how can I modify a PDF?

Depends on how it was made. Sometimes they're nothing more than a giant image, thus the text isn't changeable. Other times it is. Do a search on YAHOO! or Google for PDF editor and Mac, and you should find something to do it with. I believe the pro version of Acrobat allows this also.

On a side note, keep in mind you can only modify it if you have the legal right to do so. If you don't hold the copyright to the document, then you need to get written permission before doing anything with it.
 
You can also use Acrobat Pro, or Adobe Illustrator.

Illustrator will only allow you to work on a single page, so if you have a multipage document you need to save the result with a new file name. Then you can use Preview to remove the original page from your original document, and insert the new version.
 
I don't know if the question has been resolved or not, there is no feedback from asker. But I want to explain some methods to edit text in PDF file.
As mdnky stated, in case of that your file was created from scanner or image, the first step will be make the text editable or extract it from the file for modifying.
If it is a common pdf files then you have two ways to modify text, one is to convert pdf to editable documents and another one is to use a PDF editor like Acrobat.
 
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Hope this isn't too late for you, but the new version of PDF Studio lets us edit text in PDFs.
 
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