Where cancer patients can find advice for eating right

Maria Erdman

Maria Erdman

Upstate registered dietitian nutritionist Maria Erdman recommends these resources for help eating well during and after cancer treatment. She also sees patients who are referred by physicians. Reach her at 315-464-3607.
— The National Cancer Institute makes the booklet “Eating Hints: Before, During and After Cancer Treatment” available free of charge by calling 800-4-CANCER or online.

— The book “Nutrition for the Person With Cancer During Treatment” by the American Cancer Society is available by calling 800-227-2345 or online.

— For more information on cancer research and foods that fight cancer, see the websites of the American Institute for Cancer Research or the Academy of Nutrition and Dietetics’ oncology nutrition practice group.

— “A Consumer’s Guide to Food Safety Risks” is available at foodinsight.org, the website of the International Food Information Council Foundation.

This article appears in the fall 2016 issue of Cancer Care magazine.

Posted in research, health care, cancer, recipe, diet/nutrition, digestive/gastrointestinal, illness | Tagged , , , | Leave a comment

What might $50,000 help discover?

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Scientists think big, and long term. They measure progress incrementally, knowing that solutions are often years, decades, centuries in the making.

Such dedication can bring society closer to finding cures for cancer, ways to prevent the disease or extend survival.

To that end, the Carol M. Baldwin Breast Cancer Research Fund of CNY awarded grants of $50,000 each to five research projects at Upstate that just might help find:

A way to identify fracture risks

Breast cancer patients whose disease spreads to bone are at risk for disabling fractures. If there were a reliable method of predicting which bones were most likely to break, surgery could be done to reduce the risk. Orthopedic surgery professors Timothy Damron, MD, and Kenneth Mann, PhD, are testing a way of identifying fracture risks using computerized tomography and a structural stress analysis. The Baldwin grant money will allow them to further verify the sensitivity and specificity of this method.

A means of stemming the spread of breast cancer

Breast cancer becomes deadly when it spreads, so some researchers are focused on impeding tumor cell migration. Assistant professor of urology Dimitra Bourboulia, PhD, explains that tumor cells migrate once a group of enzymes called matrix metalloproteinases degrade structural protein barriers. She’s looking at natural inhibitors to these enzymes, hoping to understand their impact on tumor cell invasion – and come up with a new treatment strategy for metastatic breast cancer.

A route to targeted therapy

Most human cancers evolve from genetic mutations that occur due to gene damage during a person’s life. One form of damage is chromosomal DNA strand breakage, which cancer cells exploit to rearrange the genome and adopt abnormal behaviors. Wenyi Feng, PhD, an assistant professor of biochemistry and molecular biology, maps chromosome breaks in breast cancer cell lines using a novel technology called Break-seq. If proven sensitive enough, the technique could ultimately be used to help doctors prescribe targeted therapy.

A deeper understanding of cell division

Heidi Hehnly, PhD, an assistant professor of cell and developmental biology, studies mitotic cell division, in which a cell splits into two genetically identical “daughter” cells. This process relies heavily on an enzyme to segregate the chromosomes into the two cells. Defects in this process lead to the progression of cancers. Hehnly’s lab is working to understand exactly how.

A safer way to deliver medication

Not all medications have the ability to cross into the brain from the bloodstream, but a cancer drug called cabazitaxel does. It was developed for use when other drugs stop working, so it holds promise for treating cancers and brain metastases, such as breast cancer that has spread to the brain. The problem is, the drug harms other organs with which it comes into contact. That’s why Juntao Luo, PhD, an assistant professor of pharmacology, and Vivian Gahtan, MD, the division chief of vascular surgery and endovascular services, will study whether a nanocarrier delivery system developed in their lab can safely transport cabazitaxel into the brain to treat breast cancer brain metastases, while sparing healthy tissue.

This article appears in the fall 2016 issue of Cancer Care magazine.

Posted in bones/joints/orthopedics, cancer, drugs/medications/pharmacy, genetics, health care, illness, medical imaging/radiology, research, surgery, technology, urology, women's health/gynecology | Tagged , , , | Leave a comment

Art from adversity: Students transform radiation masks into artistic décor

Mask sculpture by Amina GIngold. (PHOTO BY WILLIAM MUELLER)

Mask sculpture by Amina GIngold. (PHOTO BY WILLIAM MUELLER)


“Everything will be OK. I’ll be in a better place. I love you.”

Amina Gingold’s mother spoke these words to her while dying of colon cancer.

Gingold paid tribute to her mother by embellishing these phrases with paint and flowers as a way to transform suffering into beauty.

Gingold and six other Manlius Pebble Hill School students in the advanced studio art class created art out of radiation masks used to treat head and neck cancer as part of Beneath the SurFACE, a project organized by the Upstate Cancer Center. Eight schools and 25 professional artists from Central New York participated in the project, which also educated the artists about these cancers.

Gingold lost her mother, Naomi Chernoff, in fifth grade.

“I wanted it to be something meaningful for the cause,” said Gingold, who graduated last June. “I thought I would make an ode to her.”

Gingold painted her mask white with tears flowing from its closed eyes. Clustered in the blue are vibrant flowers, representing beauty growing out of pain.

Creating beautiful art from unimaginable ordeals was no simple task, however. Teresa Henderson, chair of the visual art and design department and class instructor, described the difficulty of doing justice to a cancer patient’s experiences through the masks.

“Because it’s such a big topic and it’s such a real topic,” Henderson said, “the topic has to be treated with a level of respect, but it also needs to have the balance of the artistic voice as well.”

Six MPH masks, including Gingold’s, were auctioned off at the Upstate Cancer Center in April. The auction raised more than $6,000 for the center’s head and neck cancer patient fund. Upstate also produced a documentary about the project designed to serve as an educational tool for cancer prevention. MPH students were interviewed for the film.

Going forward, Henderson hopes the masks will be informative tools in the community. “Art isn’t something that just hangs on the wall,” she said. “Art is something that has the ability to engage, it has the ability to advocate, and it has the ability to bring more information and more awareness.”

This story by Lily Grenis, a student at MPH, first appeared in her school publication, the Pebble, and was reprinted in the fall 2016 issue of Cancer Care magazine.


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Upstate med student had a hand in PBS cancer documentary

Images from the documentary "Cancer: the Emperor of All Maladies."

Images from the documentary “Cancer: the Emperor of All Maladies.”


When Raghib Siddiqui was in his junior year of studying neurosciences and English at SUNY Stony Brook University on Long Island, he looked for work that would nurture his twin interests of science and writing.

He came across an internship opportunity he describes as “an interesting confluence of the two.” His background in biology and his college writing samples helped get him hired.

Raghib Siddiqui is a first-year medical student at Upstate. (PHOTO BY SUSAN KEETER)

His job was to research and tell the complete story of cancer, from prehistory to the present, and make it easily understandable to the crew of a film production company. The crew was making the documentary “Cancer: The Emperor of All Maladies,” based on the Pulitzer Prize-winning book by Siddhartha Mukherjee, MD, PhD. The six-hour film premiered on PBS in 2015.

Siddiqui, 26, now a first-year medical student at Upstate, worked on the project for 15 to 20 hours a week in New York City, continuing for about a year after his 2012 graduation.

“We were trying to catalog the history of cancer from the earliest recorded history, from Hammurabi and ancient prehistory, trace it down through the advent of chemotherapy, surgical procedures to remove tumors, down to the present day — a millennium of living with the disease,” he says. “My job was to look at trends in cancer all across the world, so we could break it down into key terms,” he says.

Siddiqui focused on the history of chemotherapy, which from its earliest days, about a century ago, competed with the long-established cancer treatment of surgery. “Eventually, chemotherapy proponents and surgeons worked together in a clear analogue of what we have today,” he explains.

Siddiqui got a master’s degree in biomedical sciences from Tufts University before coming to Upstate. He says with his penchant for carpentry and building things, he is leaning toward a surgical career, probably in pediatrics.

See the film

Visit PBS.org to watch the documentary “Cancer: The Emperor of All Maladies.” It’s also available for purchase at shoppbs.org.

This article appears in the fall 2016 issue of Cancer Care magazine.


Posted in cancer, drugs/medications/pharmacy, entertainment, health care, history, illness, international health care, medical student, research, surgery | Tagged , , | Leave a comment

Coping with mouth sores from cancer treatment


People with mouth sores can use a rinse made from 12 ounces of warm water, ¼ teaspoon baking soda and ½ teaspoon salt.


What they are:

Mouth sores that develop during chemotherapy and/or radiation treatment are called “oral mucositis.” They look like burns. Often they appear on the inside lining of the mouth or lips. You may notice them on your gums, tongue or the roof or floor of your mouth. They may also appear on the esophagus, the tube your food travels into the stomach.

Whether they form depends on the type and dose of chemotherapy you are taking, or the area and dose of radiation delivered if you are taking radiotherapy.

How they form:

Many cancer treatments are designed to kill rapidly growing cells. Cancer cells grow rapidly, but so do the cells that line the inside of your mouth. When these healthy cells are damaged, mouth sores may develop. This can range from a minor inconvenience to a severe complication that could impede eating, talking, swallowing and even breathing.

Why they matter:

Untreated, mouth sores can lead to infection, painful ulcers or the inability to eat and drink, and cancer treatment can be affected.

How they’re treated:

Doctors can prescribe medications that coat the entire lining of the mouth, so the sores are protected and the pain is lessened. Topical painkillers may be used for numbing.

What you can do:

  • Make sure your dentist is aware you will be undergoing chemotherapy or radiation therapy and ask about taking care of any unresolved dental issues such as gum disease, cavities or teeth that need to be pulled.
  • Tell your doctor if you have a history of mouth sores. Antiviral medicines are sometimes prescribed for people who get frequent mouth sores from the herpes simplex virus.
  • Floss with caution. If you have dentures, clean them at least once a day, wear them only when necessary and make sure they fit properly.
  • Rinse your mouth frequently while awake and if you awaken during the night. Use a solution of 12 ounces of warm water, ¼ teaspoon baking soda and ½ teaspoon salt.
  • Brush your teeth with a soft-bristle brush after every meal, using a non-irritating toothpaste as recommended by your dentist.
  • Check your mouth three or four times a day for sores or any changes – and keep your doctor posted.
  • Keep your lips and mouth moist. Drink 1 to 2 liters of fluid per day. Use a lip moisturizer. Suck on sugar-free candy or chew gum. Popsicles or ice can help decrease swelling and reduce pain. Consider using a saliva substitute.
  • Liquid Tylenol or Advil may help relieve mouth pain. Your doctor or nurse can recommend prescription options if necessary.
  • Maintain good nutrition, eating foods and liquids that are easy to swallow. Cut your food into small pieces. Or, you may need to use a blender to mix your food with a liquid.
  • Foods high in protein are the best choice. You may also include daily servings of liquid supplements such as Ensure, Boost or Carnation Instant Breakfast. Seek a referral to a nutritionist if you would like help.

What you should not do:

  • Do not assume you can crush medication if you are having trouble swallowing. Speak to your pharmacist first.
  • Do not use alcohol-based mouthwashes, which can dry out your mouth.
  • Do not use alcohol, caffeine and tobacco, as these can cause your mouth to dry out.
  • Do not eat extremely hot or cold foods or fluids, and avoid foods that are spicy or contain citric acid to avoid mouth irritation.
  • Do not eat foods that are hard, crunchy or chewy because they can irritate your mouth.

This article appears in the fall 2016 issue of Cancer Care magazine.


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State health commissioner taps Upstate doctor for cancer panel


Leslie Kohman, MD

Leslie Kohman, MD

Leslie Kohman, MD, director of outreach for the Upstate Cancer Center, has been appointed to the New York State Cancer Detection and Education Program Advisory Council.

The council has 21 members appointed by state Health Commissioner Howard Zucker, MD, JD, who provide recommendations and guidance on cancer-related prevention and detection issues, disease management and treatment, new technologies and survivorship.

Kohman points out that New York has a higher incidence of cancer but a lower death rate than the nation as a whole. This indicates good medical care in our state, she says, “however, there are striking differences by county, and these disparities need to be corrected.”

Her work with the American Cancer Society and the New York State Cancer Consortium has given Kohman familiarity with the state’s cancer plan.

This article appears in the fall 2016 issue of Cancer Care magazine.


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With lung cancer at bay, she’s cruising Florida coast on her Harley

Toni Lindgren on the motorcycle she and her husband bought for her after her chemotherapy treatments for lung cancer. This winter, she plans to ride it along the eastern coast of Florida.

Toni Lindgren on the motorcycle she and her husband bought for her after her chemotherapy treatments for lung cancer. This winter, she is riding it along the eastern coast of Florida. (PHOTO BY SUSAN KAHN)

As a retired police officer, Toni Lindgren knows how to deal with problems. So, when a physician at Fort Drum said, “I think it’s cancer,” Lindgren said, “I’m going to Upstate. I want the doctors who do cancer all day, every day.”

Last March, Lindgren, 58, of Carthage saw her primary care physician because she was concerned that her stuffy nose and occasionally bloody cough might be symptoms of an infection that her elderly mother could catch.

“Just to be on the safe side, let’s do a chest X-ray” said Lindgren’s primary care doctor. She and her husband receive care though Fort Drum because of his military service.

That evening, the doctor called her at home. He made sure she wasn’t alone. Her husband, Dale, was with her. “There’s a large mass on the lower lobe of your right lung,” the doctor told them. “Don’t wait until Monday. Get a CT scan at Carthage Hospital now.”

The CT scan confirmed a tumor in her lung, and Lindgren’s doctor gave her a referral to the Upstate Cancer Center.

Brenda Sah, MD

At Upstate, Brenda Sah, MD, inserted a scope through her mouth so he could view her lungs, trachea and surrounding area with the scope’s camera. That procedure, called a bronchoscopy, showed lung squamous cell carcinoma in a lymph node. It was followed by a PET scan, which illuminated the cancerous tumor and a number of concerning spots near her trachea.

“I lit up like a Christmas tree,” described Lindgren, shaking her head.

Since the PET scan made it appear that cancer had spread from the lung to the lymph nodes, the initial plan was to treat Lindgren with chemotherapy and radiation.

Lindgren’s reaction was, “This thing’s growing every day. I want surgery to get it out!”

Jason Wallen, MD

The multidisciplinary thoracic oncology team at Upstate met to discuss Lindgren’s case and, with her involvement, decided that a second biopsy, called a mediastinoscopy, was warranted to further examine the middle of her chest, between the lungs.

The results were encouraging. Surgeons Jason Wallen, MD, and Robert Dunton, MD, biopsied multiple lymph nodes, and none  were cancerous. Most of the areas illuminated by the PET scan were “false positives,” meaning noncancerous. Now, surgery was an option.

Robert Dunton, MD

On May 3, Lindgren had minimally invasive surgery to remove the lower lobe of her right lung. She was released from the hospital four days later, on her husband’s 60th birthday.

The final pathology report showed that only two lymph nodes were cancerous.

Oncologist Stephen Graziano, MD, recommended 12 weeks of chemotherapy. Between June and August, Lindgren and her husband rose at 5 a.m. to drive from Carthage to Syracuse for her treatments.

Lindgren tolerated the chemotherapy well. She had just a couple of bouts of nausea and never lost her hair. However, a few weeks into treatment, Lindgren faced another blow: While she was being treated at Upstate, her mother died in another hospital in another city.

Stephen Graziano, MD

“I couldn’t visit Mom because my resistance was low because of the chemo,” explained Lindgren. “But we were able to video chat. Mom told me she’d decided to stop her treatment for a lung condition. Now, she and my dad, who died six years ago, are angels in heaven making sure I’m OK.”

One tough day at the hospital, Lindgren’s husband mentioned that they ought to look at a white Harley-Davidson motorcycle that was for sale in Utica. For Lindgren, it was love at first sight. She had long dreamed of riding a Harley on Highway A1A in Florida with her husband.

With surgery and chemotherapy completed, Lindgren and her husband were ready to snowbird. Lindgren’s CT scan in September and chest X-ray in November were clear, paving the way for their extended trip. Shortly after her birthday on Nov. 14, the couple left Carthage for St. Augustine, Fla. She will see doctors there, and then she has an appointment with Graziano in April at Upstate.

The couple is grateful.

“When I got the news of lung cancer last spring,” admits Lindgren, “I didn’t think I’d live to see my birthday.”

Now, she’s in remission. She’s enjoying warm weather and long motorcycle rides with her husband.

Posted in cancer, entertainment, Expert Advice, health care, illness, lung/pulmonary, medical imaging/radiology, patient story, Smoking Cessation | Tagged , , , , , , , | Leave a comment

Installing a port and a feeding tube at the same time makes sense for some patients – and it’s safe, study shows

Upstate pathologist Rana Naous, MD, examines a spot in which a fine needle aspiration could be used to test a tumor in the neck for cancer. See the secondary story below for more on this procedure. (PHOTO BY WILLIAM MUELLER)

Upstate pathologist Rana Naous, MD, examines a spot in which a fine needle aspiration could be used to test a tumor in the neck for cancer. See the second story below for more on this procedure. (PHOTO BY WILLIAM MUELLER)


Most patients with head and neck cancer require the installation of a port, and many will also need a feeding tube.

Katsuhiro Kobayashi, MD

Katsuhiro Kobayashi, MD

“For the patient’s convenience, placing both devices at the same time would be ideal,” says Katsuhiro Kobayashi, MD, an assistant professor of radiology at Upstate who was part of a study that examined whether doing both procedures at once was as safe as doing them several days apart.

Interventional radiologists commonly install these devices. Ports help reduce the number of times patients are stuck with needles for blood samples or medication injections. Feeding tubes are necessary for patients who can’t take in enough food by mouth to stay healthy.

Kobayashi and Philip Skummer, a second-year medical student at Upstate, reviewed the medical records and imaging studies for 76 men and women treated for head and neck cancer at Upstate between January 2012 and June 2014.

Philip Skummer

Philip Skummer

The researchers wanted to know if infection rates were different for the 30 who had a port and a feeding tube installed in two separate sessions than for the 46 who had both devices installed in the same session.

None of the patients developed infections with their ports in the first 30 days after they were placed. About 11 percent of patients from the single session group and 7 percent from the two-session group developed minor infections with their feeding tubes within the first 30 days of its placement.

Infections are an unfortunate risk of the procedure. The researchers concluded that having both devices installed in the same session did not significantly increase that risk.

Fine needle aspiration: Quick way to diagnose suspicious lump

A biopsy done through fine needle aspiration is reviewed while the patient waits. (PHOTO BY WILLIAM MUELLER)

A biopsy done through fine needle aspiration is reviewed while the patient waits. (PHOTO BY WILLIAM MUELLER)

Fine needle aspiration is a quick, highly accurate biopsy for  diagnosing lumps in the breast or thyroid areas or lymph nodes in the neck, groin or armpit. The minimally invasive procedure is most often used to test for cancer.

After numbing the skin with a spray, a staffer from Upstate’s cytopathology laboratory pierces the lump with a needle – like the ones used for flu shots – then applies some suction and moves the needle inside the lump to dislodge some cells. Less than a minute later, the suction is released, the needle is withdrawn, and the cells are put on a slide and evaluated.

The patient usually waits a few minutes to see whether the cell sample is sufficient or needs to be repeated.

A pathology report to the patient’s health care provider is usually ready within 24 hours. The test might be conducted in a clinic or at a hospital bedside, sometimes guided by medical imaging. Complications are infrequent, and discomfort is usually minimal.

This article appears in the fall 2016 issue of Cancer Care magazine. Hear a radio interview/podcast with Kamal Khurana, MD, medical director of cytopathology at Upstate, about fine needle aspiration as a less invasive option to surgical biopsy. 

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Recipe: Acorn Squash and Apple Soup

Acorn Squash and Apple Soup offers a soothing dish designed to be easily eaten by those with mouth sores or sensitive stomachs due to cancer treatment.

Acorn Squash and Apple Soup offers a soothing dish designed to be easily eaten by those with mouth sores or sensitive stomachs due to cancer treatment.

For a soothing, cool-weather meal that’s easy on the mouth and the tummy, turn to squash, apples and onion. When combined into this satisfying soup, you’ll have a good source of potassium and fiber. Prep time takes about 20 minutes. Soup’s ready for serving within an hour.


1 medium acorn of butternut squash (1½ to 2 pounds)

2 tablespoons butter or margarine

1 medium yellow onion, sliced (1/2 cup)

2 medium tart cooking apples, peeled and sliced

1 teaspoon dried thyme leaves

½ teaspoon dried basil leaves

2 cans (14 ounces each) chicken broth

½ cup half-and-half

1 teaspoon ground nutmeg

½ teaspoon salt

¼ teaspoon white or black pepper


  1. Heat oven to 350 degrees. Cut squash in half; remove seeds and fibers. Place cut sides up in 13-by-9-inch pan. Pour ¼ inch water into pan. Bake uncovered about 40 minutes or until tender. Cool. Remove pulp from rind and set aside.
  2. Meanwhile, in heavy 3-quart saucepan, melt butter over medium heat. Add onion; cook 2 to 3 minutes, stirring occasionally, until crisp-tender. Stir in apples, thyme and basil. Cook 2 minutes, stirring constantly. Stir in broth. Heat to boiling. Reduce heat; simmer uncovered for 30 minutes.
  3. Remove 1 cup apples with slotted spoon; set aside. Place 1/3 each of the remaining apple mixture and squash in blender or food processor. Cover, blend on medium speed about 1 minute or until smooth, then pour into bowl. Continue to blend in small batches until all soup is pureed.
  4. Return blended mixture and 1 cup reserved apples to saucepan. Stir in half-and-half, nutmeg, salt and pepper and cook over low heat until thoroughly heated.

Nutritional information

This recipe makes six servings. Each contains:

190 calories

7 grams fat

20 milligrams cholesterol

670 milligrams sodium

690 milligrams potassium

26 grams carbohydrates

6 grams dietary fiber

5 grams protein

Source: “Betty Crocker Living With Cancer Cookbook”

This article appears in the fall 2016 issue of Cancer Care magazine.

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A moonshot: Pediatric cancer chief tells how effort could help young patients

Melanie Comito, MD, Upstate's chief of pediatric hematology and oncology. (PHOTO BY SUSAN KAHN)

Melanie Comito, MD, Upstate’s chief of pediatric hematology and oncology. (PHOTO BY SUSAN KAHN)


Overall, one could say the U.S. is doing well in battling childhood cancers.

Since the 1960s, pediatric cancer deaths have fallen steadily. Today’s average five-year survival rate is 84 percent, compared to about 50 percent in 1975.

But challenges remain, says Melanie Comito, MD, Upstate’s chief of pediatric hematology and oncology.

She points out that progress has been slow, or nonexistent, in treating some childhood cancers in the last two decades, resulting in lost lives and devastated families.

In addition, of the roughly 80 percent of childhood cancer patients who are alive after five years, about half end up with chronic medical conditions. About a fifth die prematurely.

Most of the money for cancer research goes to adult cancers, Comito says, because adults make up about 99 percent of all cancer cases. Of the 1.6 million Americans diagnosed with cancer each year, about 16,000 are younger than 20.

While far more adults get cancer, children pay a bigger cost in death or chronic medical conditions, Comito told an audience at an Upstate cancer symposium in September. The average loss of life from cancer is 71 years for children, vs. 15 years for adults, since adults tend to be diagnosed at age 67, and children at age 6.

Put another way, 11 U.S. children die of cancer every day, or about 4,000 a year, making it the biggest cause of childhood death from disease.

Comito expresses hope as she describes how the  “Cancer Moonshot” – the ambitious national effort underway to defeat the disease – could help young cancer patients:

  • repurposing drugs now used only for adults.
  • developing drugs targeted to children’s cancers and aiming to lessen later effects.
  • adapting immunotherapy – using the patient’s immune system — for children’s cancers.
  • studying the microenvironment, or healthy tissue around tumors, to better target the disease.
  • increasing research funding.
  • continuing and improving the multidisciplinary approach to treatment, to pool the knowledge of researchers and health care providers.

What if a cure meant not only getting rid of cancer but that no one could ever tell you had been treated for it? Comito muses. Or if children could be screened for cancer, then given a biologic agent of some sort, so  no one ever needed treatment?

“We not only want to cure more children, but we want a cure that will last into adulthood and make them productive adults,” she says.

This article appears in the fall 2016 issue of Cancer Care magazine. Hear a radio interview/podcast with Comito about pediatric brain and spine cancers.

Posted in adolescents, cancer, death/dying, drugs/medications/pharmacy, health care, HealthLink on Air, illness, research, Upstate Golisano Children's Hospital/pediatrics | Tagged , , , , | Leave a comment