without
their health care provider trying to influence the decision. Patient
autonomy does allow for health care providers to educate the
patient but does not allow the health care provider to make the
decision for the patient.”
At lunch the other day, I was talking about a particularly challenging
case when this concept came up. After thinking for a few minutes, I
was struck by a sense of irony that I wanted to share in case others
have thoughts about this.
The patient is a teenager with leukemia. When she was diagnosed
with leukemia, we didn’t really give her parents any choices about
treatment. We told them their daughter has leukemia, she needs
chemotherapy, and we think she should get this particular regimen.
Sure we received informed consent to treat the patient (whether
this is truly informed consent is a topic for a future post), but it’s
not like we gave the parents a choice of regimens or the option to
forego chemotherapy. And because leukemia in children is curable,
even if the parents had refused chemotherapy, we would have gone
to court to force her to be treated.
Did we respect the patient’s autonomy here? Based on the defini-
tion above, I would say we did not. We certainly influenced the deci-
sion – by not giving the parents any choices.
Fast forward to last week, when a bone marrow examination
revealed residual leukemia. The next course of action at this point is
not clear: should she go straight to a bone marrow transplant? If so,
should it be a standard transplant, or a more experimental
approach? How about more chemotherapy? Is so, which regimen?
The right choice is not clear. My “lunch date” is not a physician. So
he asked me, “How will the family decide?” Full of respect for the
Cancer Coping Kit
The multi-lingual Cancer Coping Kit to help cancer patients
cope with their journey to recovery, thanks to a grant from the
National Lottery Distribution Trust Fund (NLDTF).
The Cancer Coping Kit is available in English, Afrikaans, isiZulu
and seSotho. It provides knowledge and understanding for peo-
ple diagnosed with cancer. The kit also provides family members
and care givers with information and coping techniques.
Patients or caregivers can obtain the kit from:
Bev du Toit: 073 235 1571
People Living With Cancer: 073 975 1452
The Breast Health Foundation: 076 479 0400
CANSA: 011 648 2340
patient’s autonomy, I answered, “Well, I will lay out the options, list
some pros and cons, and the family will make a decision.”
This is when Marco asked the question that sparked this posting:
“How will they make that decision? They don’t have the expertise
to make that call, do they? Isn’t that what you are trained for?”
And that’s when it struck me. This family has had two key decision
points: the day the girl was diagnosed, and the day her marrow
showed persistent leukemia. At the first point, my expertise was
unimportant… any oncologist would have said the same thing (that
she needed chemotherapy), and the patient’s autonomy was only a
secondary consideration. At the second point, when the optimal
choice is NOT clear, when the decision should be MOST informed
by someone experienced, that’s when I was explicit about my desire
to lay out choices and let the family decide.
I still don’t think I should tell the family what decision to make… I
just think it’s ironic that when the decisions are more complex, and
my expertise matters more, the patient’s autonomy is even more
important.
Maybe that’s how it should be. What do you think?
”Dr David Loeb is Assistant Professor of Oncology and Pediatrics, Director,
Musculoskeletal Tumour Programme, and Co-Director, Sarcoma Centre at
Johns Hopkins, Baltimore, USA. You can subscribe to Doctor David’s very
readable blog at http://doctordavidsblog.blogspot.comReadingRoom/
HealthBlogs/Reflections.htm
Cancer Support Group
held monthly
August 14
September 11 ◆ October 9
November13 ◆ December 11
9h00 for 9h30
at 18 Eton Road, Parktown
(opposite WDGMC main entrance)
Enquiries:
Bernice Lass, WDCMG, (011) 356 6148
Chris Olivier, People Living with
Cancer/CANSA,
cansurvive@icon.co.za or 083 640 4949
All patients and caregivers are welcome
No charge is made
 Cancer news from
around the world
New Vitamin D Guidelines
New and updated guidelines on recommended vitamin D intake
have been published recently in the online issue of the Canadian
Medical Association Journal (CMAJ).
Dr. David Hanley, professor at the University of Calgary Faculty of
Medicine, and member of Osteoporosis Canada's (OC) Scientific
Advisory Council, is the lead author of the paper on behalf of
Osteoporosis Canada.
Vitamin D is essential to the treatment of osteoporosis because it
promotes calcium absorption from the diet and is necessary for nor-
mal bone growth. Some research suggests it may also ward off
immune diseases, infection and cancer.
The new guidelines recommend daily supplements of 400 to 1000
IU for adults under age 50 without osteoporosis or conditions
affecting vitamin D absorption. For adults over 50, supplements of
between 800 and 2000 IU are recommended.
Cancer patient leaves
a legacy for others
It was Annick von Sametzkí’s final wish that the book she had
spent three years writing during her battle with Hodgkin’s
Lymphoma be published to give other cancer patients hope, guid-
ance and straightforward advice from her own experience. Her
dream became a reality when her friends raised funds and had the
book, “From Patient to Patience”, published last year. Her story, a
poignant but informative chronicle, is an invaluable guide for those
dealing with any form of cancer. Ironically, had Annick followed
the advice she gives in the book, she may have had a better chance
of survival. And this is the core message she wanted to share with
those facing cancer, her book urges them to be better informed so
that they can make the necessary life and death decisions. The
first days after a diagnosis are bewildering - dealing with the
shock, family panic, and plethora of advice and treatment options
available can be completely overwhelming. After a few treatments
of chemotherapy and an unfortunate experience with her oncolo-
gist she gave up and pursued a range of other options and by then
the cancer had progressed. She eventually realised that she had to
go back to the conventional way and was in remission for a while
and finally lost her long battle in 2009.

"A daily supplement of 25 mcg (800 IU) should now be regarded as The book is available at a cost of R130 from
a minimum dose for adults with osteoporosis," writes Hanley with http://www.annickvons.com
co-authors. "Canadians can safely take daily vitamin D supplements or if you have a problem, email: sametzkis@mweb.co.za
up to the current definition of tolerable upper intake level (50 mcg Funds raised from the sales of the book will be donated to the
[2000 IU]), but doses above that require medical supervision." “Jungle Tots Mother Touch Academy” Pre School in the impover-
The authors conclude with a call for research into optimal doses and ished community of Diepsloot.
safe upper limits for vitamin D intake. Despite a great deal of new
research in the past decade, these major clinical questions still have
not been addressed.
Article URL:
http://www.medicalnewstoday.com/articles/194706.php

Breast cancer cells: death by peaches

and plums
Breast cancer cells - even the most aggressive type - died after
treatments with peach and plum extracts in lab tests at Texas
AgriLife Research recently, and scientists say the results are deli-
ciously promising. Not only did the cancerous cells keel over, but
the normal cells were not harmed in the process.
AgriLife Research scientists say two phenolic compounds are
responsible for the cancer cell deaths in the study, which was pub-
lished in the Journal of Agriculture and Food Chemistry. The phenols
are organic compounds that occur in fruits. They are slightly acidic
and may be associated with traits such as aroma, taste or color.
"It was a differential effect which is what you're looking for because
in current cancer treatment with chemotherapy, the substance kills
all cells, so it is really tough on the body," said Dr. David Byrne,
AgriLife Research plant breeder who studies stone fruit. "Here, there
is a five-fold difference in the toxic intensity. You can put it at a level
where it will kill the cancer cells - the very aggressive ones - and not
the normal ones."
Byrne and Dr. Luis Cisneros-Zevallos originally studied the antioxi-
dants and phytonutrients in plums and found them to match or
exceed the blueberry which had been considered superior to other
fruits in those categories.

A closer look at the extracts determined that two specific phenolic
acid components - chlorogenic and neochlorogenic - were responsi-
ble for killing the cancer cells while not affecting the normal cells,
Cisneros-Zevallos said.
The team said laboratory tests also confirmed that the compounds
prevented cancer from growing in animals given the compounds.
Article URL:
http://www.medicalnewstoday.com/articles/190800.php
White button mushrooms enhance the
immune system
Although WBMs make up about 90 percent of the total mushrooms
consumed in the United States, little research has been conducted
into their nutritional value until the last few years. In groundbreak-
ing animal and lab research conducted at the Jean Mayer USDA
Human Nutrition Research Center on Aging (HNRCA) at Tufts
University, scientists have now documented how WBMs boost the
immune system by increasing the production of proteins that fight
disease-causing pathogens. The research team, which included
HNRCA director Simin Meydani and his colleague, Dayong Wu,
from the HNRCA Nutritional Immunology Laboratory, discovered
the mushrooms have a positive impact on immune system cells
classified as dendritic cells.
This is important because dendritic cells (DCs) can make white
blood cells known as T cells that are crucial to a strong and healthy
immune system. Dendritic cells recognize and then deactivate or
destroy invading microbes such as bacteria and viruses or antigens
(any substances that cause the immune system to respond). What's
more, they may play a role in fighting cancer.
Fifteen tips for mental fitness
The University of Washington offer these tips which may well be
applied to cancer patients:
1 Learn to Relax Allow yourself to let go of inner tensions by
giving yourself a “mini vacation.” Give your mind a break by
becoming engrossed in a good book, watching a movie, listen-
ing to music, taking a walk, working on a hobby, meditating or
similar activity that is relaxing for you.
2 Be Kind To Yourself People are frequently too hard on them-
selves when things don’t go right. Tune into your self talk, and
counteract your negative thoughts about yourself with positive
statements.
3 Eat Properly Nutrition has a direct impact on feeling mentally
positive. Limit your intake of sugar, fat, salt, caffeine and alco-
hol and help yourself stay mentally fit.
4 Find A Friend Friendships are very important to mental fitness.
Working on developing and maintaining friendships is one of
the best ways to continue growing as a person. Expressing feel-
ings and ideas to another person can help us clarify what’s truly
important to ourselves.
5 Learn to Say “No” Often people feel the need to respond
immediately when a friend or family member make a request.
Help yourself set limits by avoiding the quick “knee jerk”
response in the affirmative. Instead, let them know you will get
back to them shortly. Then do a check of your schedule; ask
yourself if you really want to add to your load. Give yourself
permission to say “No” when you are too busy to take on addi-
tional commitments of your time or energy.
Walk with the Angels
at Zoo Lake
Visit us at Zoo Lake on 29th August - People Living With
Cancer are supporting Angels Walking For Cancer and would
love to meet you there.
The Donald Gordon Medical Centre are also supporting the
event and are kindly sharing their gazebo to us!
Get your entry form from www.angelswalking.co.za
6 Exercise Check with your doctor about what level is best for
you. Even a brisk 15-minute walk, three times a week does
wonders for how you think and feel.
7 Do It Now Procrastination can lead to negative feelings about
yourself. One doesn’t have to go to extremes, but it can feel
very satisfying at the end of the day to have accomplished a
hard task or met a difficult situation head-on.
8 Adapt To Rather Than Resist Change Change is inevitable and
is a necessary part of life. The important thing is to be patient
with yourself when you are going through change, and to give
yourself time to go through the phases of transition. Realize it
takes time to let go of the old and embrace the new.
9 Test Your Assumptions Sometimes in our interactions with
other people, we make the most incredible assumptions and
act as if they are true. Rather than assuming, it might be worth
the risk to ask directly what was meant.
10 Express Your Feelings Emotions are a natural response to life.
It is important to find ways to express your feelings. Journaling
your thoughts is one way that can help you clarify what you
are feeling. Once you have identified your feelings, you may
find it easier to share them with others.
11 Grieve Losses Sadness and grief are natural and appropriate
responses to the losses which we all experience. Grief over the
loss of a love one can be very painful and may last for some
time. By being kind and allowing ourselves the time to grieve,
we have the potential to be stronger than ever.
12 Rest Get a good night’s sleep. Not everyone needs the same
amount of sleep, but it should be restful sleep. There are many
techniques available to help promote relaxation; or, you might
want to check with your doctor rather than assuming your
restless sleep is simply something you have to live with.
13 Review Your “Shoulds” If you feel stuck by some things you
“Should” be doing and aren’t, set a time limit by which you will
either have them done or get rid of them. Staying stuck in the
middle is a good way to punish yourself and cause mental
anguish and stress.
14 Have A Laugh Nurture your sense of humor, especially about
yourself. Trying to see the humorous side of things makes even
DISCLAIMER: This newsletter is for information purposes only and is
not intended to replace the advice of a medical professional. Please
consult your doctor for personal medical advice before taking any
action that may impact on your health.
 the most difficult situations easier to bear. Laughter is good
medicine. Being too serious limits your ability to enjoy life.
15 Ask For Help f you need emotional support or just someone to
talk to, don’t be afraid to ask for it. There are times in life when
everyone must look outside themselves for comfort and advice.
If friends can do the job, ask them to help. If not, be assured
that professional help is available through your employee assis-
tance program.
Research on aspirin and colorectal cancer
An observational study published in the Journal of the American
Medical Association (Volume 302, page 649) finds that people with
colorectal cancer live longer if they take aspirin on a regular basis.
Researchers looked at aspirin use in 1,279 men and women with
stage I, II, or III colorectal cancer who were enrolled in two large
studies. They found that after nearly 12 years of follow-up, regular
aspirin users had a 29% lower risk of dying of colorectal cancer than
nonusers. The 10-year survival rate was 74% for the individuals who
used aspirin after their diagnosis and 69% for those who did not.
The researchers have several reasons to believe that aspirin was
responsible for the improved survival. For example, when the
researchers examined tumors from 459 participants, they found that
only tumors with high levels of COX-2 benefited from aspirin use.
Aspirin is known to inhibit COX-2, which promotes inflammation and
cell growth and is found at high levels in most colorectal cancers.
Bottom line: Aspirin has a number of side effects and shouldn't be
used by everyone. But if you have been diagnosed with non-
metastatic colorectal cancer, talk to your doctor about the possibili-
ty of regular aspirin use.
Discovery of gene that causes HER2 breast
cancer to spread raises hope
Scientists in Scotland have identified a gene that plays a key role in
the spread of HER2 positive breast cancer to other parts of the
body, raising hopes of a new treatment for this common form of
breast cancer.
HER2 positive breast cancer is a type of breast cancer where an over-
expression of the HER2/neu gene and its associated protein HER2
(Human Epidermal growth factor Receptor 2) is linked to increased
disease recurrence and worse prognosis.It accounts for 1 in 5 of all
breast cancer cases and affects about 9,000 women a year in the UK.
Research leader Dr Elad Katz, from the Breakthrough Breast Cancer
Research Unit at the University of Edinburgh, and colleagues describe
their research and discovery of the new gene, called C35, in a paper
that was published online in the British Journal of Cancer on 13 July.
They found that in primary breast cancers, high levels of C35 mRNA
gene expression were linked with HER2 gene amplification, and
using lab cultures, were able to show that high levels of C35 protein
expression were linked with hallmarks of how cancer cells are
formed: for instance they grew colonies in soft agar and then
showed they invaded collagen matrices (the scaffolding that gives
tissue its structure) to form larger three-dimensional structures.
Researchers at Breakthrough Breast Cancer are excited by this dis-
covery because there are already drugs in development that could
target C35, offering a new treatment for HER2 positive breast cancer.
Article URL:
http://www.medicalnewstoday.com/articles/194890.php
2010 dates to diarise
14 August Cancer Support Group, Parktown
28 August Bosom Buddies, 9h30 Hotel Sans Souci
29 August Angels Walking For Cancer, Zoo Lake
8-10 September CANSA Women’s Health Conference
11 September Cancer Support Group, Parktown
15 September Reach for Recovery, Jhb, meeting
9 October Cancer Support Group, Parktown
9 October Bosom Buddies, 9h30 Hotel Sans Souci
October 27 Reach for Recovery, Jhb, meeting
13 November Cancer Support Group, Parktown
27 November Bosom Buddies, 9h30 Hotel Sans Souci
December 1 Reach for Recovery, Jhb, End of Year Lunch
11 December Cancer Support Group, Parktown
CONTACT DETAILS :
People Living With Cancer Helpline 0861-ASK-NOW
www.plwc.org.za
People Living With Cancer, Johannesburg Cancer Support
Group: 073 975 1452, cansurvive@icon.co.za
Bosom Buddies: 0860 283 343, www.bosombuddies.org.za
Campaign for Cancer: www.campaign4cancer.co.za
CANSA Johannesburg Central: 011 648 2340, 19 St John Road,
Houghton, www.cansa.org.za
National Office (Bedfordview) - 011 616 7662
Reach for Recovery: Johannesburg, Antoinette 011 648 0990
or 072 849 2901
Reach for Recovery: Harare, Zimbabwe contact 707659.
Cancer Centre - Harare: 60 Livingstone Avenue, Harare
Tel: 707673 / 705522 / 707444 Fax: 732676 E-mail:
cancer@mweb.co.zw www.cancerhre.co.zw
Breakthrough treatment for anal cancer
The INTEGRIS Cancer Institute of Oklahoma and the ProCure Proton
Therapy Center announce a breakthrough treatment approach for
anal canal cancer. For the first time in the United States proton ther-
apy is now being used to treat this type of cancer.
"In the past, patients with gastrointestinal cancers, specifically those
in the pelvis, have rarely had proton therapy as an option because
the required field size and depths were too largeaccording to the
medical director of the ProCure Proton Therapy Center in
Oklahoma City. "The precision of proton therapy allows for the
tumor to be treated with much greater accuracy, with less risk to
healthy tissue permitting a more tolerable course of treatment for
our patients."
Physicians who treat patients at the INTEGRIS Cancer Institute of
Oklahoma and the ProCure Proton Therapy Center recently devel-
oped this new protocol and have successfully treated their first anal
canal cancer patient, the first in the country to receive such treat-
ment. Traditional forms of radiation therapy could have been used to
treat this patient, but the dose to the intestines and bladder would
have been twice as high, a risk the patient was unwilling to take.
Article URL:
http://www.medicalnewstoday.com/articles/195140.php
Can cancer be overdiagnosed?
The heresy of one age becomes the orthodoxy of the next.
-Helen Keller
The patient returned to my clinic several years after her original thy-
roid cancer surgery. “The cancer blood test never went completely
back to zero,” she told me. “We knew there was cancer in there
somewhere. Finally, the new ultrasound machine found it! I guess it
is time for more surgery!”
I guess. In my patient’s situation, the latest high resolution diagnos-
tic test had identified a slowly growing, small cancer. However,
there are no studies to show that taking out these small cancers has
any significant, long-term impact. At two national meetings I
attended in the past few weeks, surgeons from all around the world
scratched their heads and debated the merits of aggressive surgery
versus careful observation without coming to any conclusions.
Two recent papers help point to why this is such a difficult topic.
The first study, titled “Overdiagnosis in Cancer” published in the
Journal of the National Cancer Institute, makes a very convincing
argument that screening and very early detection can often identi-
fy cancers that would otherwise have never caused any problems.
Cancer Association
of Zimbabwe
The Cancer Association of Zimbabwe has introduced a monthly
support group for the patients who are able to attend and meet
other patients, to support each other, to encourage each other as
well as look at their problems. In the long run, it is hoped that the
members themselves will guide the way forward and help with
programming.
Forthcoming events
18/09/2010 – High Tea – Please contact Linda on 707444/
705522 for more details.
22/10/2010 – Dinner Dance at Wild Geese. Preparations are
beginning. Contact Suzie Madondo and Petronella on cell number
091 2 225421.
28/10/2010 – Think Pink Golf Tournament. Preparations are ongo-
ing, thanks to the dedicated team.
30/10/10 – Breast Cancer Breakfast . Preparations are ongoing.
Regular weekly events include meditation and relaxation classes
which all play a vital role in the healing and wellbeing of the body.
Reach For Recovery
The Reach For Recovery Support Group is operating from within
offices, as and when they can. These ladies are breast cancer sur-
vivors who have much to offer in the way of psychological and
emotional support especially HOPE to anyone out there who may
have been diagnosed with Breast Cancer. For more info contact
707659.
The Cancer Association would like to sincerely acknowledge the
support and encouragement from all our donors, survivors, friends
volunteers well wishers and associates for being there for us in all
our endeavors.
by Dr Bruce Campbell
As evidence, the investigators demonstrate that the number of
people who develop some types of cancer (prostate, thyroid,
breast, kidney, and melanoma) has doubled since 1975 with no
increase in the number of people dying from these types of cancer.
Further, they cite autopsy studies of people dying of non-cancer
diagnoses that have detected tiny, harmless cancers in as many as
one-third of people. Chasing down and treating these “overdiag-
nosed” cancers carries both risk and cost. An accompanying edito-
rial notes that policies must “reduce the burden of cancer death
AND cancer diagnosis.”
The second study looks at the rapid growth in the use of follow-up
scans in older cancer patients (mean age = 76). The paper, published
in the Journal of the American Medical Association, found that the
use of PET scans grew 36% to 54% each year between 1999 and
2006 for Medicare patients with cancers of the prostate, breast, col-
orectum, lung, as well as leukemias and non-Hodgkin’s lymphomas.
For the lung cancer patients, there was a 14-fold increase in the use
of PET scans over the seven years! Other tests grew at a slower rate.
The overall cost of imaging grew at 5% to 10% each year.
So, what does this mean? Despite the continuing good news that
fewer Americans are dying of cancer each year, there are more and
more people being treated, thanks to sophisticated screening proce-
dures capable of detecting smaller and smaller abnormalities. At
least some of these smaller cancers would have been harmless. At
the same time, spending on scans and other imaging studies is
growing much faster than inflation. The growth rate in expenses
contributes to the spiraling costs of medical care.
Some things that we always felt were “true” about cancer deserve
another look. We were all raised to believe that cancer, left untreat-
ed, was uniformly fatal. We always knew that small cancers are
more curable. For many people, these statements are certainly true.
For other people, though, it is equally true that cancer is more of a
chronic disease, like hypertension or diabetes. It is also true that
many of us have cancer and will never, ever know it. The data call for
changes in how physicians and people with cancer understand what
the diagnosis means.
Change might be great for society, but what about each individual?
Will we tolerate having less care? Witness the recent upheaval over
the evolving recommendations for mammography in younger
women. What patient, knowing that he or she might have a cancer
inside, would ever agree to just let it be?
When the door to the examination room closes, we sit with our
patients and make decisions. Do we operate? Do we watch? Do we
order a scan or don’t we? Do we try something else? As much as we
love certainty, there are times when we proceed based on the avail-
able research and our best guesses.
My patient elected to have surgery to remove the tiny recurrence
knowing that there were real risks to the surgery and that there
might be no benefits. I was never convinced that what we did made
a difference in her long-term prognosis, but I certainly hope it was
money well spent.
Dr Bruce Campbell is a head and neck cancer surgeon
(otolaryngologist) at Froedtert & the Medical College of Wisconsin.
Read his blog at http://www.froedtert.com/HealthResources/
ReadingRoom/HealthBlogs/Reflections.htm