1. Well written. I, too, am amzaed at the many "miracle cures" that I have been handed since my diagnosis of stage IV breast cancer last year.

Posted at 10:17PM on Aug 26th 2006 by Doris Juul

2. "You might just be an 'altie' if"-->

http://scienceblogs.com/insolence/2006/02/what_is_an_altie_2006_edition.php#comment-182107

Now, I know that some "alternative medicine" practitioners will be offended by this, but I just introduce the subject for those that may have plunked down or are going to plunk down some hard earned money for an alternative treatment.

The final one on the list? -->
"Finally, if you are deeply offended by the above list, you just might be an altie."

I offer this list because a real problem with evidence-lacking methods is that there often is a big let-down when these "treatments fail." The build- up is easy with vulnerable patients who will do anything to get better. But, the fall is hard.

Posted at 12:02AM on Aug 27th 2006 by Michelle

3. I too thank you Kristina. As an initially stage 3 prostate cancer patient with a challenging case (PSA 113.6, poor biopsy results) and a prognosis in late 1999 of five years from respected doctors on both the East and West Coast, I too received advice about alternative medicine, including one well-known outfit in Tijuana. I was not impressed, but did check if there were any scientific studies of their results, and found a site on complementary and alternative medicine associated with MD Anderson in Texas, one of the top institutions for prostate cancer. In the only study I thought credible and substantial, all the advanced cancer patients died fairly shortly after the therapy. Again, I was not impressed.

(Incidentally, I'm in the Washington, DC area where Dr. Mirkin practices, and I consulted him just to get a lead to good prostate cancer doctors. He gave me good advice.)

Quackwatch is a site I turn too whenever I have questions about an alternative approach that is new to me. Another good site is at the NIH, its Center for Complementary and Alternative Medicine. Its website is http://nccam/nih/gov. It has results of studies it has funded plus a link to "CAM on PubMed" (CAM: Complementary and Alternative Medicine), which is the usual www.pubmed.gov with CAM already selected as a "Limit" feature. As an example, if you look up "Gerson AND cancer NOT gerson [au]" (that finds Gerson therapy research involving cancer but does not include authors with the last name Gerson), you get twelve hits, including two with the green-heading page icons indicating free full papers available. Leaving in "AND gerson [au]" will pick up all authors named Gerson, including those associated with the Gerson Institute. Clicking on the hypertext will bring up the abstract, if available, and clicking on the green-heading page icon will take you to the free complete paper. To me, the lack of formal studies about the Gerson approach is key evidence in itself. One of the free papers available is critical of the approach.

(My own approach includes a supporting program of diet, nutrition/supplements, exercise and stress reduction, but the central core is advanced hormonal blockade.)

Jim (http://www.mycancerplace.com/profile.php?id=147)

Posted at 9:46AM on Aug 27th 2006 by Jim Waldenfels

4. THE TOOTH FAIRY: (a fable about alternative medicine, astrology, etc.....)

Is the Tooth Fairy Real?: A Fable

Harriet told her little brother Dan that there was no Tooth Fairy; it was their parents who put the money under the pillow.

Dan refused to believe Harriet. He knew there was a Tooth Fairy. Every time he put a tooth under his pillow, there was money there the next morning. And all his friends said the Tooth Fairy brought them money too. And it couldn't be Mom and Dad because he'd wake up if they came in the room and lifted his pillow. Anyway, Mom and Dad said there was a Tooth Fairy, and they wouldn't lie.

Harriet asked him how he thought the Tooth Fairy found out about lost teeth, how she got into the house, where she got the money from, and what she did with the teeth. Dan said he didn't know, but wasn't it a wonderful mystery? Harriet pointed out that older kids all eventually stopped believing in the Tooth Fairy. Dan said that only proved that the Tooth Fairy would only bring money to those who still believed in her.

Harriet got several neighborhood kids to help test whether the Tooth Fairy would appear if the parents didn't know a tooth had been lost. It turned out that every time the parents knew about the tooth, there would be money under the pillow the next morning, and every time the parents didn't know about the tooth, there would be no money. Dan said the Tooth Fairy was just refusing to cooperate in those cases, because she wouldn't bring money if she knew she was being tested.

Harriet got out her Junior Detective kit and dusted Dan's Tooth Fairy money for fingerprints. Sure enough, she found their parents' fingerprints on it. Dan said that didn't prove anything, because there are lots of ways the Tooth Fairy could get hold of money the parents had previously touched. Or she could have magically put the evidence there to confuse us. And of course, the Tooth Fairy wouldn't leave any fingerprints of her own because she was magical.

The next time Dan lost a tooth, Harriet spread flour on the floor, and the next morning, she showed Dan their parents' footprints between the door and the head of his bed. He said that didn't prove anything-his parents had probably just checked on him, and the Tooth Fairy had come later. There were no Tooth Fairy footprints, because fairies don't leave footprints.

The next time Dan lost a tooth, Harriet set up a video camera in Dan's room and caught their parents in the act. (For those readers with dirty minds, I mean the act of removing the tooth and putting money under the pillow.) Dan told her that didn't prove a thing. Maybe the Tooth Fairy wouldn't appear when a camera was present. Maybe she is a shape-shifter who made herself look like their parents on videotape. Maybe she asked Mom and Dad to do the job for her just this once.

Harriet led Dan into their parents' bedroom, opened a dresser drawer, and showed him a box containing all of Harriet's and Dan's baby teeth neatly labeled and dated. She said that was proof their parents were taking the teeth and leaving the money. Dan said it was no such thing; the Tooth Fairy probably passed the teeth on to parents for keepsakes, or maybe she sold teeth to parents to raise the money she put under the pillows. Hey, yeah, that would explain the fingerprints!

Harriet and Dan confronted their parents, who admitted they had been taking the teeth and leaving the money under the pillow. Dan said either they were lying before or they're lying now, and they're probably lying now. Why trust what anyone says? He was just going to ignore everything except what he knew: the tooth-under-the-pillow thing worked. The Tooth Fairy was real.

Harriet screamed in frustration and tore all her hair out. She left it under her pillow. It was still there in the morning.

----

A very good piece on a skeptic who encounters alties, astrologers, etc.-->

http://www.csicop.org/si/2006-03/thinking.html

Posted at 12:56PM on Aug 27th 2006 by Michelle

5. I have read many words about scientific truths and quackery and the like. There is an old adage;figures lie and liars figure. If you are merck or some other big pharma company, you literally have billions at your disposal. Enough money by far bury any truth which does not fit into you prospectus. Our current form of cancer therapy has been the same for 50 years; cut, burn, poison. More people are dying today from the disease than at any other time in our history; cancer has surpassed heart disease as the #1 killer in the US behind iatrogenic deaths caused by the doctors who spew these lies. But still, there are leigons of doctors and readers who are knocking alternative medicine and alternative therapies. These same therapies which saved my life from terminal brain cancer. It is time to wake up my friends; I am not a doctor but you do not need to be a doctor to see the truth. Huge forces right now struggle to take your rights for alternative treatments away from you; not because they are ineffective but because they work. Common sense would tell you this is true. When the FDA raids a vitamin store they are not walking in with search warrents and warning letters; they are coming in with armed police officers, weapons drawn and ready for action. They will arrest you if your health books are too close to pancreatic enzymes. If all this were drivel would the FDA go to such lengths? The same FDA that approved Vioxx resulting in 100,000 deaths? I don't know you answer this for yourself. Forget the tests; forget the clinicals. What would you do if you were trying to protect your business and you controlled the FDA. How would you react to natural supplements and those who touted them? If there were natural cures out there how would you discredit them? These people use your own intelligence against you, and you make it possible. You even side with them in this. Consider which way things are going and if you want to go there?

Posted at 10:12PM on Aug 31st 2006 by Rod Czlonka

6. Mr. Czlonka states : "Huge forces right now struggle to take your rights for alternative treatments away from you; not because they are ineffective but because they work. Common sense would tell you this is true."

In fact, the CAM is now beginning to put these "alternative treatments" to the test, though so far the tests are few and , as with St. John's Wort and Echinacea, the well done studies at CAM have shown absolutely no effect.

I'll take evidence over "common sense" any day.
Now, I know you claim to have been healed with alternatives like laetrile, but just because you survive does not in the least show cause and effect.


Now, how much do you stand to make off the vulnerable from your sales?

http://www.czlonkamediagroup.com/Nutrition.html


Mr. Czlonka is well aware that "There's a "seeker" born every minute."

Who will he prey on next?

Posted at 3:43PM on Aug 27th 2006 by Michelle

7. A problem with the empirical approach is it yields information about how large populations are likely to respond to a treatment. Doctors don't treat populations, they treat individual patients. Because of this, doctors give treatments knowing full well that only a certain percentage of patients will receive a benefit from any given medicine. They need information about the characteristics that predict which patients are more likely to respond well. The empirical approach doesn't tell doctors how to personalize their care to individual patients.

Posted at 1:16AM on Aug 28th 2006 by Gregory D. Pawelski

8.
It's true that population studies don't tell physicians how to personalize treatment, but it's what we have to work with now and it is effective. That is why we see tumor regression with treatment.

There are many problems and significant costs with the adaptive model, but the FDA is working to make it a plausible trial method.

http://www.bio-itworld.com/issues/2006/june/cover-story-sidebar

Posted at 10:02AM on Aug 28th 2006 by Michelle

9. Rod - I doubt you would believe anything I have to say, but would you mind telling us the details of your diagnosis, disease and treatment? Frankly, I would like to see if: (1) there was any sound evidence of brain cancer (often alternative methods cure "cancer" where there was no actual cancer); (2) what alternative treatment you had and whether you had proven treatment at the same time but are crediting just the alternative treatment; and (3) what evidence you have of any cure.

I credit most of the success I have had to an investigational treatment using hormonal blockade drugs against a challenging case of prostate cancer. I do use a supportive "alternative" program of diet/nutrition/supplements, exercise, and stress reduction. However, there is a lot of formally published medical research to back up that "alternative" program. There is also published evidence and yet unpublished research credible to me to back up the hormonal blockade program I am on.

Here is an example of what I consider the right way to view a nutritional item, in this case soy for prostate cancer patients. (The use of soy for breast cancer raises some serious issues and contr-indication cautions.) The doctor I follow most closely for nutritional advice for prostate cancer (and for many other aspects too) is Dr. Charles "Snuffy" Myers, Jr., a well-known medical oncologist specializing in prostate cancer (and the moderator of our national convention this coming October). A decade ago he gave a tentative endorsement of extra soy in the diet and perhaps by supplement to help against prostate cancer. Those who get his newsletter and follow his talks realized he had dropped mentioning soy, and it was clear that he was concerned about it. A couple of years ago, some solid research was published in support of soy for prostate cancer, including a study headed by eminent PC researcher Maha Hussain. Dr. Myers called that to our attention and re-endorsed soy, taking it himself as part of a program to help prevent a recurrence of his own challenging case. He explained he had become disturbed by the lack of any published clinical trial results for a nutritional item that should not be hard to put to the test. To him, that's a sign there may be problems, including possible negative findings that do not typically find as warm a welcome in major, peer-reviewed medical journals. That all changed when solid medical research was published.

Jim Web Page at http://www.mycancerplace.com/profile.php?id=147

Posted at 11:10AM on Aug 28th 2006 by Jim Waldenfels

10. Gregory (Comment #7) and Michelle (Comment #8),

Michelle - nice posts, especially about the fairy tale. Unfortunately all too true!

You both posted about the present lack of tailored, personalized medicine that we too often encounter.

For the past two years I have had the privilege of participating as a survivor representative in the Scientist-Survivor Program sponsored by the American Association of Cancer Research. Our primary activity is participating in the AACR's national conference, and we are very well treated, including hearing special talks to our small group (about forty survivors/advocates plus mentors) from leading experts who often address plenary sessions.

One of the things that has impressed me is the drive to personalize cancer treatment. It is very clear that we are not there yet, but it also clear that solid progress is being made and that personalization is high on the agenda of many researchers.

The AACR works hard to get the word out. Part of this involves a $100,000 investment in recorded webcasts that all of us can access. One set of four talks recorded in 2006 in audio only was an educational session entitled: "Educational Session: Expression Signatures: Challenges to the Promise of Individualized Therapy." You can access these by going to the AACR site at www.aacr.org, then clicking the Virtual Conferences button, and working your way to the presentations for April 1, between 9:00 and 11:00 AM, where you will see the four talks listed for downloading.

I invite you to try it and comment on the experience.

I haven't even mentioned the enormous interest in putting findings from the Human Genome Project and research about the human proteome to work. You will find abundant research about those efforts at the AACR site. My association regarding research is more on the basic and intermediate research side, though the AACR is involved in some translational research that helps bring research advances to the clinic where they can benefit patients. There is also a lot of interest in individualizing medicine at the clinical level, for example by the American Association for Clinical Oncology (ASCO), and you can get an insight into what they are doing by visiting their site, www.asco.org.

The national conventions for prostate cancer patients and an especially popular book, "A Primer on Prostate Cancer -- The Empowered Patient's Guide," have made me aware of some personalizing tools now available for prostate cancer patients. Some are simple blood tests, such as for PSA of course, for Prostatic Acid Phosphatase, for testosterone, and for dihydrotestosterone. Other involve analysis of the "ploidy" of chromosomes found in prostate cancer cells, and of the status of genes like p53 and bcl2. For advanced patients, knowing about VEGF (Vascular Endothelial Growth Factor), CEA (Carinoembryonic Antigen), NSE (Neuron-Specific Enolase) and CGA (Chromogranin Alpha) can help. Advanced imaging techniques, beyond the CT scans and bone scans that are almost useless for most patients, are also available. Much of this is not used by many doctors, but that should change.

Jim Web Page at http://www.mycancerplace.com/profile.php?id=147

Posted at 12:23PM on Aug 28th 2006 by Jim Waldenfels

11. The FDA is signaling that it's open to drug trials that shift midcourse, focusing on the trees rather than the forest. Big pharma has begun using "adaptive trials" that allow them to route larger groups of patients to more promising treatments in the middle of trials, and drop treatments that seem ineffective in early testing (a.k.a. Iressa).

The FDA has begun to show some openness to accepting these new types of trials in its assessment and approval process. That is why they are calling for predictive tests that allow for rational and cost-effective use of drugs. Not only is the EGFRx assay an important predictive test, it is also a unique tool that can help to identify newer and better drugs, evaluate promising drug combinations, and serve as a "gold standard" correlative model with which to develop new DNA, RNA, and protein-based tests that better predict for drug activity.

Over the past few years, researchers have put enormous efforts into genetic profiling as a way of predicting patient response to targeted therapies. However, no gene-based test has been described that can discriminate differing levels of anti-tumor activity occurring among different targeted therapy drugs. Nor can a gene-based test identify situations in which it is advantageous to combine a targeted drug with other types of cancer drugs. There is a growing array of targeted drugs to choose from. Most patients today are treated not with a targeted therapy drug alone but rather with a combination of chemotherapy drugs.

These so-called "smart drugs" focus their effects on specific, identifiable processes occurring within cancer cells. The new drugs are highly promising in that they sometimes provide benefit to patients who have failed traditional therapies. However, they do not work for everyone, they often have unwanted side effects, and they are all extremely expensive.

Cancer is a complex disease and needs to be attacked on many fronts. The best thing to do is to combine these different tests in ways which make the most sense.

Posted at 1:21PM on Aug 28th 2006 by Gregory D. Pawelski

12. When you read an aticle like this
http://www.nytimes.com/2006/08/29/health/29hpv.html
you can't help but marvel at the times we live in as we hammer away at the false hopes, greed, and lack of curiosity of the pseudoscientific.

Posted at 11:58AM on Aug 30th 2006 by Michelle

13. Yes it does! In 2005, Drs. Barry J. Marshall and Robin Warren, both Australians, won the Nobel Prize in medicine for proving, partly by accident, that bacteria and not stress was the main cause of painful ulcers of the stomach and intestine. A general practioner proved that ulcers are not caused by stress, spicy foods, or even cigarettes and alcohol, but rather by a bacterium. It was one of the most richly deserved Nobel Prizes in Medicine ever awarded.

Prior to the discovery, the number one surgical operation (in terms of revenue produced for the surgeons and hospitals) was the vagotomy and antrectomy. Prior to the discovery, the number one drugs were H2 receptor blockers like Tagamet and the then up and coming proton pump inhibitors like omeprazole. Single handedly, he got rid of both the number one surgical operation and the largest part of the market for the number one drugs, dealing a huge blow to both big surgery and big pharma, and making the lives of tens of millions much more pain free and enjoyable.

How many loved-ones had died of a bleeding ulcer? Today, they would have been cured permanently by a two week course of antibiotics. Oh! How having that big mug of thick black coffee without having to chase it with a half bottle of Maalox!

And the Aussies did it without any research grants and over the dead body opposition of the entire world of medicine, gastroenterology, surgery, the NIH, and the pharmaceutical industry. And, for gosh sakes, he used himself as the definitive guinea pig!

The belief that research grants will be our salvation can be so off base. Here and there around the world, there are decisions still being made by folks who aren't in the pockets of American Big Business. Individual intelligence, integrity and curiosity. Maybe there is a glimmer of hope?

Posted at 2:35PM on Aug 30th 2006 by Gregory D. Pawelski

14. "These same therapies which saved my life from terminal brain cancer."

There's no proof that alternative medicine saved your life from terminal brain cancer.

Provide the evidence for all to see. The "spewing" docs who performed surgery on you: what do they say?

Posted at 10:53PM on Sep 1st 2006 by Michelle

15. Rod,

I got a big kick out of the imagery in your post: "When the FDA raids a vitamin store they are not walking in with search warrents and warning letters; they are coming in with armed police officers, weapons drawn and ready for action."

I'm seeing a team of middle-aged, FDA ID-badged, PhDs barging through the doors, brandishing six shooters like Elliot Ness, Clint Eastwood or a modern day Barney Fife, demanding "Your statistics or your life" and shouting "Make my day" to some young clerk, perhaps an immigrant with a loose grasp of English, who is threatening to resist until the last shark cartilage capsule. Weapons drawn? Really! Perhaps the Branch Dividians did a Vitamin Boutique on the side to prompt such an assault? Seriously, did this stuff ever actually happen anywhere? I mean the guns drawn stuff. Would you mind providing dates, places, descriptions and a source?

Jim

Posted at 4:28PM on Sep 1st 2006 by Jim Waldenfels

16. One can very easily turn that logic around. There is no proof that alternative medicine didn't save his life. However Rod, I don't recall reading about legions of doctors and readers knocking alternative medicine and alternative therapies. There seems to be pretty many advocating it. It is obvious that you are passionate about your feelings, particularly after what you feel was a very successful event. There certainly was very good imagery in your post. There's really nothing at all wrong with that. The last five and a half years gave us a lot of that.

Posted at 2:18AM on Sep 2nd 2006 by Gregory D. Pawelski

17. G.P. states, "There is no proof that alternative medicine didn't save his life."

This reflects the logical fallacy:
*appealing to lack of proof of the negative.*

or
"This exists because there is no proof that it does not exist."

or

"I was cured by alternative methods because there is no proof that I was not cured by alternative methods."

or

"No one has proven that aliens do not exist. Therefore, based on that alone, they must exist, notwithstanding that I have no evidence that they do exist".

Given that it was not proven that aliens ( or alt med cure of brain cancer) do not exist, they ( alt med cure) might exist, but this alone does not prove them ( or the cure) to exist.

A very easy to understand explanation of why claims of cancer cures must be viewed skeptically
(not cynically, mind you, skptically):

http://en.wikipedia.org/wiki/Burden_of_proof_(logical_fallacy)

Posted at 10:21AM on Sep 2nd 2006 by Michelle

18. Can chemotherapy ever be bad, in cases where it apparently works? Life has been shortened by chemotherapy. The most likely mechanisms for this life shortening are toxicities of the drugs on the patient's body, such as immunosuppression and organ damage, and the mutagenic effects of chemotherapy on the genetically-unstable tumor, driving the tumor into a state of more aggressive behavior. You might kill off a whole lot of cancer, only to cause a mutation in the remaining cancer, such that the remaining cancer behaves in a more agressive fashion. Like when chemotherapy on an ER+ cancer brings about a remission, but in the process also causes any remaining cancer to become ER-.

It seems entirely reasonable that effective, although mutagenic therapy would be preferred over ineffective, mutagenic therapy. Chemotherapy not only causes mutations, which might make a given cancer more agressive, but it causes second malignancies as well (example: you cure testicular cancer, only to cause leukemia). It is bad enough that conventional cancer treatment can damage the heart, kidneys and liver and cause deaths from heart failure, kidney failure and liver failure. This means fewer deaths from cancer itself, but from the treatment.

Analysis of the records of 1.2 million cancer cases in the Surveilance, Evaluation and End Results (SEER) database showed that non-cancer deaths accounted for 21% - 37% of all deaths. The authors attributed this effect to the damage caused by cancer treatment, mainly chemotherapy. I believe that any true randomized clinical trial, where it has been shown that a group treated with chemotherapy experienced significantly increased survival when compared with that of an untreated group, would show these figures to be too low. In clinical trials, many patients are excluded because they could not complete the rather arduous treatment. So randomized comparisons are of healthier treated patients against all the controls, rendering a lot of trials invalid.

Until the controlled, randomized trial approach has delivered curative results with a high success rate, the choice of researchers to integrate promising insights and methods remains an essential component of new paradigms of treatment advocacy.

Posted at 1:56PM on Sep 2nd 2006 by Gregory D. Pawelski

19. I was rereading Michelle's comment #5 with her critical comments about Rod Czlonka's website, which she provided. (Thank you Michelle for your alertness!) I decided to visit, expecting unrealistic hype to sell product. I was not disappointed, but within seconds found outrageous hype.

The untrue statement has to do with selenium, which I use for my prostate cancer and for which I follow research developments closely. The problem is not with selenium, which PRELIMINARY evidence has identified as a potentially highly useful and inexpensive supplement that may aid a number of cancers. The problem is with this statement at the website:

"Selenium - This single nutrient has been shown to double the life expectancy of cancer patients."

Okay, Mr. Czlonka: cite the specific research, or if you cannot, admit that the statement is false! This is a direct challenge, in case I have not made that clear. Your statement is the kind of thing that makes me wish the FDA had the power to regulate sites such as yours. In fact, I think you have gone beyond even the liberal bounds now in place, and I will forward this to the FDA.

Those of us who are interested will find promising research on selenium on www.pubmed.gov, the free Government site that give access to abstracts of most of the world's medical literature (and the papers marked by green-headed page icons are complete papers for free, not just the abstracts). You can also find more preliminary reports (not yet published) at the site of the American Association for Cancer Research; look for abstracts under the annual national meetings or under the annual prevention research meetings.

I am most familiar with the work of the late Dr. Lawrence Clark, of the U. of Arizona, who was researching the impact of 200 mcg of selenium to prevent further skin cancer in a clinical trial involving about 1,100 men and women, predominantly men, with secondary study of several other cancers. The results, published in 1996, indicated no benefit for skin cancer, but dramatic reductions in the incidence of prostate cancer (63%), as well as lung and colon cancer, around 50%. If these results stand up upon verification, this will be a magnificent advance. This research spawned other studies, some now in progress, particularly including the very large SELECT clinical trial that is researching the impact of selenium, vitamin E, selenium + E, versus placebo. Unfortunately, even the early results will not be available for several years.

While Dr. Clark's research was most promising, the study was not aimed or designed for the secondary cancers, and this means the results come from relatively few patients in the selenium and placebo groups who actually got specific cancers. Features of the study bolster early confidence in the results, as do other studies from different angles such as studies using hair and nail samples and laboratory studies, but other promising approaches have looked as good and then faltered badly. Neither the Clark study nor other studies that I have seen rise to the level of proof, even in combination. The study did establish the safety of a dose of 200 mcg. Also, while the study indicated a reduction in incidence, it said nothing about the lifespans of those who already had the various cancers.

The statement at the Czlonka website implies that selenium benefits all cancer, as it is a general statement. However, it hasn't even been proved for a single cancer, as far as I am aware. The statement about selenium at the Czlonka site is highly deceptive.

I did not review the rest of the site. I did not want to waste my time.

Mr. Czlonka, you should be ashamed!!!

Jim Waldenfels

Posted at 1:18PM on Sep 4th 2006 by Jim Waldenfels

20. In comment #14, posted 9/1 at 4:26, Mr. Czlonka was asked to provide evidence that the FDA (or law enforcement acting for the FDA) had ever entered a vitamin shop with guns drawn.

In comment #19, posted 9/4, Mr. Czlonka was asked to provide a reference to evidence that selenium doubled the life spans of cancer patients.

As of this time, 9:12 AM Eastern on 9/7, Thursday, he has done neither. That supports my strong belief that no such evidence exists. I continue to think that selenium is valuable for many prostate cancer patients, and perhaps other cancer patients, as indicated in my post of 9/4, but not to the extent claimed by Mr. Czlonka.

Jim Waldenfels

Posted at 9:18AM on Sep 7th 2006 by Jim Waldenfels