Mr. Garcia is a 57-year-old retired banker who loves to play golf and garden. Despite chronic hip pain for which he takes aspirin on a regular basis, he plays golf 2-3 times a week in the spring and summer. His wife has encouraged him to see you today because over the past 3-4 months he has felt increasingly tired, and in fact, has not done his usual summer plantings. She also finds him very irritable. With some reluctance, Carmine tells you that he has been short of breath on the green on a couple of occasions over the last week, and that he really feels too fatigued to garden for any length of time. This worries him, as he has some friends with cancer, and they seemed to have the same symptoms prior to their diagnosis.