Datasets:

abhiram973

/

Llama2_medic

like 0

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What are the stages of Pituitary Tumors ? [/INST] Once a pituitary tumor has been diagnosed, tests are done to find out if it has spread within the central nervous system (brain and spinal cord) or to other parts of the body. Pituitary tumors are described in several ways. Once a pituitary tumor has been diagnosed, tests are done to find out if it has spread within the central nervous system (brain and spinal cord) or to other parts of the body. The extent or spread of cancer is usually described as stages. There is no standard staging system for pituitary tumors. Once a pituitary tumor is found, tests are done to find out if the tumor has spread into the brain or to other parts of the body. The following test may be used: MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI). Pituitary tumors are described in several ways. Pituitary tumors are described by their size and grade, whether or not they make extra hormones, and whether the tumor has spread to other parts of the body. The following sizes are used: Microadenoma: The tumor is smaller than 1 centimeter. Macroadenoma: The tumor is 1 centimeter or larger. Most pituitary adenomas are microadenomas. The grade of a pituitary tumor is based on how far it has grown into the surrounding area of the brain, including the sella (the bone at the base of the skull, where the pituitary gland sits).</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What are the treatments for Pituitary Tumors ? [/INST] There are different types of treatment for patients with pituitary tumors. Four types of standard treatment are used: Surgery Radiation therapy Drug therapy Chemotherapy New types of treatment are being tested in clinical trials. Patients may want to think about taking part in a clinical trial. Patients can enter clinical trials before, during, or after starting their cancer treatment. Followup tests may be needed. There are different types of treatment for patients with pituitary tumors. Different types of treatments are available for patients with pituitary tumors. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment. Four types of standard treatment are used: Surgery Many pituitary tumors can be removed by surgery using one of the following operations: Transsphenoidal surgery: A type of surgery in which the instruments are inserted into part of the brain by going through an incision (cut) made under the upper lip or at the bottom of the nose between the nostrils and then through the sphenoid bone (a butterflyshaped bone at the base of the skull) to reach the pituitary gland. The pituitary gland lies just above the sphenoid bone. Endoscopic transsphenoidal surgery: A type of surgery in which an endoscope is inserted through an incision (cut) made at the back of the inside of the nose and then through the sphenoid bone to reach the pituitary gland. An endoscope is a thin, tubelike instrument with a light, a lens for viewing, and a tool for removing tumor tissue. Craniotomy: Surgery to remove the tumor through an opening made in the skull. Even if the doctor removes all the cancer that can be seen at the time of the surgery, some patients may be given chemotherapy or radiation therapy after surgery to kill any cancer cells that are left. Treatment given after the surgery, to lower the risk that the cancer will come back, is called adjuvant therapy. Radiation therapy Radiation therapy is a cancer treatment that uses highenergy xrays or other types of radiation to kill cancer cells or keep them from growing. There are two types of radiation therapy: External radiation therapy uses a machine outside the body to send radiation toward the cancer. Certain ways of giving radiation therapy can help keep radiation from damaging nearby healthy tissue. This type of radiation therapy may include the following: Stereotactic radiosurgery: A rigid head frame is attached to the skull to keep the head still during the radiation treatment. A machine aims a single large dose of radiation directly at the tumor. This procedure does not involve surgery. It is also called stereotaxic radiosurgery, radiosurgery, and radiation surgery. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. The way the radiation therapy is given depends on the type of the cancer being treated. External radiation therapy is used to treat pituitary tumors. Drug therapy Drugs may be given to stop a functioning pituitary tumor from making too many hormones. Chemotherapy Chemotherapy may be used as palliative treatment for pituitary carcinomas, to relieve symptoms and improve the patient's quality of life. Chemotherapy uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the cerebrospinal fluid, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). The way the chemotherapy is given depends on the type of the cancer being treated. New types of treatment are being tested in clinical trials. Information about clinical trials is available from the NCI website. Patients may want to think about taking part in a clinical trial. For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment. Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment. Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward. Patients can enter clinical trials before, during, or after starting their cancer treatment. Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring (coming back) or reduce the side effects of cancer treatment. Clinical trials are taking place in many parts of the country. See the Treatment Options section that follows for links to current treatment clinical trials. These have been retrieved from NCI's listing of clinical trials. Followup tests may be needed. Some of the tests that were done to diagnose the cancer or to find out the stage of the cancer may be repeated. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests. Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your condition has changed or if the cancer has recurred (come back). These tests are sometimes called followup tests or checkups. Treatment Options for Pituitary Tumors Nonfunctioning Pituitary Tumors Treatment may include the following: Surgery (transsphenoidal surgery, if possible) to remove the tumor, followed by watchful waiting (closely monitoring a patients condition without giving any treatment until signs or symptoms appear or change). Radiation therapy is given if the tumor comes back. Radiation therapy alone. Treatment for luteinizing hormone producing and folliclestimulating hormone producing tumors is usually transsphenoidal surgery to remove the tumor. ProlactinProducing Pituitary Tumors Treatment may include the following: Drug therapy to stop the tumor from making prolactin and to stop the tumor from growing. Surgery to remove the tumor (transsphenoidal surgery or craniotomy) when the tumor does not respond to drug therapy or when the patient cannot take the drug. Radiation therapy. Surgery followed by radiation therapy. ACTHProducing Pituitary Tumors Treatment may include the following: Surgery (usually transsphenoidal surgery) to remove the tumor, with or without radiation therapy. Radiation therapy alone. Drug therapy to stop the tumor from making ACTH. A clinical trial of stereotactic radiation surgery. Growth HormoneProducing Pituitary Tumors Treatment may include the following: Surgery (usually transsphenoidal or endoscopic transsphenoidal surgery) to remove the tumor, with or without radiation therapy. Drug therapy to stop the tumor from making growth hormone. ThyroidStimulating HormoneProducing Tumors Treatment may include the following: Surgery (usually transsphenoidal surgery) to remove the tumor, with or without radiation therapy. Drug therapy to stop the tumor from making hormones. Pituitary Carcinomas Treatment of pituitary carcinomas is palliative, to relieve symptoms and improve the quality of life. Treatment may include the following: Surgery (transsphenoidal surgery or craniotomy) to remove the cancer, with or without radiation therapy. Drug therapy to stop the tumor from making hormones. Chemotherapy. Recurrent Pituitary Tumors Treatment may include the following: Radiation therapy. A clinical trial of stereotactic radiation surgery.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>what research (or clinical trials) is being done for Pituitary Tumors ? [/INST] New types of treatment are being tested in clinical trials. Information about clinical trials is available from the NCI website. Patients may want to think about taking part in a clinical trial. For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment. Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment. Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward. Patients can enter clinical trials before, during, or after starting their cancer treatment. Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring (coming back) or reduce the side effects of cancer treatment. Clinical trials are taking place in many parts of the country. See the Treatment Options section that follows for links to current treatment clinical trials. These have been retrieved from NCI's listing of clinical trials.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What is (are) Chronic Myeloproliferative Neoplasms ? [/INST] Myeloproliferative neoplasms are a group of diseases in which the bone marrow makes too many red blood cells, white blood cells, or platelets. There are 6 types of chronic myeloproliferative neoplasms. Tests that examine the blood and bone marrow are used to detect (find) and diagnose chronic myeloproliferative neoplasms. Myeloproliferative neoplasms are a group of diseases in which the bone marrow makes too many red blood cells, white blood cells, or platelets. Normally, the bone marrow makes blood stem cells (immature cells) that become mature blood cells over time. A blood stem cell may become a myeloid stem cell or a lymphoid stem cell. A lymphoid stem cell becomes a white blood cell. A myeloid stem cell becomes one of three types of mature blood cells: Red blood cells that carry oxygen and other substances to all tissues of the body. White blood cells that fight infection and disease. Platelets that form blood clots to stop bleeding. In myeloproliferative neoplasms, too many blood stem cells become one or more types of blood cells. The neoplasms usually get worse slowly as the number of extra blood cells increases. There are 6 types of chronic myeloproliferative neoplasms. The type of myeloproliferative neoplasm is based on whether too many red blood cells, white blood cells, or platelets are being made. Sometimes the body will make too many of more than one type of blood cell, but usually one type of blood cell is affected more than the others are. Chronic myeloproliferative neoplasms include the following 6 types: Chronic myelogenous leukemia. Polycythemia vera. Primary myelofibrosis (also called chronic idiopathic myelofibrosis). Essential thrombocythemia. Chronic neutrophilic leukemia. Chronic eosinophilic leukemia. These types are described below. Chronic myeloproliferative neoplasms sometimes become acute leukemia, in which too many abnormal white blood cells are made.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>How to diagnose Chronic Myeloproliferative Neoplasms ? [/INST] Tests that examine the blood and bone marrow are used to detect (find) and diagnose chronic myeloproliferative neoplasms. The following tests and procedures may be used: Physical exam and history : An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patients health habits and past illnesses and treatments will also be taken. Complete blood count (CBC) with differential : A procedure in which a sample of blood is drawn and checked for the following: The number of red blood cells and platelets. The number and type of white blood cells. The amount of hemoglobin (the protein that carries oxygen) in the red blood cells. The portion of the blood sample made up of red blood cells. Peripheral blood smear : A procedure in which a sample of blood is checked for the following: Whether there are red blood cells shaped like teardrops. The number and kinds of white blood cells. The number of platelets. Whether there are blast cells. Blood chemistry studies : A procedure in which a blood sample is checked to measure the amounts of certain substances released into the blood by organs and tissues in the body. An unusual (higher or lower than normal) amount of a substance can be a sign of disease. Bone marrow aspiration and biopsy : The removal of bone marrow, blood, and a small piece of bone by inserting a hollow needle into the hipbone or breastbone. A pathologist views the bone marrow, blood, and bone under a microscope to look for abnormal cells. Cytogenetic analysis : A test in which cells in a sample of blood or bone marrow are viewed under a microscope to look for certain changes in the chromosomes. Certain diseases or disorders may be diagnosed or ruled out based on the chromosomal changes. Gene mutation test: A laboratory test done on a bone marrow or blood sample to check for mutations in JAK2 , MPL , or CALR genes. A JAK2 gene mutation is often found in patients with polycythemia vera, essential thrombocythemia, or primary myelofibrosis. MPL or CALR gene mutations are found in patients with essential thrombocythemia or primary myelofibrosis.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What are the stages of Chronic Myeloproliferative Neoplasms ? [/INST] There is no standard staging system for chronic myeloproliferative neoplasms. There is no standard staging system for chronic myeloproliferative neoplasms. Staging is the process used to find out how far the cancer has spread. There is no standard staging system for chronic myeloproliferative neoplasms. Treatment is based on the type of myeloproliferative neoplasm the patient has. It is important to know the type in order to plan treatment.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What are the treatments for Chronic Myeloproliferative Neoplasms ? [/INST] There are different types of treatment for patients with chronic myeloproliferative neoplasms. Eleven types of standard treatment are used: Watchful waiting Phlebotomy Platelet apheresis Transfusion therapy Chemotherapy Radiation therapy Other drug therapy Surgery Biologic therapy Targeted therapy Highdose chemotherapy with stem cell transplant New types of treatment are being tested in clinical trials. Patients may want to think about taking part in a clinical trial. Patients can enter clinical trials before, during, or after starting their cancer treatment. Followup tests may be needed. There are different types of treatment for patients with chronic myeloproliferative neoplasms. Different types of treatments are available for patients with chronic myeloproliferative neoplasms. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment. Eleven types of standard treatment are used: Watchful waiting Watchful waiting is closely monitoring a patients condition without giving any treatment until signs or symptoms appear or change. Phlebotomy Phlebotomy is a procedure in which blood is taken from a vein. A sample of blood may be taken for tests such as a CBC or blood chemistry. Sometimes phlebotomy is used as a treatment and blood is taken from the body to remove extra red blood cells. Phlebotomy is used in this way to treat some chronic myeloproliferative neoplasms. Platelet apheresis Platelet apheresis is a treatment that uses a special machine to remove platelets from the blood. Blood is taken from the patient and put through a blood cell separator where the platelets are removed. The rest of the blood is then returned to the patients bloodstream. Transfusion therapy Transfusion therapy (blood transfusion) is a method of giving red blood cells, white blood cells, or platelets to replace blood cells destroyed by disease or cancer treatment. Chemotherapy Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the cerebrospinal fluid, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). The way the chemotherapy is given depends on the type and stage of the cancer being treated. See Drugs Approved for Myeloproliferative Neoplasms for more information. Radiation therapy Radiation therapy is a cancer treatment that uses highenergy xrays or other types of radiation to kill cancer cells or keep them from growing. There are two types of radiation therapy: External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. The way the radiation therapy is given depends on the type of cancer being treated. External radiation therapy is used to treat chronic myeloproliferative neoplasms, and is usually directed at the spleen. Other drug therapy Prednisone and danazol are drugs that may be used to treat anemia in patients with primary myelofibrosis. Anagrelide therapy is used to reduce the risk of blood clots in patients who have too many platelets in their blood. Lowdose aspirin may also be used to reduce the risk of blood clots. Thalidomide, lenalidomide, and pomalidomide are drugs that prevent blood vessels from growing into areas of tumor cells. See Drugs Approved for Myeloproliferative Neoplasms for more information. Surgery Splenectomy (surgery to remove the spleen) may be done if the spleen is enlarged. Biologic therapy Biologic therapy is a treatment that uses the patient's immune system to fight cancer or other diseases. Substances made by the body or made in a laboratory are used to boost, direct, or restore the body's natural defenses against disease. This type of treatment is also called biotherapy or immunotherapy. Interferon alfa and pegylated interferon alpha are biologic agents commonly used to treat some chronic myeloproliferative neoplasms. Erythropoietic growth factors are also biologic agents. They are used to stimulate the bone marrow to make red blood cells. Targeted therapy Targeted therapy is a type of treatment that uses drugs or other substances to identify and attack specific cancer cells without harming normal cells. Tyrosine kinase inhibitors are targeted therapy drugs that block signals needed for tumors to grow. Ruxolitinib is a tyrosine kinase inhibitor used to treat certain types of myelofibrosis. See Drugs Approved for Myeloproliferative Neoplasms for more information. Other types of targeted therapies are being studied in clinical trials. Highdose chemotherapy with stem cell transplant Highdose chemotherapy with stem cell transplant is a method of giving high doses of chemotherapy and replacing bloodforming cells destroyed by the cancer treatment. Stem cells (immature blood cells) are removed from the blood or bone marrow of the patient or a donor and are frozen and stored. After the chemotherapy is completed, the stored stem cells are thawed and given back to the patient through an infusion. These reinfused stem cells grow into (and restore) the body's blood cells. New types of treatment are being tested in clinical trials. Information about clinical trials is available from the NCI website. Patients may want to think about taking part in a clinical trial. For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment. Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment. Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward. Patients can enter clinical trials before, during, or after starting their cancer treatment. Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring (coming back) or reduce the side effects of cancer treatment. Clinical trials are taking place in many parts of the country. See the Treatment Options section that follows for links to current treatment clinical trials. These have been retrieved from NCI's listing of clinical trials. Followup tests may be needed. Some of the tests that were done to diagnose the cancer or to find out the stage of the cancer may be repeated. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests. Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your condition has changed or if the cancer has recurred (come back). These tests are sometimes called followup tests or checkups. Treatment Options for Chronic Myeloproliferative Neoplasms Chronic Myelogenous Leukemia See the PDQ summary about Chronic Myelogenous Leukemia Treatment for information. Polycythemia Vera The purpose of treatment for polycythemia vera is to reduce the number of extra blood cells. Treatment of polycythemia vera may include the following: Phlebotomy. Chemotherapy with or without phlebotomy. Biologic therapy using interferon alfa or pegylated interferon alpha. Lowdose aspirin. Check the list of NCIsupported cancer clinical trials that are now accepting patients with polycythemia vera. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the NCI website. Primary Myelofibrosis Treatment of primary myelofibrosis in patients without signs or symptoms is usually watchful waiting. Patients with primary myelofibrosis may have signs or symptoms of anemia. Anemia is usually treated with transfusion of red blood cells to relieve symptoms and improve quality of life. In addition, anemia may be treated with: Erythropoietic growth factors. Prednisone. Danazol. Thalidomide, lenalidomide, or pomalidomide, with or without prednisone. Treatment of primary myelofibrosis in patients with other signs or symptoms may include the following: Targeted therapy with ruxolitinib. Chemotherapy. Donor stem cell transplant. Thalidomide, lenalidomide, or pomalidomide. Splenectomy. Radiation therapy to the spleen, lymph nodes, or other areas outside the bone marrow where blood cells are forming. Biologic therapy using interferon alfa or erythropoietic growth factors. A clinical trial of other targeted therapy drugs. Check the list of NCIsupported cancer clinical trials that are now accepting patients with primary myelofibrosis. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the NCI website. Essential Thrombocythemia Treatment of essential thrombocythemia in patients younger than 60 years who have no signs or symptoms and an acceptable platelet count is usually watchful waiting. Treatment of other patients may include the following: Chemotherapy. Anagrelide therapy. Biologic therapy using interferon alfa or pegylated interferon alpha. Platelet apheresis. A clinical trial of a new treatment. Check the list of NCIsupported cancer clinical trials that are now accepting patients with essential thrombocythemia. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the NCI website. Chronic Neutrophilic Leukemia Treatment of chronic neutrophilic leukemia may include the following: Donor bone marrow transplant. Chemotherapy. Biologic therapy using interferon alfa. A clinical trial of a new treatment. Check the list of NCIsupported cancer clinical trials that are now accepting patients with chronic neutrophilic leukemia. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the NCI website. Chronic Eosinophilic Leukemia Treatment of chronic eosinophilic leukemia may include the following: Bone marrow transplant. Biologic therapy using interferon alfa. A clinical trial of a new treatment. Check the list of NCIsupported cancer clinical trials that are now accepting patients with chronic eosinophilic leukemia. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the NCI website.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What is (are) Skin Cancer ? [/INST] Skin cancer is a disease in which malignant (cancer) cells form in the tissues of the skin. There are several types of skin cancer. Skin cancer is the most common cancer in the United States. Skin cancer is a disease in which malignant (cancer) cells form in the tissues of the skin. The skin is the bodys largest organ. It protects against heat, sunlight, injury, and infection. Skin also helps control body temperature and stores water, fat, and vitamin D. The skin has several layers, but the two main layers are the epidermis (upper or outer layer) and the dermis (lower or inner layer). The epidermis is made up of 3 kinds of cells: Squamous cells are the thin, flat cells that make up most of the epidermis. Basal cells are the round cells under the squamous cells. Melanocytes are found throughout the lower part of the epidermis. They make melanin, the pigment that gives skin its natural color. When skin is exposed to the sun, melanocytes make more pigment, causing the skin to tan, or darken. The dermis contains blood and lymph vessels, hair follicles, and glands. See the following PDQ summaries for more information about skin cancer: Skin Cancer Screening Skin Cancer Treatment Melanoma Treatment Genetics of Skin Cancer There are several types of skin cancer. The most common types of skin cancer are squamous cell carcinoma, which forms in the squamous cells and basal cell carcinoma, which forms in the basal cells. Squamous cell carcinoma and basal cell carcinoma are also called nonmelanoma skin cancers. Melanoma, which forms in the melanocytes, is a less common type of skin cancer that grows and spreads quickly. Skin cancer can occur anywhere on the body, but it is most common in areas exposed to sunlight, such as the face, neck, hands, and arms. Skin cancer is the most common cancer in the United States. Basal cell carcinoma and squamous cell carcinoma are the most common types of skin cancer in the United States. The number of new cases of nonmelanoma skin cancer appears to be increasing every year. These nonmelanoma skin cancers can usually be cured. The number of new cases of melanoma has been increasing for at least 30 years. Melanoma is more likely to spread to nearby tissues and other parts of the body and can be harder to cure. Finding and treating melanoma skin cancer early may help prevent death from melanoma.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>How to prevent Skin Cancer ? [/INST] Avoiding risk factors and increasing protective factors may help prevent cancer. Being exposed to ultraviolet radiation is a risk factor for skin cancer. It is not known if the following lower the risk of nonmelanoma skin cancer: Sunscreen use and avoiding sun exposure Chemopreventive agents It is not known if the following lower the risk of melanoma: Sunscreen Counseling and protecting the skin from the sun Cancer prevention clinical trials are used to study ways to prevent cancer. New ways to prevent skin cancer are being studied in clinical trials. Avoiding risk factors and increasing protective factors may help prevent cancer. Avoiding cancer risk factors may help prevent certain cancers. Risk factors include smoking, being overweight, and not getting enough exercise. Increasing protective factors such as quitting smoking and exercising may also help prevent some cancers. Talk to your doctor or other health care professional about how you might lower your risk of cancer. Being exposed to ultraviolet radiation is a risk factor for skin cancer. Some studies suggest that being exposed to ultraviolet (UV) radiation and the sensitivity of a persons skin to UV radiation are risk factors for skin cancer. UV radiation is the name for the invisible rays that are part of the energy that comes from the sun. Sunlamps and tanning beds also give off UV radiation. Risk factors for nonmelanoma and melanoma cancers are not the same. Risk factors for nonmelanoma skin cancer: Being exposed to natural sunlight or artificial sunlight (such as from tanning beds) over long periods of time. Having a fair complexion, which includes the following: Fair skin that freckles and burns easily, does not tan, or tans poorly. Blue or green or other lightcolored eyes. Red or blond hair. Having actinic keratosis. Past treatment with radiation. Having a weakened immune system. Being exposed to arsenic. Risk factors for melanoma skin cancer: Having a fair complexion, which includes the following: Fair skin that freckles and burns easily, does not tan, or tans poorly. Blue or green or other lightcolored eyes. Red or blond hair. Being exposed to natural sunlight or artificial sunlight (such as from tanning beds) over long periods of time. Having a history of many blistering sunburns, especially as a child or teenager. Having several large or many small moles. Having a family history of unusual moles (atypical nevus syndrome). Having a family or personal history of melanoma. Being white. It is not known if the following lower the risk of nonmelanoma skin cancer: Sunscreen use and avoiding sun exposure It is not known if nonmelanoma skin cancer risk is decreased by staying out of the sun, using sunscreens, or wearing protective clothing when outdoors. This is because not enough studies have been done to prove this. Sunscreen may help decrease the amount of UV radiation to the skin. One study found that wearing sunscreen can help prevent actinic keratoses, scaly patches of skin that sometimes become squamous cell carcinoma. The harms of using sunscreen are likely to be small and include allergic reactions to skin creams and lower levels of vitamin D made in the skin because of less sun exposure. It is also possible that when a person uses sunscreen to avoid sunburn they may spend too much time in the sun and be exposed to harmful UV radiation. Although protecting the skin and eyes from the sun has not been proven to lower the chance of getting skin cancer, skin experts suggest the following: Use sunscreen that protects against UV radiation. Do not stay out in the sun for long periods of time, especially when the sun is at its strongest. Wear long sleeve shirts, long pants, sun hats, and sunglasses, when outdoors. Chemopreventive agents Chemoprevention is the use of drugs, vitamins, or other agents to try to reduce the risk of cancer. The following chemopreventive agents have been studied to find whether they lower the risk of nonmelanoma skin cancer: Beta carotene Studies of beta carotene (taken as a supplement in pills) have not shown that it prevents nonmelanoma skin cancer from forming or coming back. Isotretinoin High doses of isotretinoin have been shown to prevent new skin cancers in patients with xeroderma pigmentosum. However, isotretinoin has not been shown to prevent nonmelanoma skin cancers from coming back in patients previously treated for nonmelanoma skin cancers. Treatment with isotretinoin can cause serious side effects. Selenium Studies have shown that selenium (taken in brewer's yeast tablets) does not lower the risk of basal cell carcinoma, and may increase the risk of squamous cell carcinoma. Celecoxib A study of celecoxib in patients with actinic keratosis and a history of nonmelanoma skin cancer found those who took celecoxib had slightly lower rates of recurrent nonmelanoma skin cancers. Celecoxib may have serious side effects on the heart and blood vessels. Alphadifluoromethylornithine (DFMO) A study of alphadifluoromethylornithine (DFMO) in patients with a history of nonmelanoma skin cancer showed that those who took DFMO had lower rates of nonmelanoma skin cancers coming back than those who took a placebo. DFMO may cause hearing loss which is usually temporary. Nicotinamide (vitamin B3) Studies have shown that nicotinamide (vitamin B3) helps prevent new actinic keratoses lesions from forming in people who had four or fewer actinic lesions before taking nicotinamide. More studies are needed to find out if nicotinamide prevents nonmelanoma skin cancer from forming or coming back. It is not known if the following lower the risk of melanoma: Sunscreen It has not been proven that using sunscreen to prevent sunburn can protect against melanoma caused by UV radiation. Other risk factors such as having skin that burns easily, having a large number of benign moles, or having atypical nevi may also play a role in whether melanoma forms. Counseling and protecting the skin from the sun It is not known if people who receive counseling or information about avoiding sun exposure make changes in their behavior to protect their skin from the sun. Cancer prevention clinical trials are used to study ways to prevent cancer. Cancer prevention clinical trials are used to study ways to lower the risk of developing certain types of cancer. Some cancer prevention trials are conducted with healthy people who have not had cancer but who have an increased risk for cancer. Other prevention trials are conducted with people who have had cancer and are trying to prevent another cancer of the same type or to lower their chance of developing a new type of cancer. Other trials are done with healthy volunteers who are not known to have any risk factors for cancer. The purpose of some cancer prevention clinical trials is to find out whether actions people take can prevent cancer. These may include eating fruits and vegetables, exercising, quitting smoking, or taking certain medicines, vitamins, minerals, or food supplements. New ways to prevent skin cancer are being studied in clinical trials. Clinical trials are taking place in many parts of the country. Information about clinical trials can be found in the Clinical Trials section of the NCI Web site. Check NCI's list of cancer clinical trials for nonmelanoma skin cancer prevention trials and melanoma prevention trials that are now accepting patients.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>Who is at risk for Skin Cancer? ? [/INST] Avoiding risk factors and increasing protective factors may help prevent cancer. Being exposed to ultraviolet radiation is a risk factor for skin cancer. It is not known if the following lower the risk of nonmelanoma skin cancer: Sunscreen use and avoiding sun exposure Chemopreventive agents It is not known if the following lower the risk of melanoma: Sunscreen Counseling and protecting the skin from the sun Cancer prevention clinical trials are used to study ways to prevent cancer. New ways to prevent skin cancer are being studied in clinical trials. Avoiding risk factors and increasing protective factors may help prevent cancer. Avoiding cancer risk factors may help prevent certain cancers. Risk factors include smoking, being overweight, and not getting enough exercise. Increasing protective factors such as quitting smoking and exercising may also help prevent some cancers. Talk to your doctor or other health care professional about how you might lower your risk of cancer. Being exposed to ultraviolet radiation is a risk factor for skin cancer. Some studies suggest that being exposed to ultraviolet (UV) radiation and the sensitivity of a persons skin to UV radiation are risk factors for skin cancer. UV radiation is the name for the invisible rays that are part of the energy that comes from the sun. Sunlamps and tanning beds also give off UV radiation. Risk factors for nonmelanoma and melanoma cancers are not the same. Risk factors for nonmelanoma skin cancer: Being exposed to natural sunlight or artificial sunlight (such as from tanning beds) over long periods of time. Having a fair complexion, which includes the following: Fair skin that freckles and burns easily, does not tan, or tans poorly. Blue or green or other lightcolored eyes. Red or blond hair. Having actinic keratosis. Past treatment with radiation. Having a weakened immune system. Being exposed to arsenic. Risk factors for melanoma skin cancer: Having a fair complexion, which includes the following: Fair skin that freckles and burns easily, does not tan, or tans poorly. Blue or green or other lightcolored eyes. Red or blond hair. Being exposed to natural sunlight or artificial sunlight (such as from tanning beds) over long periods of time. Having a history of many blistering sunburns, especially as a child or teenager. Having several large or many small moles. Having a family history of unusual moles (atypical nevus syndrome). Having a family or personal history of melanoma. Being white. It is not known if the following lower the risk of nonmelanoma skin cancer: Sunscreen use and avoiding sun exposure It is not known if nonmelanoma skin cancer risk is decreased by staying out of the sun, using sunscreens, or wearing protective clothing when outdoors. This is because not enough studies have been done to prove this. Sunscreen may help decrease the amount of UV radiation to the skin. One study found that wearing sunscreen can help prevent actinic keratoses, scaly patches of skin that sometimes become squamous cell carcinoma. The harms of using sunscreen are likely to be small and include allergic reactions to skin creams and lower levels of vitamin D made in the skin because of less sun exposure. It is also possible that when a person uses sunscreen to avoid sunburn they may spend too much time in the sun and be exposed to harmful UV radiation. Although protecting the skin and eyes from the sun has not been proven to lower the chance of getting skin cancer, skin experts suggest the following: Use sunscreen that protects against UV radiation. Do not stay out in the sun for long periods of time, especially when the sun is at its strongest. Wear long sleeve shirts, long pants, sun hats, and sunglasses, when outdoors. Chemopreventive agents Chemoprevention is the use of drugs, vitamins, or other agents to try to reduce the risk of cancer. The following chemopreventive agents have been studied to find whether they lower the risk of nonmelanoma skin cancer: Beta carotene Studies of beta carotene (taken as a supplement in pills) have not shown that it prevents nonmelanoma skin cancer from forming or coming back. Isotretinoin High doses of isotretinoin have been shown to prevent new skin cancers in patients with xeroderma pigmentosum. However, isotretinoin has not been shown to prevent nonmelanoma skin cancers from coming back in patients previously treated for nonmelanoma skin cancers. Treatment with isotretinoin can cause serious side effects. Selenium Studies have shown that selenium (taken in brewer's yeast tablets) does not lower the risk of basal cell carcinoma, and may increase the risk of squamous cell carcinoma. Celecoxib A study of celecoxib in patients with actinic keratosis and a history of nonmelanoma skin cancer found those who took celecoxib had slightly lower rates of recurrent nonmelanoma skin cancers. Celecoxib may have serious side effects on the heart and blood vessels. Alphadifluoromethylornithine (DFMO) A study of alphadifluoromethylornithine (DFMO) in patients with a history of nonmelanoma skin cancer showed that those who took DFMO had lower rates of nonmelanoma skin cancers coming back than those who took a placebo. DFMO may cause hearing loss which is usually temporary. Nicotinamide (vitamin B3) Studies have shown that nicotinamide (vitamin B3) helps prevent new actinic keratoses lesions from forming in people who had four or fewer actinic lesions before taking nicotinamide. More studies are needed to find out if nicotinamide prevents nonmelanoma skin cancer from forming or coming back. It is not known if the following lower the risk of melanoma: Sunscreen It has not been proven that using sunscreen to prevent sunburn can protect against melanoma caused by UV radiation. Other risk factors such as having skin that burns easily, having a large number of benign moles, or having atypical nevi may also play a role in whether melanoma forms. Counseling and protecting the skin from the sun It is not known if people who receive counseling or information about avoiding sun exposure make changes in their behavior to protect their skin from the sun.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>what research (or clinical trials) is being done for Skin Cancer ? [/INST] Cancer prevention clinical trials are used to study ways to prevent cancer. Cancer prevention clinical trials are used to study ways to lower the risk of developing certain types of cancer. Some cancer prevention trials are conducted with healthy people who have not had cancer but who have an increased risk for cancer. Other prevention trials are conducted with people who have had cancer and are trying to prevent another cancer of the same type or to lower their chance of developing a new type of cancer. Other trials are done with healthy volunteers who are not known to have any risk factors for cancer. The purpose of some cancer prevention clinical trials is to find out whether actions people take can prevent cancer. These may include eating fruits and vegetables, exercising, quitting smoking, or taking certain medicines, vitamins, minerals, or food supplements. New ways to prevent skin cancer are being studied in clinical trials. Clinical trials are taking place in many parts of the country. Information about clinical trials can be found in the Clinical Trials section of the NCI Web site. Check NCI's list of cancer clinical trials for nonmelanoma skin cancer prevention trials and melanoma prevention trials that are now accepting patients.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What is (are) Colorectal Cancer ? [/INST] Colorectal cancer is a disease in which malignant (cancer) cells form in the tissues of the colon or the rectum. Colorectal cancer is the second leading cause of death from cancer in the United States. Colorectal cancer is a disease in which malignant (cancer) cells form in the tissues of the colon or the rectum. The colon is part of the body's digestive system. The digestive system removes and processes nutrients (vitamins, minerals, carbohydrates, fats, proteins, and water) from foods and helps pass waste material out of the body. The digestive system is made up of the mouth, throat, esophagus, stomach, and the small and large intestines. The colon (large bowel) is the first part of the large intestine and is about 5 feet long. Together, the rectum and anal canal make up the last part of the large intestine and are 6 to 8 inches long. The anal canal ends at the anus (the opening of the large intestine to the outside of the body). Cancer that begins in the colon is called colon cancer, and cancer that begins in the rectum is called rectal cancer. Cancer that affects either of these organs may also be called colorectal cancer. See the following PDQ summaries for more information about colorectal cancer: Colorectal Cancer Screening Colon Cancer Treatment Rectal Cancer Treatment Genetics of Colorectal Cancer Colorectal cancer is the second leading cause of death from cancer in the United States. The number of new colorectal cancer cases and the number of deaths from colorectal cancer are both decreasing a little bit each year. However, in adults younger than 50 years, the number of new colorectal cancer cases has slowly increased since 1998. The number of new colorectal cancers and deaths from colorectal cancer are higher in African Americans than in other races. Finding and treating colorectal cancer early may prevent death from colorectal cancer. Screening tests may be used to help find colorectal cancer.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>How to prevent Colorectal Cancer ? [/INST] Avoiding risk factors and increasing protective factors may help prevent cancer. The following risk factors increase the risk of colorectal cancer: Age Family history of colorectal cancer Personal history Inherited risk Alcohol Cigarette smoking Obesity The following protective factors decrease the risk of colorectal cancer: Physical activity Aspirin Combination hormone replacement therapy Polyp removal It is not clear if the following affect the risk of colorectal cancer: Nonsteroidal antiinflammatory drugs (NSAIDs) other than aspirin Calcium Diet The following factors do not affect the risk of colorectal cancer: Hormone replacement therapy with estrogen only Statins Cancer prevention clinical trials are used to study ways to prevent cancer. New ways to prevent colorectal cancer are being studied in clinical trials. Avoiding risk factors and increasing protective factors may help prevent cancer. Avoiding cancer risk factors may help prevent certain cancers. Risk factors include smoking, being overweight, and not getting enough exercise. Increasing protective factors such as quitting smoking and exercising may also help prevent some cancers. Talk to your doctor or other health care professional about how you might lower your risk of cancer. The following risk factors increase the risk of colorectal cancer: Age The risk of colorectal cancer increases after age 50. Most cases of colorectal cancer are diagnosed after age 50. Family history of colorectal cancer Having a parent, brother, sister, or child with colorectal cancer doubles a person's risk of colorectal cancer. Personal history Having a personal history of the following conditions increases the risk of colorectal cancer: Previous colorectal cancer. Highrisk adenomas (colorectal polyps that are 1 centimeter or larger in size or that have cells that look abnormal under a microscope). Ovarian cancer. Inflammatory bowel disease (such as ulcerative colitis or Crohn disease). Inherited risk The risk of colorectal cancer is increased when certain gene changes linked to familial adenomatous polyposis (FAP) or hereditary nonpolyposis colon cancer (HNPCC or Lynch Syndrome) are inherited. Alcohol Drinking 3 or more alcoholic beverages per day increases the risk of colorectal cancer. Drinking alcohol is also linked to the risk of forming large colorectal adenomas (benign tumors). Cigarette smoking Cigarette smoking is linked to an increased risk of colorectal cancer and death from colorectal cancer. Smoking cigarettes is also linked to an increased risk of forming colorectal adenomas. Cigarette smokers who have had surgery to remove colorectal adenomas are at an increased risk for the adenomas to recur (come back). Obesity Obesity is linked to an increased risk of colorectal cancer and death from colorectal cancer. The following protective factors decrease the risk of colorectal cancer: Physical activity A lifestyle that includes regular physical activity is linked to a decreased risk of colorectal cancer. Aspirin Studies have shown that taking aspirin lowers the risk of colorectal cancer and the risk of death from colorectal cancer. The decrease in risk begins 10 to 20 years after patients start taking aspirin. The possible harms of aspirin use (100 mg or less) daily or every other day include an increased risk of stroke and bleeding in the stomach and intestines. These risks may be greater among the elderly, men, and those with conditions linked to a higher than normal risk of bleeding. Combination hormone replacement therapy Studies have shown that combination hormone replacement therapy (HRT) that includes both estrogen and progestin lowers the risk of invasive colorectal cancer in postmenopausal women. However, in women who take combination HRT and do develop colorectal cancer, the cancer is more likely to be advanced when it is diagnosed and the risk of dying from colorectal cancer is not decreased. The possible harms of combination HRT include an increased risk of having: Breast cancer. Heart disease. Blood clots. Polyp removal Most colorectal polyps are adenomas, which may develop into cancer. Removing colorectal polyps that are larger than 1 centimeter (peasized) may lower the risk of colorectal cancer. It is not known if removing smaller polyps lowers the risk of colorectal cancer. The possible harms of polyp removal during colonoscopy or sigmoidoscopy include a tear in the wall of the colon and bleeding. It is not clear if the following affect the risk of colorectal cancer: Nonsteroidal antiinflammatory drugs (NSAIDs) other than aspirin It is not known if the use of nonsteroidal antiinflammatory drugs or NSAIDs (such as sulindac, celecoxib, naproxen, and ibuprofen) lowers the risk of colorectal cancer. Studies have shown that taking the nonsteroidal antiinflammatory drug celecoxib reduces the risk of colorectal adenomas (benign tumors) coming back after they have been removed. It is not clear if this results in a lower risk of colorectal cancer. Taking sulindac or celecoxib has been shown to reduce the number and size of polyps that form in the colon and rectum of people with familial adenomatous polyposis (FAP). It is not clear if this results in a lower risk of colorectal cancer. The possible harms of NSAIDs include: Kidney problems. Bleeding in the stomach, intestines, or brain. Heart problems such as heart attack and congestive heart failure. Calcium It is not known if taking calcium supplements lowers the risk of colorectal cancer. Diet It is not known if a diet low in fat and meat and high in fiber, fruits, and vegetables lowers the risk of colorectal cancer. Some studies have shown that a diet high in fat, proteins, calories, and meat increases the risk of colorectal cancer, but other studies have not. The following factors do not affect the risk of colorectal cancer: Hormone replacement therapy with estrogen only Hormone replacement therapy with estrogen only does not lower the risk of having invasive colorectal cancer or the risk of dying from colorectal cancer. Statins Studies have shown that taking statins (drugs that lower cholesterol) does not increase or decrease the risk of colorectal cancer. Cancer prevention clinical trials are used to study ways to prevent cancer. Cancer prevention clinical trials are used to study ways to lower the risk of developing certain types of cancer. Some cancer prevention trials are conducted with healthy people who have not had cancer but who have an increased risk for cancer. Other prevention trials are conducted with people who have had cancer and are trying to prevent another cancer of the same type or to lower their chance of developing a new type of cancer. Other trials are done with healthy volunteers who are not known to have any risk factors for cancer. The purpose of some cancer prevention clinical trials is to find out whether actions people take can prevent cancer. These may include exercising more or quitting smoking or taking certain medicines, vitamins, minerals, or food supplements. New ways to prevent colorectal cancer are being studied in clinical trials. Clinical trials are taking place in many parts of the country. Information about clinical trials can be found in the Clinical Trials section of the NCI website. Check NCI's list of cancer clinical trials for colon cancer prevention trials or rectal cancer prevention trials that are now accepting patients.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>Who is at risk for Colorectal Cancer? ? [/INST] Avoiding risk factors and increasing protective factors may help prevent cancer. The following risk factors increase the risk of colorectal cancer: Age Family history of colorectal cancer Personal history Inherited risk Alcohol Cigarette smoking Obesity The following protective factors decrease the risk of colorectal cancer: Physical activity Aspirin Combination hormone replacement therapy Polyp removal It is not clear if the following affect the risk of colorectal cancer: Nonsteroidal antiinflammatory drugs (NSAIDs) other than aspirin Calcium Diet The following factors do not affect the risk of colorectal cancer: Hormone replacement therapy with estrogen only Statins Cancer prevention clinical trials are used to study ways to prevent cancer. New ways to prevent colorectal cancer are being studied in clinical trials. Avoiding risk factors and increasing protective factors may help prevent cancer. Avoiding cancer risk factors may help prevent certain cancers. Risk factors include smoking, being overweight, and not getting enough exercise. Increasing protective factors such as quitting smoking and exercising may also help prevent some cancers. Talk to your doctor or other health care professional about how you might lower your risk of cancer. The following risk factors increase the risk of colorectal cancer: Age The risk of colorectal cancer increases after age 50. Most cases of colorectal cancer are diagnosed after age 50. Family history of colorectal cancer Having a parent, brother, sister, or child with colorectal cancer doubles a person's risk of colorectal cancer. Personal history Having a personal history of the following conditions increases the risk of colorectal cancer: Previous colorectal cancer. Highrisk adenomas (colorectal polyps that are 1 centimeter or larger in size or that have cells that look abnormal under a microscope). Ovarian cancer. Inflammatory bowel disease (such as ulcerative colitis or Crohn disease). Inherited risk The risk of colorectal cancer is increased when certain gene changes linked to familial adenomatous polyposis (FAP) or hereditary nonpolyposis colon cancer (HNPCC or Lynch Syndrome) are inherited. Alcohol Drinking 3 or more alcoholic beverages per day increases the risk of colorectal cancer. Drinking alcohol is also linked to the risk of forming large colorectal adenomas (benign tumors). Cigarette smoking Cigarette smoking is linked to an increased risk of colorectal cancer and death from colorectal cancer. Smoking cigarettes is also linked to an increased risk of forming colorectal adenomas. Cigarette smokers who have had surgery to remove colorectal adenomas are at an increased risk for the adenomas to recur (come back). Obesity Obesity is linked to an increased risk of colorectal cancer and death from colorectal cancer. It is not clear if the following affect the risk of colorectal cancer: Nonsteroidal antiinflammatory drugs (NSAIDs) other than aspirin It is not known if the use of nonsteroidal antiinflammatory drugs or NSAIDs (such as sulindac, celecoxib, naproxen, and ibuprofen) lowers the risk of colorectal cancer. Studies have shown that taking the nonsteroidal antiinflammatory drug celecoxib reduces the risk of colorectal adenomas (benign tumors) coming back after they have been removed. It is not clear if this results in a lower risk of colorectal cancer. Taking sulindac or celecoxib has been shown to reduce the number and size of polyps that form in the colon and rectum of people with familial adenomatous polyposis (FAP). It is not clear if this results in a lower risk of colorectal cancer. The possible harms of NSAIDs include: Kidney problems. Bleeding in the stomach, intestines, or brain. Heart problems such as heart attack and congestive heart failure. Calcium It is not known if taking calcium supplements lowers the risk of colorectal cancer. Diet It is not known if a diet low in fat and meat and high in fiber, fruits, and vegetables lowers the risk of colorectal cancer. Some studies have shown that a diet high in fat, proteins, calories, and meat increases the risk of colorectal cancer, but other studies have not. The following factors do not affect the risk of colorectal cancer: Hormone replacement therapy with estrogen only Hormone replacement therapy with estrogen only does not lower the risk of having invasive colorectal cancer or the risk of dying from colorectal cancer. Statins Studies have shown that taking statins (drugs that lower cholesterol) does not increase or decrease the risk of colorectal cancer.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>what research (or clinical trials) is being done for Colorectal Cancer ? [/INST] Cancer prevention clinical trials are used to study ways to prevent cancer. Cancer prevention clinical trials are used to study ways to lower the risk of developing certain types of cancer. Some cancer prevention trials are conducted with healthy people who have not had cancer but who have an increased risk for cancer. Other prevention trials are conducted with people who have had cancer and are trying to prevent another cancer of the same type or to lower their chance of developing a new type of cancer. Other trials are done with healthy volunteers who are not known to have any risk factors for cancer. The purpose of some cancer prevention clinical trials is to find out whether actions people take can prevent cancer. These may include exercising more or quitting smoking or taking certain medicines, vitamins, minerals, or food supplements. New ways to prevent colorectal cancer are being studied in clinical trials. Clinical trials are taking place in many parts of the country. Information about clinical trials can be found in the Clinical Trials section of the NCI website. Check NCI's list of cancer clinical trials for colon cancer prevention trials or rectal cancer prevention trials that are now accepting patients.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>How to prevent Oral Cavity and Oropharyngeal Cancer ? [/INST] Avoiding risk factors and increasing protective factors may help prevent cancer. The following are risk factors for oral cavity cancer and oropharyngeal cancer: Tobacco use Alcohol use Tobacco and alcohol use Betel quid or gutka chewing Personal history of head and neck cancer The following is a risk factor for oropharyngeal cancer: HPV infection The following is a protective factor for oral cavity cancer and oropharyngeal cancer: Quitting smoking It is not clear whether avoiding certain risk factors will decrease the risk of oral cavity cancer or oropharyngeal cancer. Cancer prevention clinical trials are used to study ways to prevent cancer. New ways to prevent oral cavity cancer and oropharyngeal cancer are being studied in clinical trials. Avoiding risk factors and increasing protective factors may help prevent cancer. Avoiding cancer risk factors may help prevent certain cancers. Risk factors include smoking, being overweight, and not getting enough exercise. Increasing protective factors such as quitting smoking and exercising may also help prevent some cancers. Talk to your doctor or other health care professional about how you might lower your risk of cancer. Oral cavity cancer and oropharyngeal cancer are two different diseases, but they have some risk factors in common. The following are risk factors for oral cavity cancer and oropharyngeal cancer: Tobacco use Using tobacco is the most common cause of oral cavity cancer and oropharyngeal cancer. The risk of these cancers is about 5 to 10 times higher for current smokers than for people who have never smoked. The use of all types of tobacco, including cigarettes, pipes, cigars, and smokeless tobacco (snuff and chewing tobacco) can cause cancer of the oral cavity and oropharynx. For cigarette smokers, the risk of oral cavity cancer and oropharyngeal cancer increases with the number of cigarettes smoked per day. Alcohol use Using alcohol is also an important risk factor for oral cavity cancer and oropharyngeal cancer. The risk of oral cavity cancer and oropharyngeal cancer increases with the number of alcoholic drinks consumed per day. The risk of oral cavity cancer and oropharyngeal cancer is about twice as high in people who have 3 to 4 alcoholic drinks per day and 5 times higher in people who have 5 or more alcoholic drinks per day compared with those who don't drink alcohol. Tobacco and alcohol use The risk of oral cavity cancer and oropharyngeal cancer is 2 to 3 times higher in people who use both tobacco and alcohol than it is in people who use only tobacco or only alcohol. The risk of oral cavity cancer and oropharyngeal cancer is about 35 times higher in people who smoke 2 or more packs of cigarettes per day and have more than 4 alcoholic drinks per day than it is in people who have never smoked cigarettes or consumed alcohol. Betel quid or gutka chewing Chewing betel quid or gutka (betel quid mixed with tobacco) has been shown to increase the risk of oral cavity cancer and oropharyngeal cancer. Betel quid contains areca nut, which is a cancercausing substance. The risk of oral cavity cancer and oropharyngeal cancer increases with how long and how often betel quid or gutka are chewed. The risk for oral cavity cancer and oropharyngeal cancer is higher when chewing gutka than when chewing betel quid alone. Betel quid and gutka chewing is common in many countries in South Asia and Southeast Asia, including China and India. Personal history of head and neck cancer A personal history of head and neck cancer increases the risk of oral cavity cancer and oropharyngeal cancer. The following is a risk factor for oropharyngeal cancer: HPV infection Being infected with certain types of HPV, especially HPV type 16, increases the risk of oropharyngeal cancer. HPV infection is spread mainly through sexual contact. The risk of oropharyngeal cancer is about 15 times higher in people who have oral HPV 16 infection compared with people who do not have oral HPV 16 infection. The following is a protective factor for oral cavity cancer and oropharyngeal cancer: Quitting smoking Studies have shown that when people stop smoking cigarettes, their risk of oral cavity cancer and oropharyngeal cancer decreases by one half (50%) within 5 years. Within 20 years of quitting, their risk of oral cavity cancer and oropharyngeal cancer is the same as for a person who never smoked cigarettes. It is not clear whether avoiding certain risk factors will decrease the risk of oral cavity cancer or oropharyngeal cancer. It has not been proven that stopping alcohol use will decrease the risk of oral cavity cancer or oropharyngeal cancer. Getting an HPV vaccination greatly lessens the risk of oral HPV infection. It is not yet known whether getting an HPV vaccination at any age will decrease the risk of oropharyngeal cancer from HPV infection. Cancer prevention clinical trials are used to study ways to prevent cancer. Cancer prevention clinical trials are used to study ways to lower the risk of certain types of cancer. Some cancer prevention trials are done with healthy people who have not had cancer but who have an increased risk for cancer. Other prevention trials are done with people who have had cancer and are trying to prevent another cancer of the same type or to lower their chance of developing a new type of cancer. Other trials are done with healthy volunteers who are not known to have any risk factors for cancer. The purpose of some cancer prevention clinical trials is to find out whether actions people take can prevent cancer. These may include eating fruits and vegetables, exercising, quitting smoking, or taking certain medicines, vitamins, minerals, or food supplements. New ways to prevent oral cavity cancer and oropharyngeal cancer are being studied in clinical trials. Clinical trials are taking place in many parts of the country. Information about clinical trials can be found in the Clinical Trials section of the NCI website. Check NCI's list of cancer clinical trials for oral cavity cancer prevention trials and oropharyngeal cancer prevention trials that are now accepting patients.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>Who is at risk for Oral Cavity and Oropharyngeal Cancer? ? [/INST] Avoiding risk factors and increasing protective factors may help prevent cancer. The following are risk factors for oral cavity cancer and oropharyngeal cancer: Tobacco use Alcohol use Tobacco and alcohol use Betel quid or gutka chewing Personal history of head and neck cancer The following is a risk factor for oropharyngeal cancer: HPV infection The following is a protective factor for oral cavity cancer and oropharyngeal cancer: Quitting smoking It is not clear whether avoiding certain risk factors will decrease the risk of oral cavity cancer or oropharyngeal cancer. Cancer prevention clinical trials are used to study ways to prevent cancer. New ways to prevent oral cavity cancer and oropharyngeal cancer are being studied in clinical trials. Avoiding risk factors and increasing protective factors may help prevent cancer. Avoiding cancer risk factors may help prevent certain cancers. Risk factors include smoking, being overweight, and not getting enough exercise. Increasing protective factors such as quitting smoking and exercising may also help prevent some cancers. Talk to your doctor or other health care professional about how you might lower your risk of cancer. Oral cavity cancer and oropharyngeal cancer are two different diseases, but they have some risk factors in common. The following are risk factors for oral cavity cancer and oropharyngeal cancer: Tobacco use Using tobacco is the most common cause of oral cavity cancer and oropharyngeal cancer. The risk of these cancers is about 5 to 10 times higher for current smokers than for people who have never smoked. The use of all types of tobacco, including cigarettes, pipes, cigars, and smokeless tobacco (snuff and chewing tobacco) can cause cancer of the oral cavity and oropharynx. For cigarette smokers, the risk of oral cavity cancer and oropharyngeal cancer increases with the number of cigarettes smoked per day. Alcohol use Using alcohol is also an important risk factor for oral cavity cancer and oropharyngeal cancer. The risk of oral cavity cancer and oropharyngeal cancer increases with the number of alcoholic drinks consumed per day. The risk of oral cavity cancer and oropharyngeal cancer is about twice as high in people who have 3 to 4 alcoholic drinks per day and 5 times higher in people who have 5 or more alcoholic drinks per day compared with those who don't drink alcohol. Tobacco and alcohol use The risk of oral cavity cancer and oropharyngeal cancer is 2 to 3 times higher in people who use both tobacco and alcohol than it is in people who use only tobacco or only alcohol. The risk of oral cavity cancer and oropharyngeal cancer is about 35 times higher in people who smoke 2 or more packs of cigarettes per day and have more than 4 alcoholic drinks per day than it is in people who have never smoked cigarettes or consumed alcohol. Betel quid or gutka chewing Chewing betel quid or gutka (betel quid mixed with tobacco) has been shown to increase the risk of oral cavity cancer and oropharyngeal cancer. Betel quid contains areca nut, which is a cancercausing substance. The risk of oral cavity cancer and oropharyngeal cancer increases with how long and how often betel quid or gutka are chewed. The risk for oral cavity cancer and oropharyngeal cancer is higher when chewing gutka than when chewing betel quid alone. Betel quid and gutka chewing is common in many countries in South Asia and Southeast Asia, including China and India. Personal history of head and neck cancer A personal history of head and neck cancer increases the risk of oral cavity cancer and oropharyngeal cancer. The following is a risk factor for oropharyngeal cancer: HPV infection Being infected with certain types of HPV, especially HPV type 16, increases the risk of oropharyngeal cancer. HPV infection is spread mainly through sexual contact. The risk of oropharyngeal cancer is about 15 times higher in people who have oral HPV 16 infection compared with people who do not have oral HPV 16 infection. It is not clear whether avoiding certain risk factors will decrease the risk of oral cavity cancer or oropharyngeal cancer. It has not been proven that stopping alcohol use will decrease the risk of oral cavity cancer or oropharyngeal cancer. Getting an HPV vaccination greatly lessens the risk of oral HPV infection. It is not yet known whether getting an HPV vaccination at any age will decrease the risk of oropharyngeal cancer from HPV infection.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>what research (or clinical trials) is being done for Oral Cavity and Oropharyngeal Cancer ? [/INST] Cancer prevention clinical trials are used to study ways to prevent cancer. Cancer prevention clinical trials are used to study ways to lower the risk of certain types of cancer. Some cancer prevention trials are done with healthy people who have not had cancer but who have an increased risk for cancer. Other prevention trials are done with people who have had cancer and are trying to prevent another cancer of the same type or to lower their chance of developing a new type of cancer. Other trials are done with healthy volunteers who are not known to have any risk factors for cancer. The purpose of some cancer prevention clinical trials is to find out whether actions people take can prevent cancer. These may include eating fruits and vegetables, exercising, quitting smoking, or taking certain medicines, vitamins, minerals, or food supplements. New ways to prevent oral cavity cancer and oropharyngeal cancer are being studied in clinical trials. Clinical trials are taking place in many parts of the country. Information about clinical trials can be found in the Clinical Trials section of the NCI website. Check NCI's list of cancer clinical trials for oral cavity cancer prevention trials and oropharyngeal cancer prevention trials that are now accepting patients.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What is (are) Salivary Gland Cancer ? [/INST] Salivary gland cancer is a rare disease in which malignant (cancer) cells form in the tissues of the salivary glands. Being exposed to certain types of radiation may increase the risk of salivary cancer. Signs of salivary gland cancer include a lump or trouble swallowing. Tests that examine the head, neck, and the inside of the mouth are used to detect (find) and diagnose salivary gland cancer. Certain factors affect treatment options and prognosis (chance of recovery). Salivary gland cancer is a rare disease in which malignant (cancer) cells form in the tissues of the salivary glands. The salivary glands make saliva and release it into the mouth. Saliva has enzymes that help digest food and antibodies that help protect against infections of the mouth and throat. There are 3 pairs of major salivary glands: Parotid glands: These are the largest salivary glands and are found in front of and just below each ear. Most major salivary gland tumors begin in this gland. Sublingual glands: These glands are found under the tongue in the floor of the mouth. Submandibular glands: These glands are found below the jawbone. There are also hundreds of small (minor) salivary glands lining parts of the mouth, nose, and larynx that can be seen only with a microscope. Most small salivary gland tumors begin in the palate (roof of the mouth). More than half of all salivary gland tumors are benign (not cancerous) and do not spread to other tissues. Salivary gland cancer is a type of head and neck cancer.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>Who is at risk for Salivary Gland Cancer? ? [/INST] Being exposed to certain types of radiation may increase the risk of salivary cancer. Anything that increases the chance of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesnt mean that you will not get cancer. Talk with your doctor if you think you may be at risk. Although the cause of most salivary gland cancers is not known, risk factors include the following: Older age. Treatment with radiation therapy to the head and neck. Being exposed to certain substances at work.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What are the symptoms of Salivary Gland Cancer ? [/INST] Signs of salivary gland cancer include a lump or trouble swallowing. Salivary gland cancer may not cause any symptoms. It may be found during a regular dental checkup or physical exam. Signs and symptoms may be caused by salivary gland cancer or by other conditions. Check with your doctor if you have any of the following: A lump (usually painless) in the area of the ear, cheek, jaw, lip, or inside the mouth. Fluid draining from the ear. Trouble swallowing or opening the mouth widely. Numbness or weakness in the face. Pain in the face that does not go away.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>How to diagnose Salivary Gland Cancer ? [/INST] Tests that examine the head, neck, and the inside of the mouth are used to detect (find) and diagnose salivary gland cancer. The following procedures may be used: Physical exam and history : An exam of the body to check general signs of health. The head, neck, mouth, and throat will be checked for signs of disease, such as lumps or anything else that seems unusual. A history of the patient's health habits and past illnesses and treatments will also be taken. MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI). CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an xray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography. PET scan (positron emission tomography scan): A procedure to find malignant tumor cells in the body. A small amount of radioactive glucose (sugar) is injected into a vein. The PET scanner rotates around the body and makes a picture of where glucose is being used in the body. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do. Endoscopy : A procedure to look at organs and tissues inside the body to check for abnormal areas. For salivary gland cancer, an endoscope is inserted into the mouth to look at the mouth, throat, and larynx. An endoscope is a thin, tubelike instrument with a light and a lens for viewing. Biopsy : The removal of cells or tissues so they can be viewed under a microscope by a pathologist to check for signs of cancer. Fine needle aspiration (FNA) biopsy : The removal of tissue or fluid using a thin needle. An FNA is the most common type of biopsy used for salivary gland cancer. Incisional biopsy : The removal of part of a lump or a sample of tissue that doesnt look normal. Surgery : If cancer cannot be diagnosed from the sample of tissue removed during an FNA biopsy or an incisional biopsy, the mass may be removed and checked for signs of cancer. Because salivary gland cancer can be hard to diagnose, patients should ask to have the tissue samples checked by a pathologist who has experience in diagnosing salivary gland cancer.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What is the outlook for Salivary Gland Cancer ? [/INST] Certain factors affect treatment options and prognosis (chance of recovery). The treatment options and prognosis (chance of recovery) depend on the following: The stage of the cancer (especially the size of the tumor). The type of salivary gland the cancer is in. The type of cancer cells (how they look under a microscope). The patient's age and general health.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What are the stages of Salivary Gland Cancer ? [/INST] After salivary gland cancer has been diagnosed, tests are done to find out if cancer cells have spread within the salivary gland or to other parts of the body. There are three ways that cancer spreads in the body. Cancer may spread from where it began to other parts of the body. The following stages are used for major salivary gland cancers: Stage I Stage II Stage III Stage IV After salivary gland cancer has been diagnosed, tests are done to find out if cancer cells have spread within the salivary gland or to other parts of the body. The process used to find out if cancer has spread within the salivary glands or to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment. The following procedures may be used in the staging process: MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI). CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an xray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography. There are three ways that cancer spreads in the body. Cancer can spread through tissue, the lymph system, and the blood: Tissue. The cancer spreads from where it began by growing into nearby areas. Lymph system. The cancer spreads from where it began by getting into the lymph system. The cancer travels through the lymph vessels to other parts of the body. Blood. The cancer spreads from where it began by getting into the blood. The cancer travels through the blood vessels to other parts of the body. Cancer may spread from where it began to other parts of the body. When cancer spreads to another part of the body, it is called metastasis. Cancer cells break away from where they began (the primary tumor) and travel through the lymph system or blood. Lymph system. The cancer gets into the lymph system, travels through the lymph vessels, and forms a tumor (metastatic tumor) in another part of the body. Blood. The cancer gets into the blood, travels through the blood vessels, and forms a tumor (metastatic tumor) in another part of the body. The metastatic tumor is the same type of cancer as the primary tumor. For example, if salivary gland cancer spreads to the lung, the cancer cells in the lung are actually salivary gland cancer cells. The disease is metastatic salivary gland cancer, not lung cancer. The following stages are used for major salivary gland cancers: Stage I In stage I, the tumor is in the salivary gland only and is 2 centimeters or smaller. Stage II In stage II, the tumor is in the salivary gland only and is larger than 2 centimeters but not larger than 4 centimeters. Stage III In stage III, one of the following is true: The tumor is not larger than 4 centimeters and has spread to a single lymph node on the same side as the tumor and the lymph node is 3 centimeters or smaller. The tumor is larger than 4 centimeters and/or has spread to soft tissue around the affected gland. Cancer may have spread to a single lymph node on the same side as the tumor and the lymph node is 3 centimeters or smaller. Stage IV Stage IV is divided into stages IVA, IVB, and IVC as follows: Stage IVA: The tumor may be any size and may have spread to soft tissue around the affected gland. Cancer has spread to a single lymph node on the same side as the tumor and the lymph node is larger than 3 centimeters but not larger than 6 centimeters, or has spread to more than one lymph node on either or both sides of the body and the lymph nodes are not larger than 6 centimeters; or Cancer has spread to the skin, jawbone, ear canal, and/or facial nerve, and may have spread to one or more lymph nodes on either or both sides of the body. The lymph nodes are not larger than 6 centimeters. Stage IVB: The tumor may be any size and may have spread to soft tissue around the affected gland. Cancer has spread to a lymph node larger than 6 centimeters; or Cancer has spread to the base of the skull and/or the carotid artery, and may have spread to one or more lymph nodes of any size on either or both sides of the body. Stage IVC: The tumor may be any size and may have spread to soft tissue around the affected gland, to the skin, jawbone, ear canal, facial nerve, base of the skull, or carotid artery, or to one or more lymph nodes on either or both sides of the body. Cancer has spread to distant parts of the body. Salivary gland cancers are also grouped by grade. The grade of a tumor tells how fast the cancer cells are growing, based on how the cells look under a microscope. Lowgrade cancers grow more slowly than highgrade cancers. Minor salivary gland cancers are staged according to where they were first found in the body.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What are the treatments for Salivary Gland Cancer ? [/INST] There are different types of treatment for patients with salivary gland cancer. Patients with salivary gland cancer should have their treatment planned by a team of doctors who are experts in treating head and neck cancer. Three types of standard treatment are used: Surgery Radiation therapy Chemotherapy New types of treatment are being tested in clinical trials. Radiosensitizers Patients may want to think about taking part in a clinical trial. Patients can enter clinical trials before, during, or after starting their cancer treatment. Followup tests may be needed. There are different types of treatment for patients with salivary gland cancer. Different types of treatment are available for patients with salivary gland cancer. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment. Patients with salivary gland cancer should have their treatment planned by a team of doctors who are experts in treating head and neck cancer. Your treatment will be overseen by a medical oncologist, a doctor who specializes in treating people with cancer. Because the salivary glands help in eating and digesting food, patients may need special help adjusting to the side effects of the cancer and its treatment. The medical oncologist may refer you to other doctors who have experience and expertise in treating patients with head and neck cancer and who specialize in certain areas of medicine. These include the following: Head and neck surgeon. Radiation oncologist. Dentist. Speech therapist. Dietitian. Psychologist. Rehabilitation specialist. Plastic surgeon. Three types of standard treatment are used: Surgery Surgery (removing the cancer in an operation) is a common treatment for salivary gland cancer. A doctor may remove the cancer and some of the healthy tissue around the cancer. In some cases, a lymphadenectomy (surgery in which lymph nodes are removed) will also be done. Even if the doctor removes all the cancer that can be seen at the time of the surgery, some patients may be given radiation therapy after surgery to kill any cancer cells that are left. Treatment given after surgery, to lower the risk that the cancer will come back, is called adjuvant therapy. Radiation therapy Radiation therapy is a cancer treatment that uses highenergy xrays or other types of radiation to kill cancer cells or keep them from growing. There are two types of radiation therapy: External radiation therapy uses a machine outside the body to send radiation toward the cancer. Special types of external radiation may be used to treat some salivary gland tumors. These include: Fast neutron radiation therapy: Fast neutron radiation therapy is a type of highenergy external radiation therapy. A radiation therapy machine aims neutrons (tiny, invisible particles) at the cancer cells to kill them. Fast neutron radiation therapy uses a higherenergy radiation than the xray type of radiation therapy. This allows the radiation therapy to be given in fewer treatments. Photonbeam radiation therapy: Photonbeam radiation therapy is a type of external radiation therapy that reaches deep tumors with highenergy xrays made by a machine called a linear accelerator. This can be delivered as hyperfractionated radiation therapy, in which the total dose of radiation is divided into small doses and the treatments are given more than once a day. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. The way the radiation therapy is given depends on the type and stage of the cancer being treated. External radiation therapy is used to treat salivary gland cancer, and may also be used as palliative therapy to relieve symptoms and improve quality of life. Chemotherapy Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the cerebrospinal fluid, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). The way the chemotherapy is given depends on the type and stage of the cancer being treated. See Drugs Approved for Head and Neck Cancer for more information. (Salivary gland cancer is a type of head and neck cancer.) New types of treatment are being tested in clinical trials. This summary section describes treatments that are being studied in clinical trials. It may not mention every new treatment being studied. Information about clinical trials is available from the NCI website. Radiosensitizers Radiosensitizers are drugs that make tumor cells more sensitive to radiation therapy. Combining radiation therapy with radiosensitizers may kill more tumor cells. Patients may want to think about taking part in a clinical trial. For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment. Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment. Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward. Patients can enter clinical trials before, during, or after starting their cancer treatment. Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring (coming back) or reduce the side effects of cancer treatment. Clinical trials are taking place in many parts of the country. See the Treatment Options section that follows for links to current treatment clinical trials. These have been retrieved from NCI's listing of clinical trials. Followup tests may be needed. Some of the tests that were done to diagnose the cancer or to find out the stage of the cancer may be repeated. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests. Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your condition has changed or if the cancer has recurred (come back). These tests are sometimes called followup tests or checkups. Treatment Options by Stage Stage I Salivary Gland Cancer Treatment for stage I salivary gland cancer depends on whether the cancer is lowgrade (slow growing) or highgrade (fast growing). If the cancer is lowgrade, treatment may include the following: Surgery with or without radiation therapy. Fast neutron radiation therapy. If the cancer is highgrade, treatment may include the following: Surgery with or without radiation therapy. A clinical trial of chemotherapy. A clinical trial of a new local therapy. Check the list of NCIsupported cancer clinical trials that are now accepting patients with stage I salivary gland cancer. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the NCI website. Stage II Salivary Gland Cancer Treatment for stage II salivary gland cancer depends on whether the cancer is lowgrade (slow growing) or highgrade (fast growing). If the cancer is lowgrade, treatment may include the following: Surgery with or without radiation therapy. Radiation therapy. Chemotherapy. If the cancer is highgrade, treatment may include the following: Surgery with or without radiation therapy. Fast neutron or photonbeam radiation therapy. A clinical trial of radiation therapy and/or radiosensitizers. A clinical trial of chemotherapy. Check the list of NCIsupported cancer clinical trials that are now accepting patients with stage II salivary gland cancer. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the NCI website. Stage III Salivary Gland Cancer Treatment for stage III salivary gland cancer depends on whether the cancer is lowgrade (slow growing) or highgrade (fast growing). If the cancer is lowgrade, treatment may include the following: Surgery with or without lymphadenectomy. Radiation therapy may also be given after surgery. Radiation therapy. Fast neutron radiation therapy to lymph nodes with cancer. Chemotherapy. A clinical trial of fast neutron radiation therapy to the tumor. A clinical trial of chemotherapy. If the cancer is highgrade, treatment may include the following: Surgery with or without lymphadenectomy. Radiation therapy may also be given after surgery. Fast neutron radiation therapy. Radiation therapy as palliative therapy to relieve symptoms and improve quality of life. A clinical trial of radiation therapy and/or radiosensitizers. A clinical trial of chemotherapy. Check the list of NCIsupported cancer clinical trials that are now accepting patients with stage III salivary gland cancer. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the NCI website. Stage IV Salivary Gland Cancer Treatment of stage IV salivary gland cancer may include the following: Fast neutron or photonbeam radiation therapy. A clinical trial of chemotherapy with or without radiation therapy. Check the list of NCIsupported cancer clinical trials that are now accepting patients with stage IV salivary gland cancer. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the NCI website.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>what research (or clinical trials) is being done for Salivary Gland Cancer ? [/INST] New types of treatment are being tested in clinical trials. This summary section describes treatments that are being studied in clinical trials. It may not mention every new treatment being studied. Information about clinical trials is available from the NCI website. Radiosensitizers Radiosensitizers are drugs that make tumor cells more sensitive to radiation therapy. Combining radiation therapy with radiosensitizers may kill more tumor cells. Patients may want to think about taking part in a clinical trial. For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment. Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment. Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward. Patients can enter clinical trials before, during, or after starting their cancer treatment. Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring (coming back) or reduce the side effects of cancer treatment. Clinical trials are taking place in many parts of the country. See the Treatment Options section that follows for links to current treatment clinical trials. These have been retrieved from NCI's listing of clinical trials.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What is (are) Rectal Cancer ? [/INST] Rectal cancer is a disease in which malignant (cancer) cells form in the tissues of the rectum. Health history affects the risk of developing rectal cancer. Signs of rectal cancer include a change in bowel habits or blood in the stool. Tests that examine the rectum and colon are used to detect (find) and diagnose rectal cancer. Certain factors affect prognosis (chance of recovery) and treatment options. Rectal cancer is a disease in which malignant (cancer) cells form in the tissues of the rectum. The rectum is part of the bodys digestive system. The digestive system takes in nutrients (vitamins, minerals, carbohydrates, fats, proteins, and water) from foods and helps pass waste material out of the body. The digestive system is made up of the esophagus, stomach, and the small and large intestines. The colon (large bowel) is the first part of the large intestine and is about 5 feet long. Together, the rectum and anal canal make up the last part of the large intestine and are 68 inches long. The anal canal ends at the anus (the opening of the large intestine to the outside of the body). See the following PDQ summaries for more information about rectal cancer: Unusual Cancers of Childhood Treatment (see Colorectal Cancer section) Colorectal Cancer Prevention Colorectal Cancer Screening Gastrointestinal Stromal Tumors Treatment Genetics of Colorectal Cancer</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>Who is at risk for Rectal Cancer? ? [/INST] Health history affects the risk of developing rectal cancer. Anything that increases your chance of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesnt mean that you will not get cancer. Talk to your doctor if you think you may be at risk for colorectal cancer. Risk factors for colorectal cancer include the following: Having a family history of colon or rectal cancer in a firstdegree relative (parent, sibling, or child). Having a personal history of cancer of the colon, rectum, or ovary. Having a personal history of highrisk adenomas (colorectal polyps that are 1 centimeter or larger in size or that have cells that look abnormal under a microscope). Having inherited changes in certain genes that increase the risk of familial adenomatous polyposis (FAP) or Lynch syndrome (hereditary nonpolyposis colorectal cancer). Having a personal history of chronic ulcerative colitis or Crohn disease for 8 years or more. Having three or more alcoholic drinks per day. Smoking cigarettes. Being black. Being obese. Older age is a main risk factor for most cancers. The chance of getting cancer increases as you get older.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What are the symptoms of Rectal Cancer ? [/INST] Signs of rectal cancer include a change in bowel habits or blood in the stool. These and other signs and symptoms may be caused by rectal cancer or by other conditions. Check with your doctor if you have any of the following: Blood (either bright red or very dark) in the stool. A change in bowel habits. Diarrhea. Constipation. Feeling that the bowel does not empty completely. Stools that are narrower or have a different shape than usual. General abdominal discomfort (frequent gas pains, bloating, fullness, or cramps). Change in appetite. Weight loss for no known reason. Feeling very tired.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>How to diagnose Rectal Cancer ? [/INST] Tests that examine the rectum and colon are used to detect (find) and diagnose rectal cancer. Tests used to diagnose rectal cancer include the following: Physical exam and history : An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patients health habits and past illnesses and treatments will also be taken. Digital rectal exam (DRE): An exam of the rectum. The doctor or nurse inserts a lubricated, gloved finger into the lower part of the rectum to feel for lumps or anything else that seems unusual. In women, the vagina may also be examined. Colonoscopy : A procedure to look inside the rectum and colon for polyps (small pieces of bulging tissue), abnormal areas, or cancer. A colonoscope is a thin, tubelike instrument with a light and a lens for viewing. It may also have a tool to remove polyps or tissue samples, which are checked under a microscope for signs of cancer. Biopsy : The removal of cells or tissues so they can be viewed under a microscope to check for signs of cancer. Tumor tissue that is removed during the biopsy may be checked to see if the patient is likely to have the gene mutation that causes HNPCC. This may help to plan treatment. The following tests may be used: Reverse transcriptionpolymerase chain reaction (RTPCR) test: A laboratory test in which cells in a sample of tissue are studied using chemicals to look for certain changes in the structure or function of genes. Immunohistochemistry : A test that uses antibodies to check for certain antigens in a sample of tissue. The antibody is usually linked to a radioactive substance or a dye that causes the tissue to light up under a microscope. This type of test may be used to tell the difference between different types of cancer. Carcinoembryonic antigen (CEA) assay : A test that measures the level of CEA in the blood. CEA is released into the bloodstream from both cancer cells and normal cells. When found in higher than normal amounts, it can be a sign of rectal cancer or other conditions.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What is the outlook for Rectal Cancer ? [/INST] Certain factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery) and treatment options depend on the following: The stage of the cancer (whether it affects the inner lining of the rectum only, involves the whole rectum, or has spread to lymph nodes, nearby organs, or other places in the body). Whether the tumor has spread into or through the bowel wall. Where the cancer is found in the rectum. Whether the bowel is blocked or has a hole in it. Whether all of the tumor can be removed by surgery. The patients general health. Whether the cancer has just been diagnosed or has recurred (come back).</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What are the stages of Rectal Cancer ? [/INST] After rectal cancer has been diagnosed, tests are done to find out if cancer cells have spread within the rectum or to other parts of the body. There are three ways that cancer spreads in the body. Cancer may spread from where it began to other parts of the body. The following stages are used for rectal cancer: Stage 0 (Carcinoma in Situ) Stage I Stage II Stage III Stage IV After rectal cancer has been diagnosed, tests are done to find out if cancer cells have spread within the rectum or to other parts of the body. The process used to find out whether cancer has spread within the rectum or to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment. The following tests and procedures may be used in the staging process: Chest xray : An xray of the organs and bones inside the chest. An xray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body. Colonoscopy : A procedure to look inside the rectum and colon for polyps (small pieces of bulging tissue). abnormal areas, or cancer. A colonoscope is a thin, tubelike instrument with a light and a lens for viewing. It may also have a tool to remove polyps or tissue samples, which are checked under a microscope for signs of cancer. CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, such as the abdomen, pelvis, or chest, taken from different angles. The pictures are made by a computer linked to an xray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography. MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI). PET scan (positron emission tomography scan): A procedure to find malignant tumor cells in the body. A small amount of radioactive glucose (sugar) is injected into a vein. The PET scanner rotates around the body and makes a picture of where glucose is being used in the body. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do. Endorectal ultrasound : A procedure used to examine the rectum and nearby organs. An ultrasound transducer (probe) is inserted into the rectum and used to bounce highenergy sound waves (ultrasound) off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram. The doctor can identify tumors by looking at the sonogram. This procedure is also called transrectal ultrasound. There are three ways that cancer spreads in the body. Cancer can spread through tissue, the lymph system, and the blood: Tissue. The cancer spreads from where it began by growing into nearby areas. Lymph system. The cancer spreads from where it began by getting into the lymph system. The cancer travels through the lymph vessels to other parts of the body. Blood. The cancer spreads from where it began by getting into the blood. The cancer travels through the blood vessels to other parts of the body. Cancer may spread from where it began to other parts of the body. When cancer spreads to another part of the body, it is called metastasis. Cancer cells break away from where they began (the primary tumor) and travel through the lymph system or blood. Lymph system. The cancer gets into the lymph system, travels through the lymph vessels, and forms a tumor (metastatic tumor) in another part of the body. Blood. The cancer gets into the blood, travels through the blood vessels, and forms a tumor (metastatic tumor) in another part of the body. The metastatic tumor is the same type of cancer as the primary tumor. For example, if rectal cancer spreads to the lung, the cancer cells in the lung are actually rectal cancer cells. The disease is metastatic rectal cancer, not lung cancer. The following stages are used for rectal cancer: Stage 0 (Carcinoma in Situ) In stage 0, abnormal cells are found in the mucosa (innermost layer) of the rectum wall. These abnormal cells may become cancer and spread. Stage 0 is also called carcinoma in situ. Stage I In stage I, cancer has formed in the mucosa (innermost layer) of the rectum wall and has spread to the submucosa (layer of tissue under the mucosa). Cancer may have spread to the muscle layer of the rectum wall. Stage II Stage II rectal cancer is divided into stage IIA, stage IIB, and stage IIC. Stage IIA: Cancer has spread through the muscle layer of the rectum wall to the serosa (outermost layer) of the rectum wall. Stage IIB: Cancer has spread through the serosa (outermost layer) of the rectum wall but has not spread to nearby organs. Stage IIC: Cancer has spread through the serosa (outermost layer) of the rectum wall to nearby organs. Stage III Stage III rectal cancer is divided into stage IIIA, stage IIIB, and stage IIIC. In stage IIIA: Cancer has spread through the mucosa (innermost layer) of the rectum wall to the submucosa (layer of tissue under the mucosa) and may have spread to the muscle layer of the rectum wall. Cancer has spread to at least one but not more than 3 nearby lymph nodes or cancer cells have formed in tissues near the lymph nodes; or Cancer has spread through the mucosa (innermost layer) of the rectum wall to the submucosa (layer of tissue under the mucosa). Cancer has spread to at least 4 but not more than 6 nearby lymph nodes. In stage IIIB: Cancer has spread through the muscle layer of the rectum wall to the serosa (outermost layer) of the rectum wall or has spread through the serosa but not to nearby organs. Cancer has spread to at least one but not more than 3 nearby lymph nodes or cancer cells have formed in tissues near the lymph nodes; or Cancer has spread to the muscle layer of the rectum wall or to the serosa (outermost layer) of the rectum wall. Cancer has spread to at least 4 but not more than 6 nearby lymph nodes; or Cancer has spread through the mucosa (innermost layer) of the rectum wall to the submucosa (layer of tissue under the mucosa) and may have spread to the muscle layer of the rectum wall. Cancer has spread to 7 or more nearby lymph nodes. In stage IIIC: Cancer has spread through the serosa (outermost layer) of the rectum wall but has not spread to nearby organs. Cancer has spread to at least 4 but not more than 6 nearby lymph nodes; or Cancer has spread through the muscle layer of the rectum wall to the serosa (outermost layer) of the rectum wall or has spread through the serosa but has not spread to nearby organs. Cancer has spread to 7 or more nearby lymph nodes; or Cancer has spread through the serosa (outermost layer) of the rectum wall and has spread to nearby organs. Cancer has spread to one or more nearby lymph nodes or cancer cells have formed in tissues near the lymph nodes. Stage IV Stage IV rectal cancer is divided into stage IVA and stage IVB. Stage IVA: Cancer may have spread through the rectum wall and may have spread to nearby organs or lymph nodes. Cancer has spread to one organ that is not near the rectum, such as the liver, lung, or ovary, or to a distant lymph node. Stage IVB: Cancer may have spread through the rectum wall and may have spread to nearby organs or lymph nodes. Cancer has spread to more than one organ that is not near the rectum or into the lining of the abdominal wall.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What are the treatments for Rectal Cancer ? [/INST] There are different types of treatment for patients with rectal cancer. Five types of standard treatment are used: Surgery Radiation therapy Chemotherapy Active surveillance Targeted therapy Other types of treatment are being tested in clinical trials. Patients may want to think about taking part in a clinical trial. Patients can enter clinical trials before, during, or after starting their cancer treatment. Followup tests may be needed. There are different types of treatment for patients with rectal cancer. Different types of treatment are available for patients with rectal cancer. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment. Five types of standard treatment are used: Surgery Surgery is the most common treatment for all stages of rectal cancer. The cancer is removed using one of the following types of surgery: Polypectomy: If the cancer is found in a polyp (a small piece of bulging tissue), the polyp is often removed during a colonoscopy. Local excision: If the cancer is found on the inside surface of the rectum and has not spread into the wall of the rectum, the cancer and a small amount of surrounding healthy tissue is removed. Resection: If the cancer has spread into the wall of the rectum, the section of the rectum with cancer and nearby healthy tissue is removed. Sometimes the tissue between the rectum and the abdominal wall is also removed. The lymph nodes near the rectum are removed and checked under a microscope for signs of cancer. Radiofrequency ablation: The use of a special probe with tiny electrodes that kill cancer cells. Sometimes the probe is inserted directly through the skin and only local anesthesia is needed. In other cases, the probe is inserted through an incision in the abdomen. This is done in the hospital with general anesthesia. Cryosurgery: A treatment that uses an instrument to freeze and destroy abnormal tissue. This type of treatment is also called cryotherapy. Pelvic exenteration: If the cancer has spread to other organs near the rectum, the lower colon, rectum, and bladder are removed. In women, the cervix, vagina, ovaries, and nearby lymph nodes may be removed. In men, the prostate may be removed. Artificial openings (stoma) are made for urine and stool to flow from the body to a collection bag. After the cancer is removed, the surgeon will either: do an anastomosis (sew the healthy parts of the rectum together, sew the remaining rectum to the colon, or sew the colon to the anus); or make a stoma (an opening) from the rectum to the outside of the body for waste to pass through. This procedure is done if the cancer is too close to the anus and is called a colostomy. A bag is placed around the stoma to collect the waste. Sometimes the colostomy is needed only until the rectum has healed, and then it can be reversed. If the entire rectum is removed, however, the colostomy may be permanent. Radiation therapy and/or chemotherapy may be given before surgery to shrink the tumor, make it easier to remove the cancer, and help with bowel control after surgery. Treatment given before surgery is called neoadjuvant therapy. Even if all the cancer that can be seen at the time of the operation is removed, some patients may be given radiation therapy and/or chemotherapy after surgery to kill any cancer cells that are left. Treatment given after the surgery, to lower the risk that the cancer will come back, is called adjuvant therapy. Radiation therapy Radiation therapy is a cancer treatment that uses highenergy xrays or other types of radiation to kill cancer cells or keep them from growing. There are two types of radiation therapy: External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. The way the radiation therapy is given depends on the type and stage of the cancer being treated. External radiation therapy is used to treat rectal cancer. Shortcourse preoperative radiation therapy is used in some types of rectal cancer. This treatment uses fewer and lower doses of radiation than standard treatment, followed by surgery several days after the last dose. Chemotherapy Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping the cells from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly in the cerebrospinal fluid, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). Chemoembolization of the hepatic artery is a type of regional chemotherapy that may be used to treat cancer that has spread to the liver. This is done by blocking the hepatic artery (the main artery that supplies blood to the liver) and injecting anticancer drugs between the blockage and the liver. The livers arteries then carry the drugs into the liver. Only a small amount of the drug reaches other parts of the body. The blockage may be temporary or permanent, depending on what is used to block the artery. The liver continues to receive some blood from the hepatic portal vein, which carries blood from the stomach and intestine. The way the chemotherapy is given depends on the type and stage of the cancer being treated. See Drugs Approved for Rectal Cancer for more information. Active surveillance Active surveillance is closely following a patient's condition without giving any treatment unless there are changes in test results. It is used to find early signs that the condition is getting worse. In active surveillance, patients are given certain exams and tests to check if the cancer is growing. When the cancer begins to grow, treatment is given to cure the cancer. Tests include the following: Digital rectal exam. MRI. Endoscopy. Sigmoidoscopy. CT scan. Carcinoembryonic antigen (CEA) assay. Targeted therapy Targeted therapy is a type of treatment that uses drugs or other substances to identify and attack specific cancer cells without harming normal cells. Types of targeted therapies used in the treatment of rectal cancer include the following: Monoclonal antibodies: Monoclonal antibody therapy is a type of targeted therapy being used for the treatment of rectal cancer. Monoclonal antibody therapy uses antibodies made in the laboratory from a single type of immune system cell. These antibodies can identify substances on cancer cells or normal substances that may help cancer cells grow. The antibodies attach to the substances and kill the cancer cells, block their growth, or keep them from spreading. Monoclonal antibodies are given by infusion. They may be used alone or to carry drugs, toxins, or radioactive material directly to cancer cells. Bevacizumab and ramucirumab are types of monoclonal antibodies that bind to a protein called vascular endothelial growth factor (VEGF). This may prevent the growth of new blood vessels that tumors need to grow. Cetuximab and panitumumab are types of monoclonal antibodies that bind to a protein called epidermal growth factor receptor (EGFR) on the surface of some types of cancer cells. This may stop cancer cells from growing and dividing. Angiogenesis inhibitors: Angiogenesis inhibitors stop the growth of new blood vessels that tumors need to grow. Zivaflibercept is a vascular endothelial growth factor trap that blocks an enzyme needed for the growth of new blood vessels in tumors. Regorafenib is used to treat colorectal cancer that has spread to other parts of the body and has not gotten better with other treatment. It blocks the action of certain proteins, including vascular endothelial growth factor. This may help keep cancer cells from growing and may kill them. It may also prevent the growth of new blood vessels that tumors need to grow. See Drugs Approved for Rectal Cancer for more information. Other types of treatment are being tested in clinical trials. Information about clinical trials is available from the NCI website. Patients may want to think about taking part in a clinical trial. For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment. Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment. Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward. Patients can enter clinical trials before, during, or after starting their cancer treatment. Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring (coming back) or reduce the side effects of cancer treatment. Clinical trials are taking place in many parts of the country. See the Treatment Options section that follows for links to current treatment clinical trials. These have been retrieved from NCI's listing of clinical trials. Followup tests may be needed. Some of the tests that were done to diagnose the cancer or to find out the stage of the cancer may be repeated. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests. Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your condition has changed or if the cancer has recurred (come back). These tests are sometimes called followup tests or checkups. After treatment for rectal cancer, a blood test to measure amounts of carcinoembryonic antigen (a substance in the blood that may be increased when cancer is present) may be done to see if the cancer has come back. Treatment Options by Stage Stage 0 (Carcinoma in Situ) Treatment of stage 0 may include the following: Simple polypectomy. Local excision. Resection (when the tumor is too large to remove by local excision). Check the list of NCIsupported cancer clinical trials that are now accepting patients with stage 0 rectal cancer. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the NCI website. Stage I Rectal Cancer Treatment of stage I rectal cancer may include the following: Local excision. Resection. Resection with radiation therapy and chemotherapy after surgery. Check the list of NCIsupported cancer clinical trials that are now accepting patients with stage I rectal cancer. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the NCI website. Stages II and III Rectal Cancer Treatment of stage II and stage III rectal cancer may include the following: Surgery. Chemotherapy combined with radiation therapy, followed by surgery. Shortcourse radiation therapy followed by surgery and chemotherapy. Resection followed by chemotherapy combined with radiation therapy. Chemotherapy combined with radiation therapy, followed by active surveillance. Surgery may be done if the cancer recurs (comes back). A clinical trial of a new treatment. Check the list of NCIsupported cancer clinical trials that are now accepting patients with stage II rectal cancer. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the NCI website. Stage IV and Recurrent Rectal Cancer Treatment of stage IV and recurrent rectal cancer may include the following: Surgery with or without chemotherapy or radiation therapy. Systemic chemotherapy with or without targeted therapy (a monoclonal antibody or angiogenesis inhibitor). Chemotherapy to control the growth of the tumor. Radiation therapy, chemotherapy, or a combination of both, as palliative therapy to relieve symptoms and improve the quality of life. Placement of a stent to help keep the rectum open if it is partly blocked by the tumor, as palliative therapy to relieve symptoms and improve the quality of life. A clinical trial of a new anticancer drug. Treatment of rectal cancer that has spread to other organs depends on where the cancer has spread. Treatment for areas of cancer that have spread to the liver includes the following: Surgery to remove the tumor. Chemotherapy may be given before surgery, to shrink the tumor. Cryosurgery or radiofrequency ablation. Chemoembolization and/or systemic chemotherapy. A clinical trial of chemoembolization combined with radiation therapy to the tumors in the liver. Check the list of NCIsupported cancer clinical trials that are now accepting patients with stage IV rectal cancer and recurrent rectal cancer. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the NCI website.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>what research (or clinical trials) is being done for Rectal Cancer ? [/INST] Other types of treatment are being tested in clinical trials. Information about clinical trials is available from the NCI website. Patients may want to think about taking part in a clinical trial. For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment. Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment. Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward. Patients can enter clinical trials before, during, or after starting their cancer treatment. Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring (coming back) or reduce the side effects of cancer treatment. Clinical trials are taking place in many parts of the country. See the Treatment Options section that follows for links to current treatment clinical trials. These have been retrieved from NCI's listing of clinical trials.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What is (are) Skin Cancer ? [/INST] Skin cancer is a disease in which malignant (cancer) cells form in the tissues of the skin. Nonmelanoma skin cancer is the most common cancer in the United States. Being exposed to ultraviolet radiation may increase the risk of skin cancer. Skin cancer is a disease in which malignant (cancer) cells form in the tissues of the skin. The skin is the body's largest organ. It protects against heat, sunlight, injury, and infection. Skin also helps control body temperature and stores water, fat, and vitamin D. The skin has several layers, but the two main layers are the epidermis (top or outer layer) and the dermis (lower or inner layer). Skin cancer begins in the epidermis, which is made up of three kinds of cells: Squamous cells: Thin, flat cells that form the top layer of the epidermis. Cancer that forms in squamous cells is called squamous cell carcinoma. Basal cells: Round cells under the squamous cells. Cancer that forms in basal cells is called basal cell carcinoma. Melanocytes: Found in the lower part of the epidermis, these cells make melanin, the pigment that gives skin its natural color. When skin is exposed to the sun, melanocytes make more pigment and cause the skin to tan, or darken. Cancer that forms in melanocytes is called melanoma. Nonmelanoma skin cancer is the most common cancer in the United States. Basal cell carcinoma and squamous cell carcinoma are also called nonmelanoma skin cancer and are the most common forms of skin cancer. Most basal cell and squamous cell skin cancers can be cured. Melanoma is more likely to spread to nearby tissues and other parts of the body and can be harder to cure. Melanoma is easier to cure if the tumor is found before it spreads to the dermis (inner layer of skin). Melanoma is less likely to cause death when it is found and treated early. In the United States, the number of cases of nonmelanoma skin cancer seems to have increased in recent years. The number of cases of melanoma has increased over the last 30 years. Part of the reason for these increases may be that people are more aware of skin cancer. They are more likely to have skin exams and biopsies and to be diagnosed with skin cancer. Over the past 20 years, the number of deaths from melanoma has decreased slightly among white men and women younger than 50 years. During that time, the number of deaths from melanoma has increased slightly among white men older than 50 years and stayed about the same among white women older than 50 years. The number of cases of childhood melanoma diagnosed in the United States is low, but increasing over time. The number of childhood deaths from melanoma has stayed about the same. See the following PDQ summaries for more information about skin cancer: Skin Cancer Prevention Skin Cancer Treatment Melanoma Treatment Genetics of Skin Cancer</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>Who is at risk for Skin Cancer? ? [/INST] Being exposed to ultraviolet radiation may increase the risk of skin cancer. Anything that increases your chance of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesn't mean that you will not get cancer. People who think they may be at risk should discuss this with their doctor. Being exposed to ultraviolet (UV) radiation and having skin that is sensitive to UV radiation are risk factors for skin cancer. UV radiation is the name for the invisible rays that are part of the energy that comes from the sun. Sunlamps and tanning beds also give off UV radiation. Risk factors for nonmelanoma and melanoma cancers are not the same. Nonmelanoma skin cancer risk factors include: Being exposed to natural sunlight or artificial sunlight (such as from tanning beds) over long periods of time. Having a fair complexion, which includes the following: Fair skin that freckles and burns easily, does not tan, or tans poorly. Blue or green or other lightcolored eyes. Red or blond hair. Having actinic keratosis. Past treatment with radiation. Having a weakened immune system. Being exposed to arsenic. Melanoma skin cancer risk factors include: Having a fair complexion, which includes the following: Fair skin that freckles and burns easily, does not tan, or tans poorly. Blue or green or other lightcolored eyes. Red or blond hair. Being exposed to natural sunlight or artificial sunlight (such as from tanning beds) over long periods of time. Having a history of many blistering sunburns, especially as a child or teenager. Having several large or many small moles. Having a family history of unusual moles (atypical nevus syndrome). Having a family or personal history of melanoma. Being white.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What is (are) Myelodysplastic/ Myeloproliferative Neoplasms ? [/INST] Myelodysplastic/myeloproliferative neoplasms are a group of diseases in which the bone marrow makes too many white blood cells. Myelodysplastic/myeloproliferative neoplasms have features of both myelodysplastic syndromes and myeloproliferative neoplasms. There are different types of myelodysplastic/myeloproliferative neoplasms. Tests that examine the blood and bone marrow are used to detect (find) and diagnose myelodysplastic/myeloproliferative neoplasms. Myelodysplastic/myeloproliferative neoplasms are a group of diseases in which the bone marrow makes too many white blood cells. Myelodysplastic /myeloproliferative neoplasms are diseases of the blood and bone marrow. Normally, the bone marrow makes blood stem cells (immature cells) that become mature blood cells over time. A blood stem cell may become a myeloid stem cell or a lymphoid stem cell. A lymphoid stem cell becomes a white blood cell. A myeloid stem cell becomes one of three types of mature blood cells: Red blood cells that carry oxygen and other substances to all tissues of the body. White blood cells that fight infection and disease. Platelets that form blood clots to stop bleeding. Myelodysplastic/myeloproliferative neoplasms have features of both myelodysplastic syndromes and myeloproliferative neoplasms. In myelodysplastic diseases, the blood stem cells do not mature into healthy red blood cells, white blood cells, or platelets. The immature blood cells, called blasts, do not work the way they should and die in the bone marrow or soon after they enter the blood. As a result, there are fewer healthy red blood cells, white blood cells, and platelets. In myeloproliferative diseases, a greater than normal number of blood stem cells become one or more types of blood cells and the total number of blood cells slowly increases. This summary is about neoplasms that have features of both myelodysplastic and myeloproliferative diseases. See the following PDQ summaries for more information about related diseases: Myelodysplastic Syndromes Treatment Chronic Myeloproliferative Neoplasms Treatment Chronic Myelogenous Leukemia Treatment There are different types of myelodysplastic/myeloproliferative neoplasms. The 3 main types of myelodysplastic/myeloproliferative neoplasms include the following: Chronic myelomonocytic leukemia (CMML). Juvenile myelomonocytic leukemia (JMML). Atypical chronic myelogenous leukemia (CML). When a myelodysplastic/myeloproliferative neoplasm does not match any of these types, it is called myelodysplastic/myeloproliferative neoplasm, unclassifiable (MDS/MPNUC). Myelodysplastic/myeloproliferative neoplasms may progress to acute leukemia.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>How to diagnose Myelodysplastic/ Myeloproliferative Neoplasms ? [/INST] Tests that examine the blood and bone marrow are used to detect (find) and diagnose myelodysplastic/myeloproliferative neoplasms. The following tests and procedures may be used: Physical exam and history : An exam of the body to check general signs of health, including checking for signs of disease such as an enlarged spleen and liver. A history of the patients health habits and past illnesses and treatments will also be taken. Complete blood count (CBC) with differential : A procedure in which a sample of blood is drawn and checked for the following: The number of red blood cells and platelets. The number and type of white blood cells. The amount of hemoglobin (the protein that carries oxygen) in the red blood cells. The portion of the sample made up of red blood cells. Peripheral blood smear : A procedure in which a sample of blood is checked for blast cells, the number and kinds of white blood cells, the number of platelets, and changes in the shape of blood cells. Blood chemistry studies : A procedure in which a blood sample is checked to measure the amounts of certain substances released into the blood by organs and tissues in the body. An unusual (higher or lower than normal) amount of a substance can be a sign of disease. Bone marrow aspiration and biopsy : The removal of a small piece of bone and bone marrow by inserting a needle into the hipbone or breastbone. A pathologist views both the bone and bone marrow samples under a microscope to look for abnormal cells. The following tests may be done on the sample of tissue that is removed: Cytogenetic analysis : A test in which cells in a sample of blood or bone marrow are viewed under a microscope to look for certain changes in the chromosomes. The cancer cells in myelodysplastic/myeloproliferative neoplasms do not contain the Philadelphia chromosome that is present in chronic myelogenous leukemia. Immunocytochemistry : A test that uses antibodies to check for certain antigens in a sample of bone marrow. The antibody is usually linked to a radioactive substance or a dye that causes the cells in the sample to light up under a microscope. This type of test is used to tell the difference between myelodysplastic/myeloproliferative neoplasms, leukemia, and other conditions.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What are the stages of Myelodysplastic/ Myeloproliferative Neoplasms ? [/INST] There is no standard staging system for myelodysplastic/myeloproliferative neoplasms. There is no standard staging system for myelodysplastic/myeloproliferative neoplasms. Staging is the process used to find out how far the cancer has spread. There is no standard staging system for myelodysplastic /myeloproliferative neoplasms. Treatment is based on the type of myelodysplastic/myeloproliferative neoplasm the patient has. It is important to know the type in order to plan treatment.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What are the treatments for Myelodysplastic/ Myeloproliferative Neoplasms ? [/INST] There are different types of treatment for patients with myelodysplastic/myeloproliferative neoplasms. Five types of standard treatment are used: Chemotherapy Other drug therapy Stem cell transplant Supportive care Targeted therapy New types of treatment are being tested in clinical trials. Patients may want to think about taking part in a clinical trial. Patients can enter clinical trials before, during, or after starting their cancer treatment. Followup tests may be needed. There are different types of treatment for patients with myelodysplastic/myeloproliferative neoplasms. Different types of treatments are available for patients with myelodysplastic /myeloproliferative neoplasms. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment. Five types of standard treatment are used: Chemotherapy Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the cerebrospinal fluid, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). The way the chemotherapy is given depends on the type and stage of the cancer being treated. Combination chemotherapy is treatment using more than one anticancer drug. See Drugs Approved for Myeloproliferative Neoplasms for more information. Other drug therapy 13cis retinoic acid is a vitamin like drug that slows the cancer's ability to make more cancer cells and changes the way these cells look and act. Stem cell transplant Stem cell transplant is a method of replacing blood forming cells that are destroyed by chemotherapy. Stem cells (immature blood cells) are removed from the blood or bone marrow of the patient or a donor and are frozen and stored. After the chemotherapy is completed, the stored stem cells are thawed and given back to the patient through an infusion. These reinfused stem cells grow into (and restore) the body's blood cells. Supportive care Supportive care is given to lessen the problems caused by the disease or its treatment. Supportive care may include transfusion therapy or drug therapy, such as antibiotics to fight infection. Targeted therapy Targeted therapy is a cancer treatment that uses drugs or other substances to attack cancer cells without harming normal cells. Targeted therapy drugs called tyrosine kinase inhibitors (TKIs) are used to treat myelodysplastic/myeloproliferative neoplasm, unclassifiable. TKIs block the enzyme, tyrosine kinase, that causes stem cells to become more blood cells (blasts) than the body needs. Imatinib mesylate (Gleevec) is a TKI that may be used. Other targeted therapy drugs are being studied in the treatment of JMML. See Drugs Approved for Myeloproliferative Neoplasms for more information. New types of treatment are being tested in clinical trials. Information about clinical trials is available from the NCI website. Patients may want to think about taking part in a clinical trial. For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment. Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment. Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward. Patients can enter clinical trials before, during, or after starting their cancer treatment. Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring (coming back) or reduce the side effects of cancer treatment. Clinical trials are taking place in many parts of the country. See the Treatment Options section that follows for links to current treatment clinical trials. These have been retrieved from NCI's listing of clinical trials. Followup tests may be needed. Some of the tests that were done to diagnose the cancer or to find out the stage of the cancer may be repeated. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests. Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your condition has changed or if the cancer has recurred (come back). These tests are sometimes called followup tests or checkups. Treatment Options for Myelodysplastic/ Myeloproliferative Neoplasms Chronic Myelomonocytic Leukemia Treatment of chronic myelomonocytic leukemia (CMML) may include the following: Chemotherapy with one or more agents. Stem cell transplant. A clinical trial of a new treatment. Check the list of NCIsupported cancer clinical trials that are now accepting patients with chronic myelomonocytic leukemia. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the NCI website. Juvenile Myelomonocytic Leukemia Treatment of juvenile myelomonocytic leukemia (JMML) may include the following: Combination chemotherapy. Stem cell transplant. 13cisretinoic acid therapy. A clinical trial of a new treatment, such as targeted therapy. Check the list of NCIsupported cancer clinical trials that are now accepting patients with juvenile myelomonocytic leukemia. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the NCI website. Atypical Chronic Myelogenous Leukemia Treatment of atypical chronic myelogenous leukemia (CML) may include chemotherapy. Check the list of NCIsupported cancer clinical trials that are now accepting patients with atypical chronic myeloid leukemia, BCRABL1 negative. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the NCI website. Myelodysplastic/ Myeloproliferative Neoplasm, Unclassifiable Because myelodysplastic /myeloproliferative neoplasm, unclassifiable (MDS/MPNUC) is a rare disease, little is known about its treatment. Treatment may include the following: Supportive care treatments to manage problems caused by the disease such as infection, bleeding, and anemia. Targeted therapy (imatinib mesylate). Check the list of NCIsupported cancer clinical trials that are now accepting patients with myelodysplastic/myeloproliferative neoplasm, unclassifiable. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the NCI website.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What is (are) Ovarian, Fallopian Tube, and Primary Peritoneal Cancer ? [/INST] Ovarian, fallopian tube, and primary peritoneal cancers are diseases in which malignant (cancer) cells form in the ovaries, fallopian tubes, or peritoneum. In the United States, ovarian cancer is the fifth leading cause of cancer death in women. Different factors increase or decrease the risk of getting ovarian, fallopian tube, and primary peritoneal cancer. Ovarian, fallopian tube, and primary peritoneal cancers are diseases in which malignant (cancer) cells form in the ovaries, fallopian tubes, or peritoneum. The ovaries are a pair of organs in the female reproductive system. They are located in the pelvis, one on each side of the uterus (the hollow, pearshaped organ where a fetus grows). Each ovary is about the size and shape of an almond. The ovaries produce eggs and female hormones (chemicals that control the way certain cells or organs function). The fallopian tubes are a pair of long, slender tubes, one on each side of the uterus. Eggs pass from the ovaries, through the fallopian tubes, to the uterus. Cancer sometimes begins at the end of the fallopian tube near the ovary and spreads to the ovary. The peritoneum is the tissue that lines the abdominal wall and covers organs in the abdomen. Primary peritoneal cancer is cancer that forms in the peritoneum and has not spread there from another part of the body. Cancer sometimes begins in the peritoneum and spreads to the ovary. Ovarian epithelial cancer, fallopian tube cancer, and primary peritoneal cancer form in the same type of tissue. Studies of screening tests look at these cancers together. See the following PDQ summaries for more information about ovarian, fallopian tube, and primary peritoneal cancers: Ovarian, Fallopian Tube, and Primary Peritoneal Cancer Prevention Genetics of Breast and Gynecologic Cancers Ovarian Epithelial, Fallopian Tube, and Primary Peritoneal Cancer Treatment Ovarian Germ Cell Tumors Treatment Ovarian Low Malignant Potential Tumors Treatment In the United States, ovarian cancer is the fifth leading cause of cancer death in women. Ovarian cancer is also the leading cause of death from cancer of the female reproductive system. Over the last 20 years, the number of new cases of ovarian cancer has gone down slightly in white women and in black women. Since 2005, the number of deaths from ovarian cancer also decreased slightly in white and black women.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>Who is at risk for Ovarian, Fallopian Tube, and Primary Peritoneal Cancer? ? [/INST] Different factors increase or decrease the risk of getting ovarian, fallopian tube, and primary peritoneal cancer. Anything that increases your chance of getting a disease is called a risk factor. Anything that decreases your chance of getting a disease is called a protective factor. For information about risk factors and protective factors for ovarian cancer, see the Ovarian, Fallopian Tube, and Primary Peritoneal Cancer Prevention summary. Talk to your doctor about your risk of ovarian cancer. Screening tests have risks. Decisions about screening tests can be difficult. Not all screening tests are helpful and most have risks. Before having any screening test, you may want to talk about the test with your doctor. It is important to know the risks of the test and whether it has been proven to reduce the risk of dying from cancer. The risks of ovarian, fallopian tube, and primary peritoneal cancer screening tests include the following: Finding ovarian, fallopian tube, and primary peritoneal cancer may not improve health or help a woman live longer. Screening may not improve your health or help you live longer if you have advanced ovarian cancer or if it has already spread to other places in your body. Falsenegative test results can occur. Screening test results may appear to be normal even though ovarian cancer is present. A woman who receives a falsenegative test result (one that shows there is no cancer when there really is) may delay seeking medical care even if she has symptoms. Falsepositive test results can occur. Screening test results may appear to be abnormal even though no cancer is present. A falsepositive test result (one that shows there is cancer when there really isn't) can cause anxiety and is usually followed by more tests (such as a laparoscopy or a laparotomy to see if cancer is present), which also have risks. Problems caused by tests used to diagnose ovarian cancer include infection, blood loss, bowel injury, and heart and blood vessel problems. A falsepositive test result can also lead to an unneeded oophorectomy (removal of one or both ovaries).</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What is (are) Childhood Brain and Spinal Cord Tumors ? [/INST] A childhood brain or spinal cord tumor is a disease in which abnormal cells form in the tissues of the brain or spinal cord. The brain controls many important body functions. The spinal cord connects the brain with nerves in most parts of the body. Brain and spinal cord tumors are a common type of childhood cancer. The cause of most childhood brain and spinal cord tumors is unknown. The signs and symptoms of childhood brain and spinal cord tumors are not the same in every child. Tests that examine the brain and spinal cord are used to detect (find) childhood brain and spinal cord tumors. Most childhood brain tumors are diagnosed and removed in surgery. Some childhood brain and spinal cord tumors are diagnosed by imaging tests. Certain factors affect prognosis (chance of recovery). A childhood brain or spinal cord tumor is a disease in which abnormal cells form in the tissues of the brain or spinal cord. There are many types of childhood brain and spinal cord tumors. The tumors are formed by the abnormal growth of cells and may begin in different areas of the brain or spinal cord. The tumors may be benign (not cancer) or malignant (cancer). Benign brain tumors grow and press on nearby areas of the brain. They rarely spread into other tissues. Malignant brain tumors are likely to grow quickly and spread into other brain tissue. When a tumor grows into or presses on an area of the brain, it may stop that part of the brain from working the way it should. Both benign and malignant brain tumors can cause signs or symptoms and need treatment. Together, the brain and spinal cord make up the central nervous system (CNS). The brain controls many important body functions. The brain has three major parts: The cerebrum is the largest part of the brain. It is at the top of the head. The cerebrum controls thinking, learning, problem solving, emotions, speech, reading, writing, and voluntary movement. The cerebellum is in the lower back of the brain (near the middle of the back of the head). It controls movement, balance, and posture. The brain stem connects the brain to the spinal cord. It is in the lowest part of the brain (just above the back of the neck). The brain stem controls breathing, heart rate, and the nerves and muscles used in seeing, hearing, walking, talking, and eating. The spinal cord connects the brain with nerves in most parts of the body. The spinal cord is a column of nerve tissue that runs from the brain stem down the center of the back. It is covered by three thin layers of tissue called membranes. These membranes are surrounded by the vertebrae (back bones). Spinal cord nerves carry messages between the brain and the rest of the body, such as a message from the brain to cause muscles to move or a message from the skin to the brain to feel touch. Brain and spinal cord tumors are a common type of childhood cancer. Although cancer is rare in children, brain and spinal cord tumors are the third most common type of childhood cancer, after leukemia and lymphoma. Brain tumors can occur in both children and adults. Treatment for children is usually different than treatment for adults. (See the PDQ summary on Adult Central Nervous System Tumors Treatment for more information about the treatment of adults.) This summary describes the treatment of primary brain and spinal cord tumors (tumors that begin in the brain and spinal cord). Treatment of metastatic brain and spinal cord tumors is not covered in this summary. Metastatic tumors are formed by cancer cells that begin in other parts of the body and spread to the brain or spinal cord.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What causes Childhood Brain and Spinal Cord Tumors ? [/INST] The cause of most childhood brain and spinal cord tumors is unknown.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What are the symptoms of Childhood Brain and Spinal Cord Tumors ? [/INST] The signs and symptoms of childhood brain and spinal cord tumors are not the same in every child. Signs and symptoms depend on the following: Where the tumor forms in the brain or spinal cord. The size of the tumor. How fast the tumor grows. The child's age and development. Signs and symptoms may be caused by childhood brain and spinal cord tumors or by other conditions, including cancer that has spread to the brain. Check with your child's doctor if your child has any of the following: Brain Tumor Signs and Symptoms Morning headache or headache that goes away after vomiting. Frequent nausea and vomiting. Vision, hearing, and speech problems. Loss of balance and trouble walking. Unusual sleepiness or change in activity level. Unusual changes in personality or behavior. Seizures. Increase in the head size (in infants). Spinal Cord Tumor Signs and Symptoms Back pain or pain that spreads from the back towards the arms or legs. A change in bowel habits or trouble urinating. Weakness in the legs. Trouble walking. In addition to these signs and symptoms of brain and spinal cord tumors, some children are unable to reach certain growth and development milestones such as sitting up, walking, and talking in sentences.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>How to diagnose Childhood Brain and Spinal Cord Tumors ? [/INST] Tests that examine the brain and spinal cord are used to detect (find) childhood brain and spinal cord tumors. The following tests and procedures may be used: Physical exam and history : An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patients health habits and past illnesses and treatments will also be taken. Neurological exam : A series of questions and tests to check the brain, spinal cord, and nerve function. The exam checks a persons mental status, coordination, and ability to walk normally, and how well the muscles, senses, and reflexes work. This may also be called a neuro exam or a neurologic exam. MRI (magnetic resonance imaging) with gadolinium : A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of the brain and spinal cord. A substance called gadolinium is injected into a vein. The gadolinium collects around the cancer cells so they show up brighter in the picture. This procedure is also called nuclear magnetic resonance imaging (NMRI). Serum tumor marker test : A procedure in which a sample of blood is examined to measure the amounts of certain substances released into the blood by organs, tissues, or tumor cells in the body. Certain substances are linked to specific types of cancer when found in increased levels in the blood. These are called tumor markers. Most childhood brain tumors are diagnosed and removed in surgery. If doctors think there might be a brain tumor, a biopsy may be done to remove a sample of tissue. For tumors in the brain, the biopsy is done by removing part of the skull and using a needle to remove a sample of tissue. A pathologist views the tissue under a microscope to look for cancer cells. If cancer cells are found, the doctor may remove as much tumor as safely possible during the same surgery. The pathologist checks the cancer cells to find out the type and grade of brain tumor. The grade of the tumor is based on how abnormal the cancer cells look under a microscope and how quickly the tumor is likely to grow and spread. The following test may be done on the sample of tissue that is removed: Immunohistochemistry : A test that uses antibodies to check for certain antigens in a sample of tissue. The antibody is usually linked to a radioactive substance or a dye that causes the tissue to light up under a microscope. This type of test may be used to tell the difference between different types of cancer. Some childhood brain and spinal cord tumors are diagnosed by imaging tests. Sometimes a biopsy or surgery cannot be done safely because of where the tumor formed in the brain or spinal cord. These tumors are diagnosed based on the results of imaging tests and other procedures.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What is the outlook for Childhood Brain and Spinal Cord Tumors ? [/INST] Certain factors affect prognosis (chance of recovery). The prognosis (chance of recovery) depends on the following: Whether there are any cancer cells left after surgery. The type of tumor. Where the tumor is in the body. The child's age. Whether the tumor has just been diagnosed or has recurred (come back).</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>what research (or clinical trials) is being done for Childhood Brain and Spinal Cord Tumors ? [/INST] New types of treatment are being tested in clinical trials. This summary section describes treatments that are being studied in clinical trials. It may not mention every new treatment being studied. Information about clinical trials is available from the NCI website. Highdose chemotherapy with stem cell transplant Highdose chemotherapy with stem cell transplant is a way of giving high doses of chemotherapy and replacing blood forming cells destroyed by the cancer treatment. Stem cells (immature blood cells) are removed from the blood or bone marrow of the patient or a donor and are frozen and stored. After the chemotherapy is completed, the stored stem cells are thawed and given back to the patient through an infusion. These reinfused stem cells grow into (and restore) the bodys blood cells. Patients may want to think about taking part in a clinical trial. For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment. Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment. Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward. Patients can enter clinical trials before, during, or after starting their cancer treatment. Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring (coming back) or reduce the side effects of cancer treatment. Clinical trials are taking place in many parts of the country. Information about clinical trials is available from the NCI website.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What are the treatments for Childhood Brain and Spinal Cord Tumors ? [/INST] There are different types of treatment for children with brain and spinal cord tumors. Children with brain or spinal cord tumors should have their treatment planned by a team of health care providers who are experts in treating childhood brain and spinal cord tumors. Childhood brain and spinal cord tumors may cause signs or symptoms that begin before the cancer is diagnosed and continue for months or years. Some cancer treatments cause side effects months or years after treatment has ended. Three types of standard treatment are used: Surgery Radiation therapy Chemotherapy New types of treatment are being tested in clinical trials. Highdose chemotherapy with stem cell transplant Patients may want to think about taking part in a clinical trial. Patients can enter clinical trials before, during, or after starting their cancer treatment. Followup tests may be needed. There are different types of treatment for children with brain and spinal cord tumors. Different types of treatment are available for children with brain and spinal cord tumors. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Because cancer in children is rare, taking part in a clinical trial should be considered. Clinical trials are taking place in many parts of the country. Some clinical trials are open only to patients who have not started treatment. Children with brain or spinal cord tumors should have their treatment planned by a team of health care providers who are experts in treating childhood brain and spinal cord tumors. Treatment will be overseen by a pediatric oncologist, a doctor who specializes in treating children with cancer. The pediatric oncologist works with other health care providers who are experts in treating children with brain tumors and who specialize in certain areas of medicine. These may include the following specialists: Pediatrician. Neurosurgeon. Neurologist. Neurooncologist. Neuropathologist. Neuroradiologist. Radiation oncologist. Endocrinologist. Psychologist. Ophthalmologist. Rehabilitation specialist. Social worker. Nurse specialist. Childhood brain and spinal cord tumors may cause signs or symptoms that begin before the cancer is diagnosed and continue for months or years. Childhood brain and spinal cord tumors may cause signs or symptoms that continue for months or years. Signs or symptoms caused by the tumor may begin before diagnosis. Signs or symptoms caused by treatment may begin during or right after treatment. Some cancer treatments cause side effects months or years after treatment has ended. These are called late effects. Late effects of cancer treatment may include the following: Physical problems. Changes in mood, feelings, thinking, learning, or memory. Second cancers (new types of cancer). Some late effects may be treated or controlled. It is important to talk with your child's doctors about the effects cancer treatment can have on your child. (See the PDQ summary on Late Effects of Treatment for Childhood Cancer for more information). Three types of standard treatment are used: Surgery Surgery may be used to diagnose and treat childhood brain and spinal cord tumors. See the General Information section of this summary. Radiation therapy Radiation therapy is a cancer treatment that uses highenergy xrays or other types of radiation to kill cancer cells or keep them from growing. There are two types of radiation therapy: External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. The way the radiation therapy is given depends on the type of cancer being treated. External radiation therapy is used to treat childhood brain and spinal cord tumors. Chemotherapy Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly in the cerebrospinal fluid, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). The way the chemotherapy is given depends on the type and stage of the cancer being treated. Anticancer drugs given by mouth or vein to treat brain and spinal cord tumors cannot cross the bloodbrain barrier and enter the fluid that surrounds the brain and spinal cord. Instead, an anticancer drug is injected into the fluidfilled space to kill cancer cells there. This is called intrathecal chemotherapy. New types of treatment are being tested in clinical trials. This summary section describes treatments that are being studied in clinical trials. It may not mention every new treatment being studied. Information about clinical trials is available from the NCI website. Highdose chemotherapy with stem cell transplant Highdose chemotherapy with stem cell transplant is a way of giving high doses of chemotherapy and replacing blood forming cells destroyed by the cancer treatment. Stem cells (immature blood cells) are removed from the blood or bone marrow of the patient or a donor and are frozen and stored. After the chemotherapy is completed, the stored stem cells are thawed and given back to the patient through an infusion. These reinfused stem cells grow into (and restore) the bodys blood cells. Patients may want to think about taking part in a clinical trial. For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment. Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment. Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward. Patients can enter clinical trials before, during, or after starting their cancer treatment. Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring (coming back) or reduce the side effects of cancer treatment. Clinical trials are taking place in many parts of the country. Information about clinical trials is available from the NCI website. Followup tests may be needed. Some of the tests that were done to diagnose the cancer or to find out the stage of the cancer may be repeated. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests. Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your child's condition has changed or if the cancer has recurred (come back). These tests are sometimes called followup tests or checkups.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What is (are) Gallbladder Cancer ? [/INST] Gallbladder cancer is a disease in which malignant (cancer) cells form in the tissues of the gallbladder. Being female can increase the risk of developing gallbladder cancer. Signs and symptoms of gallbladder cancer include jaundice, fever, and pain. Gallbladder cancer is difficult to detect (find) and diagnose early. Tests that examine the gallbladder and nearby organs are used to detect (find), diagnose, and stage gallbladder cancer. Certain factors affect the prognosis (chance of recovery) and treatment options. Gallbladder cancer is a disease in which malignant (cancer) cells form in the tissues of the gallbladder. Gallbladder cancer is a rare disease in which malignant (cancer) cells are found in the tissues of the gallbladder. The gallbladder is a pearshaped organ that lies just under the liver in the upper abdomen. The gallbladder stores bile, a fluid made by the liver to digest fat. When food is being broken down in the stomach and intestines, bile is released from the gallbladder through a tube called the common bile duct, which connects the gallbladder and liver to the first part of the small intestine. The wall of the gallbladder has 3 main layers of tissue. Mucosal (inner) layer. Muscularis (middle, muscle) layer. Serosal (outer) layer. Between these layers is supporting connective tissue. Primary gallbladder cancer starts in the inner layer and spreads through the outer layers as it grows. Gallbladder cancer is difficult to detect (find) and diagnose early. Gallbladder cancer is difficult to detect and diagnose for the following reasons: There are no signs or symptoms in the early stages of gallbladder cancer. The symptoms of gallbladder cancer, when present, are like the symptoms of many other illnesses. The gallbladder is hidden behind the liver. Gallbladder cancer is sometimes found when the gallbladder is removed for other reasons. Patients with gallstones rarely develop gallbladder cancer.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>Who is at risk for Gallbladder Cancer? ? [/INST] Being female can increase the risk of developing gallbladder cancer. Anything that increases your chance of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesn't mean that you will not get cancer. Talk with your doctor if you think you may be at risk. Risk factors for gallbladder cancer include the following: Being female. Being Native American.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What are the symptoms of Gallbladder Cancer ? [/INST] Signs and symptoms of gallbladder cancer include jaundice, fever, and pain. These and other signs and symptoms may be caused by gallbladder cancer or by other conditions. Check with your doctor if you have any of the following: Jaundice (yellowing of the skin and whites of the eyes). Pain above the stomach. Fever. Nausea and vomiting. Bloating. Lumps in the abdomen.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>How to diagnose Gallbladder Cancer ? [/INST] Tests that examine the gallbladder and nearby organs are used to detect (find), diagnose, and stage gallbladder cancer. Procedures that make pictures of the gallbladder and the area around it help diagnose gallbladder cancer and show how far the cancer has spread. The process used to find out if cancer cells have spread within and around the gallbladder is called staging. In order to plan treatment, it is important to know if the gallbladder cancer can be removed by surgery. Tests and procedures to detect, diagnose, and stage gallbladder cancer are usually done at the same time. The following tests and procedures may be used: Physical exam and history : An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patients health habits and past illnesses and treatments will also be taken. Liver function tests : A procedure in which a blood sample is checked to measure the amounts of certain substances released into the blood by the liver. A higher than normal amount of a substance can be a sign of liver disease that may be caused by gallbladder cancer. Carcinoembryonic antigen (CEA) assay : A test that measures the level of CEA in the blood. CEA is released into the bloodstream from both cancer cells and normal cells. When found in higher than normal amounts, it can be a sign of gallbladder cancer or other conditions. CA 199 assay : A test that measures the level of CA 199 in the blood. CA 199 is released into the bloodstream from both cancer cells and normal cells. When found in higher than normal amounts, it can be a sign of gallbladder cancer or other conditions. Blood chemistry studies : A procedure in which a blood sample is checked to measure the amounts of certain substances released into the blood by organs and tissues in the body. An unusual (higher or lower than normal) amount of a substance can be a sign of disease. CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, such as the chest, abdomen, and pelvis, taken from different angles. The pictures are made by a computer linked to an xray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography. Ultrasound exam: A procedure in which highenergy sound waves (ultrasound) are bounced off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram. An abdominal ultrasound is done to diagnose gallbladder cancer. PTC (percutaneous transhepatic cholangiography): A procedure used to xray the liver and bile ducts. A thin needle is inserted through the skin below the ribs and into the liver. Dye is injected into the liver or bile ducts and an xray is taken. If a blockage is found, a thin, flexible tube called a stent is sometimes left in the liver to drain bile into the small intestine or a collection bag outside the body. Chest xray : An xray of the organs and bones inside the chest. An xray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body. ERCP (endoscopic retrograde cholangiopancreatography): A procedure used to xray the ducts (tubes) that carry bile from the liver to the gallbladder and from the gallbladder to the small intestine. Sometimes gallbladder cancer causes these ducts to narrow and block or slow the flow of bile, causing jaundice. An endoscope (a thin, lighted tube) is passed through the mouth, esophagus, and stomach into the first part of the small intestine. A catheter (a smaller tube) is then inserted through the endoscope into the bile ducts. A dye is injected through the catheter into the ducts and an xray is taken. If the ducts are blocked by a tumor, a fine tube may be inserted into the duct to unblock it. This tube (or stent) may be left in place to keep the duct open. Tissue samples may also be taken. Laparoscopy : A surgical procedure to look at the organs inside the abdomen to check for signs of disease. Small incisions (cuts) are made in the wall of the abdomen and a laparoscope (a thin, lighted tube) is inserted into one of the incisions. Other instruments may be inserted through the same or other incisions to perform procedures such as removing organs or taking tissue samples for biopsy. The laparoscopy helps to find out if the cancer is within the gallbladder only or has spread to nearby tissues and if it can be removed by surgery. Biopsy : The removal of cells or tissues so they can be viewed under a microscope by a pathologist to check for signs of cancer. The biopsy may be done after surgery to remove the tumor. If the tumor clearly cannot be removed by surgery, the biopsy may be done using a fine needle to remove cells from the tumor.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What is the outlook for Gallbladder Cancer ? [/INST] Certain factors affect the prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery) and treatment options depend on the following: The stage of the cancer (whether the cancer has spread from the gallbladder to other places in the body). Whether the cancer can be completely removed by surgery. The type of gallbladder cancer (how the cancer cell looks under a microscope). Whether the cancer has just been diagnosed or has recurred (come back). Treatment may also depend on the age and general health of the patient and whether the cancer is causing signs or symptoms. Gallbladder cancer can be cured only if it is found before it has spread, when it can be removed by surgery. If the cancer has spread, palliative treatment can improve the patient's quality of life by controlling the symptoms and complications of this disease. Taking part in one of the clinical trials being done to improve treatment should be considered. Information about ongoing clinical trials is available from the NCI website.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What are the stages of Gallbladder Cancer ? [/INST] Tests and procedures to stage gallbladder cancer are usually done at the same time as diagnosis. There are three ways that cancer spreads in the body. Cancer may spread from where it began to other parts of the body. The following stages are used for gallbladder cancer: Stage 0 (Carcinoma in Situ) Stage I Stage II Stage IIIA Stage IIIB Stage IVA Stage IVB For gallbladder cancer, stages are also grouped according to how the cancer may be treated. There are two treatment groups: Localized (Stage I) Unresectable, recurrent, or metastatic (Stage II, Stage III, and Stage IV) Tests and procedures to stage gallbladder cancer are usually done at the same time as diagnosis. See the General Information section for a description of tests and procedures used to detect, diagnose, and stage gallbladder cancer. There are three ways that cancer spreads in the body. Cancer can spread through tissue, the lymph system, and the blood: Tissue. The cancer spreads from where it began by growing into nearby areas. Lymph system. The cancer spreads from where it began by getting into the lymph system. The cancer travels through the lymph vessels to other parts of the body. Blood. The cancer spreads from where it began by getting into the blood. The cancer travels through the blood vessels to other parts of the body. Cancer may spread from where it began to other parts of the body. When cancer spreads to another part of the body, it is called metastasis. Cancer cells break away from where they began (the primary tumor) and travel through the lymph system or blood. Lymph system. The cancer gets into the lymph system, travels through the lymph vessels, and forms a tumor (metastatic tumor) in another part of the body. Blood. The cancer gets into the blood, travels through the blood vessels, and forms a tumor (metastatic tumor) in another part of the body. The metastatic tumor is the same type of cancer as the primary tumor. For example, if gallbladder cancer spreads to the liver, the cancer cells in the liver are actually gallbladder cancer cells. The disease is metastatic gallbladder cancer, not liver cancer. The following stages are used for gallbladder cancer: Stage 0 (Carcinoma in Situ) In stage 0, abnormal cells are found in the inner (mucosal) layer of the gallbladder. These abnormal cells may become cancer and spread into nearby normal tissue. Stage 0 is also called carcinoma in situ. Stage I In stage I, cancer has formed and has spread beyond the inner (mucosal) layer to a layer of tissue with blood vessels or to the muscle layer. Stage II In stage II, cancer has spread beyond the muscle layer to the connective tissue around the muscle. Stage IIIA In stage IIIA, cancer has spread through the thin layers of tissue that cover the gallbladder and/or to the liver and/or to one nearby organ (such as the stomach, small intestine, colon, pancreas, or bile ducts outside the liver). Stage IIIB In stage IIIB, cancer has spread to nearby lymph nodes and: beyond the inner layer of the gallbladder to a layer of tissue with blood vessels or to the muscle layer; or beyond the muscle layer to the connective tissue around the muscle; or through the thin layers of tissue that cover the gallbladder and/or to the liver and/or to one nearby organ (such as the stomach, small intestine, colon, pancreas, or bile ducts outside the liver). Stage IVA In stage IVA, cancer has spread to a main blood vessel of the liver or to 2 or more nearby organs or areas other than the liver. Cancer may have spread to nearby lymph nodes. Stage IVB In stage IVB, cancer has spread to either: lymph nodes along large arteries in the abdomen and/or near the lower part of the backbone; or to organs or areas far away from the gallbladder. For gallbladder cancer, stages are also grouped according to how the cancer may be treated. There are two treatment groups: Localized (Stage I) Cancer is found in the wall of the gallbladder and can be completely removed by surgery. Unresectable, recurrent, or metastatic (Stage II, Stage III, and Stage IV) Unresectable cancer cannot be removed completely by surgery. Most patients with gallbladder cancer have unresectable cancer. Recurrent cancer is cancer that has recurred (come back) after it has been treated. Gallbladder cancer may come back in the gallbladder or in other parts of the body. Metastasis is the spread of cancer from the primary site (place where it started) to other places in the body. Metastatic gallbladder cancer may spread to surrounding tissues, organs, throughout the abdominal cavity, or to distant parts of the body.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What are the treatments for Gallbladder Cancer ? [/INST] There are different types of treatment for patients with gallbladder cancer. Three types of standard treatment are used: Surgery Radiation therapy Chemotherapy New types of treatment are being tested in clinical trials. Radiation sensitizers Patients may want to think about taking part in a clinical trial. Patients can enter clinical trials before, during, or after starting their cancer treatment. Followup tests may be needed. There are different types of treatment for patients with gallbladder cancer. Different types of treatments are available for patients with gallbladder cancer. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment. Three types of standard treatment are used: Surgery Gallbladder cancer may be treated with a cholecystectomy, surgery to remove the gallbladder and some of the tissues around it. Nearby lymph nodes may be removed. A laparoscope is sometimes used to guide gallbladder surgery. The laparoscope is attached to a video camera and inserted through an incision (port) in the abdomen. Surgical instruments are inserted through other ports to perform the surgery. Because there is a risk that gallbladder cancer cells may spread to these ports, tissue surrounding the port sites may also be removed. If the cancer has spread and cannot be removed, the following types of palliative surgery may relieve symptoms: Surgical biliary bypass: If the tumor is blocking the small intestine and bile is building up in the gallbladder, a biliary bypass may be done. During this operation, the gallbladder or bile duct will be cut and sewn to the small intestine to create a new pathway around the blocked area. Endoscopic stent placement: If the tumor is blocking the bile duct, surgery may be done to put in a stent (a thin, flexible tube) to drain bile that has built up in the area. The stent may be placed through a catheter that drains to the outside of the body or the stent may go around the blocked area and drain the bile into the small intestine. Percutaneous transhepatic biliary drainage: A procedure done to drain bile when there is a blockage and endoscopic stent placement is not possible. An xray of the liver and bile ducts is done to locate the blockage. Images made by ultrasound are used to guide placement of a stent, which is left in the liver to drain bile into the small intestine or a collection bag outside the body. This procedure may be done to relieve jaundice before surgery. Radiation therapy Radiation therapy is a cancer treatment that uses highenergy xrays or other types of radiation to kill cancer cells or keep them from growing. There are two types of radiation therapy: External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. The way the radiation therapy is given depends on the type and stage of the cancer being treated. External radiation therapy is used to treat gallbladder cancer. Chemotherapy Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping the cells from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the cerebrospinal fluid, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). The way the chemotherapy is given depends on the type and stage of the cancer being treated. New types of treatment are being tested in clinical trials. This summary section describes treatments that are being studied in clinical trials. It may not mention every new treatment being studied. Information about clinical trials is available from the NCI website. Radiation sensitizers Clinical trials are studying ways to improve the effect of radiation therapy on tumor cells, including the following: Hyperthermia therapy: A treatment in which body tissue is exposed to high temperatures to damage and kill cancer cells or to make cancer cells more sensitive to the effects of radiation therapy and certain anticancer drugs. Radiosensitizers: Drugs that make tumor cells more sensitive to radiation therapy. Giving radiation therapy together with radiosensitizers may kill more tumor cells. Patients may want to think about taking part in a clinical trial. For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment. Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment. Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward. Patients can enter clinical trials before, during, or after starting their cancer treatment. Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring (coming back) or reduce the side effects of cancer treatment. Clinical trials are taking place in many parts of the country. See the Treatment Options section that follows for links to current treatment clinical trials. These have been retrieved from NCI's listing of clinical trials. Followup tests may be needed. Some of the tests that were done to diagnose the cancer or to find out the stage of the cancer may be repeated. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests. Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your condition has changed or if the cancer has recurred (come back). These tests are sometimes called followup tests or checkups. Treatment Options for Gallbladder Cancer Localized Gallbladder Cancer Treatment of localized gallbladder cancer may include the following: Surgery to remove the gallbladder and some of the tissue around it. Part of the liver and nearby lymph nodes may also be removed. Radiation therapy with or without chemotherapy may follow surgery. Radiation therapy with or without chemotherapy. A clinical trial of radiation therapy with radiosensitizers. Check the list of NCIsupported cancer clinical trials that are now accepting patients with localized gallbladder cancer. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the NCI website. Unresectable, Recurrent, or Metastatic Gallbladder Cancer Treatment of unresectable, recurrent, or metastatic gallbladder cancer is usually within a clinical trial. Treatment may include the following: Percutaneous transhepatic biliary drainage or the placement of stents to relieve symptoms caused by blocked bile ducts. This may be followed by radiation therapy as palliative treatment. Surgery as palliative treatment to relieve symptoms caused by blocked bile ducts. Chemotherapy. A clinical trial of new ways to give palliative radiation therapy, such as giving it together with hyperthermia therapy, radiosensitizers, or chemotherapy. A clinical trial of new drugs and drug combinations. Check the list of NCIsupported cancer clinical trials that are now accepting patients with unresectable gallbladder cancer, recurrent gallbladder cancer and metastatic gallbladder cancer. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the NCI website.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>what research (or clinical trials) is being done for Gallbladder Cancer ? [/INST] New types of treatment are being tested in clinical trials. This summary section describes treatments that are being studied in clinical trials. It may not mention every new treatment being studied. Information about clinical trials is available from the NCI website. Radiation sensitizers Clinical trials are studying ways to improve the effect of radiation therapy on tumor cells, including the following: Hyperthermia therapy: A treatment in which body tissue is exposed to high temperatures to damage and kill cancer cells or to make cancer cells more sensitive to the effects of radiation therapy and certain anticancer drugs. Radiosensitizers: Drugs that make tumor cells more sensitive to radiation therapy. Giving radiation therapy together with radiosensitizers may kill more tumor cells. Patients may want to think about taking part in a clinical trial. For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment. Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment. Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward. Patients can enter clinical trials before, during, or after starting their cancer treatment. Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring (coming back) or reduce the side effects of cancer treatment. Clinical trials are taking place in many parts of the country. See the Treatment Options section that follows for links to current treatment clinical trials. These have been retrieved from NCI's listing of clinical trials.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What is (are) Nasopharyngeal Cancer ? [/INST] Nasopharyngeal cancer is a disease in which malignant (cancer) cells form in the tissues of the nasopharynx. Ethnic background and being exposed to the EpsteinBarr virus can affect the risk of nasopharyngeal cancer. Signs of nasopharyngeal cancer include trouble breathing, speaking, or hearing. Tests that examine the nose and throat are used to detect (find) and diagnose nasopharyngeal cancer. Certain factors affect prognosis (chance of recovery) and treatment options. Nasopharyngeal cancer is a disease in which malignant (cancer) cells form in the tissues of the nasopharynx. The nasopharynx is the upper part of the pharynx (throat) behind the nose. The pharynx is a hollow tube about 5 inches long that starts behind the nose and ends at the top of the trachea (windpipe) and esophagus (the tube that goes from the throat to the stomach). Air and food pass through the pharynx on the way to the trachea or the esophagus. The nostrils lead into the nasopharynx. An opening on each side of the nasopharynx leads into an ear. Nasopharyngeal cancer most commonly starts in the squamous cells that line the nasopharynx. Nasopharyngeal cancer is a type of head and neck cancer.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>Who is at risk for Nasopharyngeal Cancer? ? [/INST] Ethnic background and being exposed to the EpsteinBarr virus can affect the risk of nasopharyngeal cancer. Anything that increases your risk of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesn't mean that you will not get cancer. Talk with your doctor if you think you may be at risk. Risk factors for nasopharyngeal cancer include the following: Having Chinese or Asian ancestry. Being exposed to the EpsteinBarr virus: The EpsteinBarr virus has been associated with certain cancers, including nasopharyngeal cancer and some lymphomas. Drinking large amounts of alcohol.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What are the symptoms of Nasopharyngeal Cancer ? [/INST] Signs of nasopharyngeal cancer include trouble breathing, speaking, or hearing. These and other signs and symptoms may be caused by nasopharyngeal cancer or by other conditions. Check with your doctor if you have any of the following: A lump in the nose or neck. A sore throat. Trouble breathing or speaking. Nosebleeds. Trouble hearing. Pain or ringing in the ear. Headaches.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>How to diagnose Nasopharyngeal Cancer ? [/INST] Tests that examine the nose and throat are used to detect (find) and diagnose nasopharyngeal cancer. The following tests and procedures may be used: Physical exam and history : An exam of the body to check general signs of health, including checking for signs of disease, such as swollen lymph nodes in the neck or anything else that seems unusual. A history of the patients health habits and past illnesses and treatments will also be taken. Neurological exam : A series of questions and tests to check the brain, spinal cord, and nerve function. The exam checks a persons mental status, coordination, and ability to walk normally, and how well the muscles, senses, and reflexes work. This may also be called a neuro exam or a neurologic exam. Biopsy : The removal of cells or tissues so they can be viewed under a microscope by a pathologist to check for signs of cancer. The tissue sample is removed during one of the following procedures: Nasoscopy : A procedure to look inside the nose for abnormal areas. A nasoscope is inserted through the nose. A nasoscope is a thin, tubelike instrument with a light and a lens for viewing. It may also have a tool to remove tissue samples, which are checked under a microscope for signs of cancer. Upper endoscopy : A procedure to look at the inside of the nose, throat, esophagus, stomach, and duodenum (first part of the small intestine, near the stomach). An endoscope is inserted through the mouth and into the esophagus, stomach, and duodenum. An endoscope is a thin, tubelike instrument with a light and a lens for viewing. It may also have a tool to remove tissue samples. The tissue samples are checked under a microscope for signs of cancer. MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI). CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an xray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography. PET scan (positron emission tomography scan): A procedure to find malignant tumor cells in the body. A small amount of radioactive glucose (sugar) is injected into a vein. The PET scanner rotates around the body and makes a picture of where glucose is being used in the body. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do. PET scans may be used to find nasopharyngeal cancers that have spread to the bone. Sometimes a PET scan and a CT scan are done at the same time. If there is any cancer, this increases the chance that it will be found. Blood chemistry studies : A procedure in which a blood sample is checked to measure the amounts of certain substances released into the blood by organs and tissues in the body. An unusual (higher or lower than normal) amount of a substance can be a sign of disease. Complete blood count (CBC): A procedure in which a sample of blood is drawn and checked for the following: The number of red blood cells, white blood cells, and platelets. The amount of hemoglobin (the protein that carries oxygen) in the red blood cells. The portion of the blood sample made up of red blood cells. EpsteinBarr virus (EBV) test: A blood test to check for antibodies to the EpsteinBarr virus and DNA markers of the EpsteinBarr virus. These are found in the blood of patients who have been infected with EBV. Hearing test: A procedure to check whether soft and loud sounds and low and highpitched sounds can be heard. Each ear is checked separately.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What is the outlook for Nasopharyngeal Cancer ? [/INST] Certain factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery) and treatment options depend on the following: The stage of the cancer (whether it affects part of the nasopharynx, involves the whole nasopharynx, or has spread to other places in the body). The type of nasopharyngeal cancer. The size of the tumor. The patients age and general health.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What are the stages of Nasopharyngeal Cancer ? [/INST] After nasopharyngeal cancer has been diagnosed, tests are done to find out if cancer cells have spread within the nasopharynx or to other parts of the body. There are three ways that cancer spreads in the body. Cancer may spread from where it began to other parts of the body. The following stages are used for nasopharyngeal cancer: Stage 0 (Carcinoma in Situ) Stage I Stage II Stage III Stage IV After nasopharyngeal cancer has been diagnosed, tests are done to find out if cancer cells have spread within the nasopharynx or to other parts of the body. The process used to find out whether cancer has spread within the nasopharynx or to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment. The results of the tests used to diagnose nasopharyngeal cancer are often also used to stage the disease. (See the General Information section.) There are three ways that cancer spreads in the body. Cancer can spread through tissue, the lymph system, and the blood: Tissue. The cancer spreads from where it began by growing into nearby areas. Lymph system. The cancer spreads from where it began by getting into the lymph system. The cancer travels through the lymph vessels to other parts of the body. Blood. The cancer spreads from where it began by getting into the blood. The cancer travels through the blood vessels to other parts of the body. Cancer may spread from where it began to other parts of the body. When cancer spreads to another part of the body, it is called metastasis. Cancer cells break away from where they began (the primary tumor) and travel through the lymph system or blood. Lymph system. The cancer gets into the lymph system, travels through the lymph vessels, and forms a tumor (metastatic tumor) in another part of the body. Blood. The cancer gets into the blood, travels through the blood vessels, and forms a tumor (metastatic tumor) in another part of the body. The metastatic tumor is the same type of cancer as the primary tumor. For example, if nasopharyngeal cancer spreads to the lung, the cancer cells in the lung are actually nasopharyngeal cancer cells. The disease is metastatic nasopharyngeal cancer, not lung cancer. The following stages are used for nasopharyngeal cancer: Stage 0 (Carcinoma in Situ) In stage 0, abnormal cells are found in the lining of the nasopharynx. These abnormal cells may become cancer and spread into nearby normal tissue. Stage 0 is also called carcinoma in situ. Stage I In stage I, cancer has formed and the cancer: is found in the nasopharynx only; or has spread from the nasopharynx to the oropharynx and/or to the nasal cavity. The oropharynx is the middle part of the throat and includes the soft palate, the base of the tongue, and the tonsils. Stage II In stage II nasopharyngeal cancer, the cancer: is found in the nasopharynx only or has spread from the nasopharynx to the oropharynx and/or to the nasal cavity. Cancer has spread to one or more lymph nodes on one side of the neck and/or to lymph nodes behind the pharynx. The affected lymph nodes are 6 centimeters or smaller; or is found in the parapharyngeal space. Cancer may have spread to one or more lymph nodes on one side of the neck and/or to lymph nodes behind the pharynx. The affected lymph nodes are 6 centimeters or smaller. The oropharynx is the middle part of the throat and includes the soft palate, the base of the tongue, and the tonsils. The parapharyngeal space is a fatfilled, triangular area near the pharynx, between the base of the skull and the lower jaw. Stage III In stage III nasopharyngeal cancer, the cancer: is found in the nasopharynx only or has spread from the nasopharynx to the oropharynx and/or to the nasal cavity. Cancer has spread to one or more lymph nodes on both sides of the neck. The affected lymph nodes are 6 centimeters or smaller; or is found in the parapharyngeal space. Cancer has spread to one or more lymph nodes on both sides of the neck. The affected lymph nodes are 6 centimeters or smaller; or has spread to nearby bones or sinuses. Cancer may have spread to one or more lymph nodes on one or both sides of the neck and/or to lymph nodes behind the pharynx. The affected lymph nodes are 6 centimeters or smaller. The oropharynx is the middle part of the throat and includes the soft palate, the base of the tongue, and the tonsils. The parapharyngeal space is a fatfilled, triangular area near the pharynx, between the base of the skull and the lower jaw. Stage IV Stage IV nasopharyngeal cancer is divided into stages IVA, IVB, and IVC. Stage IVA: Cancer has spread beyond the nasopharynx and may have spread to the cranial nerves, the hypopharynx (bottom part of the throat), areas in and around the side of the skull or jawbone, and/or the bone around the eye. Cancer may also have spread to one or more lymph nodes on one or both sides of the neck and/or to lymph nodes behind the pharynx. The affected lymph nodes are 6 centimeters or smaller. Stage IVB: Cancer has spread to lymph nodes between the collarbone and the top of the shoulder and/or the affected lymph nodes are larger than 6 centimeters. Stage IVC: Cancer has spread beyond nearby lymph nodes to other parts of the body.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What are the treatments for Nasopharyngeal Cancer ? [/INST] There are different types of treatment for patients with nasopharyngeal cancer. Three types of standard treatment are used: Radiation therapy Chemotherapy Surgery New types of treatment are being tested in clinical trials. Patients may want to think about taking part in a clinical trial. Patients can enter clinical trials before, during, or after starting their cancer treatment. Followup tests may be needed. There are different types of treatment for patients with nasopharyngeal cancer. Different types of treatment are available for patients with nasopharyngeal cancer. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment. Three types of standard treatment are used: Radiation therapy Radiation therapy is a cancer treatment that uses highenergy xrays or other types of radiation to kill cancer cells or keep them from growing. There are two types of radiation therapy: External radiation therapy uses a machine outside the body to send radiation toward the cancer. Certain ways of giving radiation therapy can help keep radiation from damaging nearby healthy tissue. These types of radiation therapy include the following: Intensitymodulated radiation therapy (IMRT): IMRT is a type of 3dimensional (3D) radiation therapy that uses a computer to make pictures of the size and shape of the tumor. Thin beams of radiation of different intensities (strengths) are aimed at the tumor from many angles. Compared to standard radiation therapy, intensitymodulated radiation therapy may be less likely to cause dry mouth. Stereotactic radiation therapy: A rigid head frame is attached to the skull to keep the head still during the radiation treatment. A machine aims radiation directly at the tumor. The total dose of radiation is divided into several smaller doses given over several days. This procedure is also called stereotactic externalbeam radiation therapy and stereotaxic radiation therapy. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. The way the radiation therapy is given depends on the type and stage of the cancer being treated. External and internal radiation therapy are used to treat nasopharyngeal cancer. External radiation therapy to the thyroid or the pituitary gland may change the way the thyroid gland works. A blood test to check the thyroid hormone level in the blood is done before and after therapy to make sure the thyroid gland is working properly. It is also important that a dentist check the patients teeth, gums, and mouth, and fix any existing problems before radiation therapy begins. Chemotherapy Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the cerebrospinal fluid, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). The way the chemotherapy is given depends on the type and stage of the cancer being treated. Chemotherapy may be given after radiation therapy to kill any cancer cells that are left. Treatment given after radiation therapy, to lower the risk that the cancer will come back, is called adjuvant therapy. See Drugs Approved for Head and Neck Cancer for more information. (Nasopharyngeal cancer is a type of head and neck cancer.) Surgery Surgery is a procedure to find out whether cancer is present, to remove cancer from the body, or to repair a body part. Also called an operation. Surgery is sometimes used for nasopharyngeal cancer that does not respond to radiation therapy. If cancer has spread to the lymph nodes, the doctor may remove lymph nodes and other tissues in the neck. New types of treatment are being tested in clinical trials. Information about clinical trials is available from the NCI website. Patients may want to think about taking part in a clinical trial. For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment. Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment. Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward. Patients can enter clinical trials before, during, or after starting their cancer treatment. Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring (coming back) or reduce the side effects of cancer treatment. Clinical trials are taking place in many parts of the country. See the Treatment Options section that follows for links to current treatment clinical trials. These have been retrieved from NCI's listing of clinical trials. Followup tests may be needed. Some of the tests that were done to diagnose the cancer or to find out the stage of the cancer may be repeated. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests. Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your condition has changed or if the cancer has recurred (come back). These tests are sometimes called followup tests or checkups. Treatment Options by Stage Stage I Nasopharyngeal Cancer Treatment of stage I nasopharyngeal cancer is usually radiation therapy to the tumor and lymph nodes in the neck. Check the list of NCIsupported cancer clinical trials that are now accepting patients with stage I nasopharyngeal cancer. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the NCI website. Stage II Nasopharyngeal Cancer Treatment of stage II nasopharyngeal cancer may include the following: Chemotherapy given with radiation therapy, followed by more chemotherapy. Radiation therapy to the tumor and lymph nodes in the neck. Check the list of NCIsupported cancer clinical trials that are now accepting patients with stage II nasopharyngeal cancer. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the NCI website. Stage III Nasopharyngeal Cancer Treatment of stage III nasopharyngeal cancer may include the following: Chemotherapy given with radiation therapy, which may be followed by more chemotherapy. Radiation therapy. Radiation therapy followed by surgery to remove cancer containing lymph nodes in the neck that remain or come back after radiation therapy. A clinical trial of chemotherapy given before, with, or after radiation therapy. Check the list of NCIsupported cancer clinical trials that are now accepting patients with stage III nasopharyngeal cancer. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the NCI website. Stage IV Nasopharyngeal Cancer Treatment of stage IV nasopharyngeal cancer may include the following: Chemotherapy given with radiation therapy, followed by more chemotherapy. Radiation therapy. Radiation therapy followed by surgery to remove cancer containing lymph nodes in the neck that remain or come back after radiation therapy. Chemotherapy for cancer that has metastasized (spread) to other parts of the body. A clinical trial of chemotherapy given before, with, or after radiation therapy. Check the list of NCIsupported cancer clinical trials that are now accepting patients with stage IV nasopharyngeal cancer. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the NCI website.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>what research (or clinical trials) is being done for Nasopharyngeal Cancer ? [/INST] New types of treatment are being tested in clinical trials. Information about clinical trials is available from the NCI website. Patients may want to think about taking part in a clinical trial. For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment. Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment. Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward. Patients can enter clinical trials before, during, or after starting their cancer treatment. Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring (coming back) or reduce the side effects of cancer treatment. Clinical trials are taking place in many parts of the country. See the Treatment Options section that follows for links to current treatment clinical trials. These have been retrieved from NCI's listing of clinical trials.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What is (are) Small Intestine Cancer ? [/INST] Small intestine cancer is a rare disease in which malignant (cancer) cells form in the tissues of the small intestine. There are five types of small intestine cancer. Diet and health history can affect the risk of developing small intestine cancer. Signs and symptoms of small intestine cancer include unexplained weight loss and abdominal pain. Tests that examine the small intestine are used to detect (find), diagnose, and stage small intestine cancer. Certain factors affect prognosis (chance of recovery) and treatment options. Small intestine cancer is a rare disease in which malignant (cancer) cells form in the tissues of the small intestine. The small intestine is part of the bodys digestive system, which also includes the esophagus, stomach, and large intestine. The digestive system removes and processes nutrients (vitamins, minerals, carbohydrates, fats, proteins, and water) from foods and helps pass waste material out of the body. The small intestine is a long tube that connects the stomach to the large intestine. It folds many times to fit inside the abdomen. There are five types of small intestine cancer. The types of cancer found in the small intestine are adenocarcinoma, sarcoma, carcinoid tumors, gastrointestinal stromal tumor, and lymphoma. This summary discusses adenocarcinoma and leiomyosarcoma (a type of sarcoma). Adenocarcinoma starts in glandular cells in the lining of the small intestine and is the most common type of small intestine cancer. Most of these tumors occur in the part of the small intestine near the stomach. They may grow and block the intestine. Leiomyosarcoma starts in the smooth muscle cells of the small intestine. Most of these tumors occur in the part of the small intestine near the large intestine. See the following PDQ summaries for more information on small intestine cancer: Adult Soft Tissue Sarcoma Treatment Childhood Soft Tissue Sarcoma Treatment Adult NonHodgkin Lymphoma Treatment Childhood NonHodgkin Lymphoma Treatment Gastrointestinal Carcinoid Tumors Treatment Gastrointestinal Stromal Tumors Treatment</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>Who is at risk for Small Intestine Cancer? ? [/INST] Diet and health history can affect the risk of developing small intestine cancer. Anything that increases your risk of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesn't mean that you will not get cancer. Talk with your doctor if you think you may be at risk. Risk factors for small intestine cancer include the following: Eating a highfat diet. Having Crohn disease. Having celiac disease. Having familial adenomatous polyposis (FAP).</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What are the symptoms of Small Intestine Cancer ? [/INST] Signs and symptoms of small intestine cancer include unexplained weight loss and abdominal pain. These and other signs and symptoms may be caused by small intestine cancer or by other conditions. Check with your doctor if you have any of the following: Pain or cramps in the middle of the abdomen. Weight loss with no known reason. A lump in the abdomen. Blood in the stool.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>How to diagnose Small Intestine Cancer ? [/INST] Tests that examine the small intestine are used to detect (find), diagnose, and stage small intestine cancer.Procedures that make pictures of the small intestine and the area around it help diagnose small intestine cancer and show how far the cancer has spread. The process used to find out if cancer cells have spread within and around the small intestine is called staging. In order to plan treatment, it is important to know the type of small intestine cancer and whether the tumor can be removed by surgery. Tests and procedures to detect, diagnose, and stage small intestine cancer are usually done at the same time. The following tests and procedures may be used: Physical exam and history : An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patients health habits and past illnesses and treatments will also be taken. Blood chemistry studies : A procedure in which a blood sample is checked to measure the amounts of certain substances released into the blood by organs and tissues in the body. An unusual (higher or lower than normal) amount of a substance can be a sign of disease. Liver function tests : A procedure in which a blood sample is checked to measure the amounts of certain substances released into the blood by the liver. A higher than normal amount of a substance can be a sign of liver disease that may be caused by small intestine cancer. Endoscopy : A procedure to look at organs and tissues inside the body to check for abnormal areas. There are different types of endoscopy: Upper endoscopy : A procedure to look at the inside of the esophagus, stomach, and duodenum (first part of the small intestine, near the stomach). An endoscope is inserted through the mouth and into the esophagus, stomach, and duodenum. An endoscope is a thin, tubelike instrument with a light and a lens for viewing. It may also have a tool to remove tissue samples, which are checked under a microscope for signs of cancer. Capsule endoscopy : A procedure to look at the inside of the small intestine. A capsule that is about the size of a large pill and contains a light and a tiny wireless camera is swallowed by the patient. The capsule travels through the digestive tract, including the small intestine, and sends many pictures of the inside of the digestive tract to a recorder that is worn around the waist or over the shoulder. The pictures are sent from the recorder to a computer and viewed by the doctor who checks for signs of cancer. The capsule passes out of the body during a bowel movement. Double balloon endoscopy : A procedure to look at the inside of the small intestine. A special instrument made up of two tubes (one inside the other) is inserted through the mouth or rectum and into the small intestine. The inside tube (an endoscope with a light and lens for viewing) is moved through part of the small intestine and a balloon at the end of it is inflated to keep the endoscope in place. Next, the outer tube is moved through the small intestine to reach the end of the endoscope, and a balloon at the end of the outer tube is inflated to keep it in place. Then, the balloon at the end of the endoscope is deflated and the endoscope is moved through the next part of the small intestine. These steps are repeated many times as the tubes move through the small intestine. The doctor is able to see the inside of the small intestine through the endoscope and use a tool to remove samples of abnormal tissue. The tissue samples are checked under a microscope for signs of cancer. This procedure may be done if the results of a capsule endoscopy are abnormal. This procedure is also called double balloon enteroscopy. Laparotomy : A surgical procedure in which an incision (cut) is made in the wall of the abdomen to check the inside of the abdomen for signs of disease. The size of the incision depends on the reason the laparotomy is being done. Sometimes organs or lymph nodes are removed or tissue samples are taken and checked under a microscope for signs of disease. Biopsy : The removal of cells or tissues so they can be viewed under a microscope to check for signs of cancer. This may be done during an endoscopy or laparotomy. The sample is checked by a pathologist to see if it contains cancer cells. Upper GI series with small bowel followthrough: A series of xrays of the esophagus, stomach, and small bowel. The patient drinks a liquid that contains barium (a silverwhite metallic compound). The liquid coats the esophagus, stomach, and small bowel. Xrays are taken at different times as the barium travels through the upper GI tract and small bowel. CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an xray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography. MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI).</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What is the outlook for Small Intestine Cancer ? [/INST] Certain factors affect prognosis (chance of recovery) and treatment options.The prognosis (chance of recovery) and treatment options depend on the following: The type of small intestine cancer. Whether the cancer is in the inner lining of the small intestine only or has spread into or beyond the wall of the small intestine. Whether the cancer has spread to other places in the body, such as the lymph nodes, liver, or peritoneum (tissue that lines the wall of the abdomen and covers most of the organs in the abdomen). Whether the cancer can be completely removed by surgery. Whether the cancer is newly diagnosed or has recurred.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What are the stages of Small Intestine Cancer ? [/INST] Tests and procedures to stage small intestine cancer are usually done at the same time as diagnosis. There are three ways that cancer spreads in the body. Cancer may spread from where it began to other parts of the body. Small intestine cancer is grouped according to whether or not the tumor can be completely removed by surgery. Tests and procedures to stage small intestine cancer are usually done at the same time as diagnosis. Staging is used to find out how far the cancer has spread, but treatment decisions are not based on stage. See the General Information section for a description of tests and procedures used to detect, diagnose, and stage small intestine cancer. There are three ways that cancer spreads in the body. Cancer can spread through tissue, the lymph system, and the blood: Tissue. The cancer spreads from where it began by growing into nearby areas. Lymph system. The cancer spreads from where it began by getting into the lymph system. The cancer travels through the lymph vessels to other parts of the body. Blood. The cancer spreads from where it began by getting into the blood. The cancer travels through the blood vessels to other parts of the body. Cancer may spread from where it began to other parts of the body. When cancer spreads to another part of the body, it is called metastasis. Cancer cells break away from where they began (the primary tumor) and travel through the lymph system or blood. Lymph system. The cancer gets into the lymph system, travels through the lymph vessels, and forms a tumor (metastatic tumor) in another part of the body. Blood. The cancer gets into the blood, travels through the blood vessels, and forms a tumor (metastatic tumor) in another part of the body. The metastatic tumor is the same type of cancer as the primary tumor. For example, if small intestine cancer spreads to the liver, the cancer cells in the liver are actually small intestine cancer cells. The disease is metastatic small intestine cancer, not liver cancer. Small intestine cancer is grouped according to whether or not the tumor can be completely removed by surgery. Treatment depends on whether the tumor can be removed by surgery and if the cancer is being treated as a primary tumor or is metastatic cancer.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What are the treatments for Small Intestine Cancer ? [/INST] There are different types of treatment for patients with small intestine cancer. Three types of standard treatment are used: Surgery Radiation therapy Chemotherapy New types of treatment are being tested in clinical trials. Biologic therapy Radiation therapy with radiosensitizers Patients may want to think about taking part in a clinical trial. Patients can enter clinical trials before, during, or after starting their cancer treatment. Followup tests may be needed. There are different types of treatment for patients with small intestine cancer. Different types of treatments are available for patients with small intestine cancer. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment. Three types of standard treatment are used: Surgery Surgery is the most common treatment of small intestine cancer. One of the following types of surgery may be done: Resection: Surgery to remove part or all of an organ that contains cancer. The resection may include the small intestine and nearby organs (if the cancer has spread). The doctor may remove the section of the small intestine that contains cancer and perform an anastomosis (joining the cut ends of the intestine together). The doctor will usually remove lymph nodes near the small intestine and examine them under a microscope to see whether they contain cancer. Bypass: Surgery to allow food in the small intestine to go around (bypass) a tumor that is blocking the intestine but cannot be removed. Even if the doctor removes all the cancer that can be seen at the time of the surgery, some patients may be given radiation therapy after surgery to kill any cancer cells that are left. Treatment given after the surgery, to lower the risk that the cancer will come back, is called adjuvant therapy. Radiation therapy Radiation therapy is a cancer treatment that uses highenergy xrays or other types of radiation to kill cancer cells or keep them from growing. There are two types of radiation therapy: External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. The way the radiation therapy is given depends on the type of the cancer being treated. External radiation therapy is used to treat small intestine cancer. Chemotherapy Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the cerebrospinal fluid, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). The way the chemotherapy is given depends on the type and stage of the cancer being treated. New types of treatment are being tested in clinical trials. This summary section describes treatments that are being studied in clinical trials. It may not mention every new treatment being studied. Information about clinical trials is available from the NCI website. Biologic therapy Biologic therapy is a treatment that uses the patient's immune system to fight cancer. Substances made by the body or made in a laboratory are used to boost, direct, or restore the body's natural defenses against cancer. This type of cancer treatment is also called biotherapy or immunotherapy. Radiation therapy with radiosensitizers Radiosensitizers are drugs that make tumor cells more sensitive to radiation therapy. Combining radiation therapy with radiosensitizers may kill more tumor cells. Patients may want to think about taking part in a clinical trial. For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment. Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment. Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward. Patients can enter clinical trials before, during, or after starting their cancer treatment. Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring (coming back) or reduce the side effects of cancer treatment. Clinical trials are taking place in many parts of the country. See the Treatment Options section that follows for links to current treatment clinical trials. These have been retrieved from NCI's listing of clinical trials. Followup tests may be needed. Some of the tests that were done to diagnose the cancer or to find out the stage of the cancer may be repeated. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests. Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your condition has changed or if the cancer has recurred (come back). These tests are sometimes called followup tests or checkups. Treatment Options for Small Intestine Cancer Small Intestine Adenocarcinoma When possible, treatment of small intestine adenocarcinoma will be surgery to remove the tumor and some of the normal tissue around it. Treatment of small intestine adenocarcinoma that cannot be removed by surgery may include the following: Surgery to bypass the tumor. Radiation therapy as palliative therapy to relieve symptoms and improve the patient's quality of life. A clinical trial of radiation therapy with radiosensitizers, with or without chemotherapy. A clinical trial of new anticancer drugs. A clinical trial of biologic therapy. Check the list of NCIsupported cancer clinical trials that are now accepting patients with small intestine adenocarcinoma. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the NCI website. Small Intestine Leiomyosarcoma When possible, treatment of small intestine leiomyosarcoma will be surgery to remove the tumor and some of the normal tissue around it. Treatment of small intestine leiomyosarcoma that cannot be removed by surgery may include the following: Surgery (to bypass the tumor) and radiation therapy. Surgery, radiation therapy, or chemotherapy as palliative therapy to relieve symptoms and improve the patient's quality of life. A clinical trial of new anticancer drugs. A clinical trial of biologic therapy. Check the list of NCIsupported cancer clinical trials that are now accepting patients with small intestine leiomyosarcoma. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the NCI website. Recurrent Small Intestine Cancer Treatment of recurrent small intestine cancer that has spread to other parts of the body is usually a clinical trial of new anticancer drugs or biologic therapy. Treatment of locally recurrent small intestine cancer may include the following: Surgery. Radiation therapy or chemotherapy as palliative therapy to relieve symptoms and improve the patient's quality of life. A clinical trial of radiation therapy with radiosensitizers, with or without chemotherapy. Check the list of NCIsupported cancer clinical trials that are now accepting patients with recurrent small intestine cancer. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the NCI website.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What is (are) Metastatic Squamous Neck Cancer with Occult Primary ? [/INST] Metastatic squamous neck cancer with occult primary is a disease in which squamous cell cancer spreads to lymph nodes in the neck and it is not known where the cancer first formed in the body. Signs and symptoms of metastatic squamous neck cancer with occult primary include a lump or pain in the neck or throat. Tests that examine the tissues of the neck, respiratory tract, and upper part of the digestive tract are used to detect (find) and diagnose metastatic squamous neck cancer and the primary tumor. Certain factors affect prognosis (chance of recovery) and treatment options. Metastatic squamous neck cancer with occult primary is a disease in which squamous cell cancer spreads to lymph nodes in the neck and it is not known where the cancer first formed in the body. Squamous cells are thin, flat cells found in tissues that form the surface of the skin and the lining of body cavities such as the mouth, hollow organs such as the uterus and blood vessels, and the lining of the respiratory (breathing) and digestive tracts. Some organs with squamous cells are the esophagus, lungs, kidneys, and uterus. Cancer can begin in squamous cells anywhere in the body and metastasize (spread) through the blood or lymph system to other parts of the body. When squamous cell cancer spreads to lymph nodes in the neck or around the collarbone, it is called metastatic squamous neck cancer. The doctor will try to find the primary tumor (the cancer that first formed in the body), because treatment for metastatic cancer is the same as treatment for the primary tumor. For example, when lung cancer spreads to the neck, the cancer cells in the neck are lung cancer cells and they are treated the same as the cancer in the lung. Sometimes doctors cannot find where in the body the cancer first began to grow. When tests cannot find a primary tumor, it is called an occult (hidden) primary tumor. In many cases, the primary tumor is never found.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What are the symptoms of Metastatic Squamous Neck Cancer with Occult Primary ? [/INST] Signs and symptoms of metastatic squamous neck cancer with occult primary include a lump or pain in the neck or throat. Check with your doctor if you have a lump or pain in your neck or throat that doesn't go away. These and other signs and symptoms may be caused by metastatic squamous neck cancer with occult primary. Other conditions may cause the same signs and symptoms.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>How to diagnose Metastatic Squamous Neck Cancer with Occult Primary ? [/INST] Tests that examine the tissues of the neck, respiratory tract, and upper part of the digestive tract are used to detect (find) and diagnose metastatic squamous neck cancer and the primary tumor. Tests will include checking for a primary tumor in the organs and tissues of the respiratory tract (part of the trachea), the upper part of the digestive tract (including the lips, mouth, tongue, nose, throat, vocal cords, and part of the esophagus), and the genitourinary system. The following procedures may be used: Physical exam and history : An exam of the body, especially the head and neck, to check general signs of health. This includes checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patients health habits and past illnesses and treatments will also be taken. Biopsy : The removal of cells or tissues so they can be viewed under a microscope by a pathologist or tested in the laboratory to check for signs of cancer. Three types of biopsy may be done: Fineneedle aspiration (FNA) biopsy : The removal of tissue or fluid using a thin needle. Core needle biopsy : The removal of tissue using a wide needle. Excisional biopsy : The removal of an entire lump of tissue. The following procedures are used to remove samples of cells or tissue: Tonsillectomy: Surgery to remove both tonsils. Endoscopy : A procedure to look at organs and tissues inside the body to check for abnormal areas. An endoscope is inserted through an incision (cut) in the skin or opening in the body, such as the mouth or nose. An endoscope is a thin, tubelike instrument with a light and a lens for viewing. It may also have a tool to remove abnormal tissue or lymph node samples, which are checked under a microscope for signs of disease. The nose, throat, back of the tongue, esophagus, stomach, voice box, windpipe, and large airways will be checked. One or more of the following laboratory tests may be done to study the tissue samples: Immunohistochemistry : A test that uses antibodies to check for certain antigens in a sample of blood or bone marrow. The antibody is usually linked to a radioactive substance or a dye that causes the tissue to light up under a microscope. This type of test may be used to tell the difference between different types of cancer. Light and electron microscopy : A test in which cells in a sample of tissue are viewed under regular and highpowered microscopes to look for certain changes in the cells. EpsteinBarr virus (EBV) and human papillomavirus (HPV) test: A test that checks the cells in a sample of tissue for EBV and HPV DNA. MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI). CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an xray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography. PET scan (positron emission tomography scan): A procedure to find malignant tumor cells in the body. A small amount of radioactive glucose (sugar) is injected into a vein. The PET scanner rotates around the body and makes a picture of where glucose is being used in the body. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do. A whole body PET scan and a CT scan are done at the same time to look for where the cancer first formed. If there is any cancer, this increases the chance that it will be found. A diagnosis of occult primary tumor is made if the primary tumor is not found during testing or treatment.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What is the outlook for Metastatic Squamous Neck Cancer with Occult Primary ? [/INST] Certain factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery) and treatment options depend on the following: The number and size of lymph nodes that have cancer in them. Whether the cancer has responded to treatment or has recurred (come back). How different from normal the cancer cells look under a microscope. The patient's age and general health. Treatment options also depend on the following: Which part of the neck the cancer is in. Whether certain tumor markers are found.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What are the stages of Metastatic Squamous Neck Cancer with Occult Primary ? [/INST] After metastatic squamous neck cancer with occult primary has been diagnosed, tests are done to find out if cancer cells have spread to other parts of the body. There are three ways that cancer spreads in the body. After metastatic squamous neck cancer with occult primary has been diagnosed, tests are done to find out if cancer cells have spread to other parts of the body. The process used to find out if cancer has spread to other parts of the body is called staging. The results from tests and procedures used to detect and diagnose the primary tumor are also used to find out if cancer has spread to other parts of the body. There is no standard staging system for metastatic squamous neck cancer with occult primary. The tumors are described as untreated or recurrent. Untreated metastatic squamous neck cancer with occult primary is cancer that is newly diagnosed and has not been treated, except to relieve signs and symptoms caused by the cancer. There are three ways that cancer spreads in the body. Cancer can spread through tissue, the lymph system, and the blood: Tissue. The cancer spreads from where it began by growing into nearby areas. Lymph system. The cancer spreads from where it began by getting into the lymph system. The cancer travels through the lymph vessels to other parts of the body. Blood. The cancer spreads from where it began by getting into the blood. The cancer travels through the blood vessels to other parts of the body.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What are the treatments for Metastatic Squamous Neck Cancer with Occult Primary ? [/INST] There are different types of treatment for patients with metastatic squamous neck cancer with occult primary. Two types of standard treatment are used: Surgery Radiation therapy New types of treatment are being tested in clinical trials. Chemotherapy Hyperfractionated radiation therapy Patients may want to think about taking part in a clinical trial. Patients can enter clinical trials before, during, or after starting their cancer treatment. Followup tests may be needed. There are different types of treatment for patients with metastatic squamous neck cancer with occult primary. Different types of treatment are available for patients with metastatic squamous neck cancer with occult primary. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment. Two types of standard treatment are used: Surgery Surgery may include neck dissection. There are different types of neck dissection, based on the amount of tissue that is removed. Radical neck dissection: Surgery to remove tissues in one or both sides of the neck between the jawbone and the collarbone, including the following: All lymph nodes. The jugular vein. Muscles and nerves that are used for face, neck, and shoulder movement, speech, and swallowing. The patient may need physical therapy of the throat, neck, shoulder, and/or arm after radical neck dissection. Radical neck dissection may be used when cancer has spread widely in the neck. Modified radical neck dissection: Surgery to remove all the lymph nodes in one or both sides of the neck without removing the neck muscles. The nerves and/or the jugular vein may be removed. Partial neck dissection: Surgery to remove some of the lymph nodes in the neck. This is also called selective neck dissection. Even if the doctor removes all the cancer that can be seen at the time of surgery, some patients may be given radiation therapy after surgery to kill any cancer cells that are left. Treatment given after surgery, to lower the risk that the cancer will come back, is called adjuvant therapy. Radiation therapy Radiation therapy is a cancer treatment that uses highenergy xrays or other types of radiation to kill cancer cells or keep them from growing. There are two types of radiation therapy: External radiation therapy uses a machine outside the body to send radiation toward the cancer. Certain ways of giving radiation therapy can help keep radiation from damaging nearby healthy tissue. This type of radiation therapy may include the following: Intensitymodulated radiation therapy (IMRT): IMRT is a type of 3dimensional (3D) radiation therapy that uses a computer to make pictures of the size and shape of the tumor. Thin beams of radiation of different intensities (strengths) are aimed at the tumor from many angles. This type of radiation therapy is less likely to cause dry mouth, trouble swallowing, and damage to the skin. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. The way the radiation therapy is given depends on the type of cancer being treated. External radiation therapy is used to treat metastatic squamous neck cancer with occult primary. Radiation therapy to the neck may change the way the thyroid gland works. Blood tests may be done to check the thyroid hormone level in the body before treatment and at regular checkups after treatment. New types of treatment are being tested in clinical trials. This summary section describes treatments that are being studied in clinical trials. It may not mention every new treatment being studied. Information about clinical trials is available from the NCI website. Chemotherapy Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the cerebrospinal fluid, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). Hyperfractionated radiation therapy Hyperfractionated radiation therapy is a type of external radiation treatment in which a smaller than usual total daily dose of radiation is divided into two doses and the treatments are given twice a day. Hyperfractionated radiation therapy is given over the same period of time (days or weeks) as standard radiation therapy. Patients may want to think about taking part in a clinical trial. For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment. Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment. Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward. Patients can enter clinical trials before, during, or after starting their cancer treatment. Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring (coming back) or reduce the side effects of cancer treatment. Clinical trials are taking place in many parts of the country. See the Treatment Options section that follows for links to current treatment clinical trials. These have been retrieved from NCI's listing of clinical trials. Followup tests may be needed. Some of the tests that were done to diagnose the cancer or to find out the stage of the cancer may be repeated. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests. Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your condition has changed or if the cancer has recurred (come back). These tests are sometimes called followup tests or checkups. Treatment Options for Metastatic Squamous Neck Cancer with Occult Primary Untreated Metastatic Squamous Neck Cancer with Occult Primary Treatment of untreated metastatic squamous neck cancer with occult primary may include the following: Radiation therapy. Surgery. Radiation therapy followed by surgery. A clinical trial of chemotherapy followed by radiation therapy. A clinical trial of chemotherapy given at the same time as hyperfractionated radiation therapy. Clinical trials of new treatments. Check the list of NCIsupported cancer clinical trials that are now accepting patients with untreated metastatic squamous neck cancer with occult primary. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the NCI website. Recurrent Metastatic Squamous Neck Cancer with Occult Primary Treatment of recurrent metastatic squamous neck cancer with occult primary is usually within a clinical trial. Check the list of NCIsupported cancer clinical trials that are now accepting patients with recurrent metastatic squamous neck cancer with occult primary. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the NCI website.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>what research (or clinical trials) is being done for Metastatic Squamous Neck Cancer with Occult Primary ? [/INST] New types of treatment are being tested in clinical trials. This summary section describes treatments that are being studied in clinical trials. It may not mention every new treatment being studied. Information about clinical trials is available from the NCI website. Chemotherapy Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the cerebrospinal fluid, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). Hyperfractionated radiation therapy Hyperfractionated radiation therapy is a type of external radiation treatment in which a smaller than usual total daily dose of radiation is divided into two doses and the treatments are given twice a day. Hyperfractionated radiation therapy is given over the same period of time (days or weeks) as standard radiation therapy. Patients may want to think about taking part in a clinical trial. For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment. Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment. Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward. Patients can enter clinical trials before, during, or after starting their cancer treatment. Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring (coming back) or reduce the side effects of cancer treatment. Clinical trials are taking place in many parts of the country. See the Treatment Options section that follows for links to current treatment clinical trials. These have been retrieved from NCI's listing of clinical trials.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What is (are) Childhood Astrocytomas ? [/INST] Childhood astrocytoma is a disease in which benign (noncancer) or malignant (cancer) cells form in the tissues of the brain. Astrocytomas may be benign (not cancer) or malignant (cancer). The central nervous system controls many important body functions. The cause of most childhood brain tumors is not known. The signs and symptoms of astrocytomas are not the same in every child. Tests that examine the brain and spinal cord are used to detect (find) childhood astrocytomas. Childhood astrocytomas are usually diagnosed and removed in surgery. Certain factors affect prognosis (chance of recovery) and treatment options. Childhood astrocytoma is a disease in which benign (noncancer) or malignant (cancer) cells form in the tissues of the brain. Astrocytomas are tumors that start in starshaped brain cells called astrocytes. An astrocyte is a type of glial cell. Glial cells hold nerve cells in place, bring food and oxygen to them, and help protect them from disease, such as infection. Gliomas are tumors that form from glial cells. An astrocytoma is a type of glioma. Astrocytoma is the most common type of glioma diagnosed in children. It can form anywhere in the central nervous system (brain and spinal cord). This summary is about the treatment of tumors that begin in astrocytes in the brain (primary brain tumors). Metastatic brain tumors are formed by cancer cells that begin in other parts of the body and spread to the brain. Treatment of metastatic brain tumors is not discussed here. Brain tumors can occur in both children and adults. However, treatment for children may be different than treatment for adults. See the following PDQ summaries for more information about other types of brain tumors in children and adults: Childhood Brain and Spinal Cord Tumors Treatment Overview Adult Central Nervous System Tumors Treatment Astrocytomas may be benign (not cancer) or malignant (cancer). Benign brain tumors grow and press on nearby areas of the brain. They rarely spread into other tissues. Malignant brain tumors are likely to grow quickly and spread into other brain tissue. When a tumor grows into or presses on an area of the brain, it may stop that part of the brain from working the way it should. Both benign and malignant brain tumors can cause signs and symptoms and almost all need treatment. The central nervous system controls many important body functions. Astrocytomas are most common in these parts of the central nervous system (CNS): Cerebrum : The largest part of the brain, at the top of the head. The cerebrum controls thinking, learning, problemsolving, speech, emotions, reading, writing, and voluntary movement. Cerebellum : The lower, back part of the brain (near the middle of the back of the head). The cerebellum controls movement, balance, and posture. Brain stem : The part that connects the brain to the spinal cord, in the lowest part of the brain (just above the back of the neck). The brain stem controls breathing, heart rate, and the nerves and muscles used in seeing, hearing, walking, talking, and eating. Hypothalamus : The area in the middle of the base of the brain. It controls body temperature, hunger, and thirst. Visual pathway: The group of nerves that connect the eye with the brain. Spinal cord: The column of nerve tissue that runs from the brain stem down the center of the back. It is covered by three thin layers of tissue called membranes. The spinal cord and membranes are surrounded by the vertebrae (back bones). Spinal cord nerves carry messages between the brain and the rest of the body, such as a message from the brain to cause muscles to move or a message from the skin to the brain to feel touch.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What causes Childhood Astrocytomas ? [/INST] The cause of most childhood brain tumors is not known.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>Who is at risk for Childhood Astrocytomas? ? [/INST] Anything that increases your risk of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesnt mean that you will not get cancer. Talk with your child's doctor if you think your child may be at risk. Possible risk factors for astrocytoma include: Past radiation therapy to the brain. Having certain genetic disorders, such as neurofibromatosis type 1 (NF1) or tuberous sclerosis.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What are the symptoms of Childhood Astrocytomas ? [/INST] The signs and symptoms of astrocytomas are not the same in every child. Signs and symptoms depend on the following: Where the tumor forms in the brain or spinal cord. The size of the tumor. How fast the tumor grows. The child's age and development. Some tumors do not cause signs or symptoms. Signs and symptoms may be caused by childhood astrocytomas or by other conditions. Check with your child's doctor if your child has any of the following: Morning headache or headache that goes away after vomiting. Nausea and vomiting. Vision, hearing, and speech problems. Loss of balance and trouble walking. Worsening handwriting or slow speech. Weakness or change in feeling on one side of the body. Unusual sleepiness. More or less energy than usual. Change in personality or behavior. Seizures. Weight loss or weight gain for no known reason. Increase in the size of the head (in infants).</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>How to diagnose Childhood Astrocytomas ? [/INST] Tests that examine the brain and spinal cord are used to detect (find) childhood astrocytomas. The following tests and procedures may be used: Physical exam and history : An exam of the body to check general signs of health. This includes checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patients health habits and past illnesses and treatments will also be taken. Neurological exam : A series of questions and tests to check the brain, spinal cord, and nerve function. The exam checks a persons mental status, coordination, and ability to walk normally, and how well the muscles, senses, and reflexes work. This may also be called a neuro exam or a neurologic exam. Visual field exam: An exam to check a persons field of vision (the total area in which objects can be seen). This test measures both central vision (how much a person can see when looking straight ahead) and peripheral vision (how much a person can see in all other directions while staring straight ahead). The eyes are tested one at a time. The eye not being tested is covered. MRI (magnetic resonance imaging) with gadolinium : A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of the brain and spinal cord. A substance called gadolinium is injected into a vein. The gadolinium collects around the cancer cells so they show up brighter in the picture. This procedure is also called nuclear magnetic resonance imaging (NMRI). Sometimes magnetic resonance spectroscopy (MRS) is done during the same MRI scan to look at the chemical makeup of the brain tissue. Childhood astrocytomas are usually diagnosed and removed in surgery. If doctors think there may be an astrocytoma, a biopsy may be done to remove a sample of tissue. For tumors in the brain, a part of the skull is removed and a needle is used to remove tissue. Sometimes, the needle is guided by a computer. A pathologist views the tissue under a microscope to look for cancer cells. If cancer cells are found, the doctor may remove as much tumor as safely possible during the same surgery. Because it can be hard to tell the difference between types of brain tumors, you may want to have your child's tissue sample checked by a pathologist who has experience in diagnosing brain tumors. The following test may be done on the tissue that was removed: Immunohistochemistry : A test that uses antibodies to check for certain antigens in a sample of tissue. The antibody is usually linked to a radioactive substance or a dye that causes the tissue to light up under a microscope. This type of test may be used to tell the difference between different types of cancer. An MIB1 test is a type of immunohistochemistry that checks tumor tissue for an antigen called MIB1. This may show how fast a tumor is growing. Sometimes tumors form in a place that makes them hard to remove. If removing the tumor may cause severe physical, emotional, or learning problems, a biopsy is done and more treatment is given after the biopsy. Children who have NF1 may form a lowgrade astrocytoma in the area of the brain that controls vision and may not need a biopsy. If the tumor does not continue to grow or symptoms do not occur, surgery to remove the tumor may not be needed.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What is the outlook for Childhood Astrocytomas ? [/INST] Certain factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery) and treatment options depend on the following: Whether the tumor is a lowgrade or highgrade astrocytoma. Where the tumor has formed in the CNS and if it has spread to nearby tissue or to other parts of the body. How fast the tumor is growing. The child's age. Whether cancer cells remain after surgery. Whether there are changes in certain genes. Whether the child has NF1 or tuberous sclerosis. Whether the child has diencephalic syndrome (a condition which slows physical growth). Whether the child has intracranial hypertension (cerebrospinal fluid pressure within the skull is high) at the time of diagnosis. Whether the astrocytoma has just been diagnosed or has recurred (come back). For recurrent astrocytoma, prognosis and treatment depend on how much time passed between the time treatment ended and the time the astrocytoma recurred.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What are the stages of Childhood Astrocytomas ? [/INST] The grade of the tumor is used to plan cancer treatment. Lowgrade astrocytomas Highgrade astrocytomas An MRI is done after surgery. The grade of the tumor is used to plan cancer treatment. Staging is the process used to find out how much cancer there is and if cancer has spread. It is important to know the stage in order to plan treatment. There is no standard staging system for childhood astrocytoma. Treatment is based on the following: Whether the tumor is low grade or high grade. Whether the tumor is newly diagnosed or recurrent (has come back after treatment). The grade of the tumor describes how abnormal the cancer cells look under a microscope and how quickly the tumor is likely to grow and spread. The following grades are used: Lowgrade astrocytomas Lowgrade astrocytomas are slowgrowing and rarely spread to other parts of the brain and spinal cord or other parts of the body. There are many types of lowgrade astrocytomas. Lowgrade astrocytomas can be either: Grade I tumors pilocytic astrocytoma, subependymal giant cell tumor, or angiocentric glioma. Grade II tumors diffuse astrocytoma, pleomorphic xanthoastrocytoma, or choroid glioma of the third ventricle. Children who have neurofibromatosis type 1 may have more than one lowgrade tumor in the brain. Children who have tuberous sclerosis have an increased risk of subependymal giant cell astrocytoma. Highgrade astrocytomas Highgrade astrocytomas are fastgrowing and often spread within the brain and spinal cord. There are several types of highgrade astrocytomas. High grade astrocytomas can be either: Grade III tumors anaplastic astrocytoma or anaplastic pleomorphic xanthoastrocytoma. Grade IV tumors glioblastoma or diffuse midline glioma. Childhood astrocytomas usually do not spread to other parts of the body. An MRI is done after surgery. An MRI (magnetic resonance imaging) is done in the first few days after surgery. This is to find out how much tumor, if any, remains after surgery and to plan further treatment.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>what research (or clinical trials) is being done for Childhood Astrocytomas ? [/INST] New types of treatment are being tested in clinical trials. This summary section describes treatments that are being studied in clinical trials. It may not mention every new treatment being studied. Information about clinical trials is available from the NCI website. Other drug therapy Lenalidomide is a type of angiogenesis inhibitor. It prevents the growth of new blood vessels that are needed by a tumor to grow. Patients may want to think about taking part in a clinical trial. For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment. Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment. Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward. Patients can enter clinical trials before, during, or after starting their cancer treatment. Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring (coming back) or reduce the side effects of cancer treatment. Clinical trials are taking place in many parts of the country. See the Treatment Options section that follows for links to current treatment clinical trials. These have been retrieved from NCI's listing of clinical trials.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What are the treatments for Childhood Astrocytomas ? [/INST] There are different types of treatment for patients with childhood astrocytoma. Children with astrocytomas should have their treatment planned by a team of health care providers who are experts in treating childhood brain tumors. Childhood brain tumors may cause signs or symptoms that begin before the cancer is diagnosed and continue for months or years. Some cancer treatments cause side effects months or years after treatment has ended. Six types of treatment are used: Surgery Observation Radiation therapy Chemotherapy Highdose chemotherapy with stem cell transplant Targeted therapy New types of treatment are being tested in clinical trials. Other drug therapy If fluid builds up around the brain and spinal cord, a cerebrospinal fluid diversion procedure may be done. Patients may want to think about taking part in a clinical trial. Patients can enter clinical trials before, during, or after starting their cancer treatment. Followup tests may be needed. There are different types of treatment for patients with childhood astrocytoma. Different types of treatment are available for children with astrocytomas. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Because cancer in children is rare, taking part in a clinical trial should be considered. Some clinical trials are open only to patients who have not started treatment. Children with astrocytomas should have their treatment planned by a team of health care providers who are experts in treating childhood brain tumors. Treatment will be overseen by a pediatric oncologist, a doctor who specializes in treating children with cancer. The pediatric oncologist works with other healthcare providers who are experts in treating children with brain tumors and who specialize in certain areas of medicine. These may include the following specialists: Pediatrician. Pediatric neurosurgeon. Neurologist. Neuropathologist. Neuroradiologist. Rehabilitation specialist. Radiation oncologist. Endocrinologist. Psychologist. Childhood brain tumors may cause signs or symptoms that begin before the cancer is diagnosed and continue for months or years. Signs or symptoms caused by the tumor may begin before diagnosis. These signs or symptoms may continue for months or years. It is important to talk with your child's doctors about signs or symptoms caused by the tumor that may continue after treatment. Some cancer treatments cause side effects months or years after treatment has ended. Side effects from cancer treatment that begin during or after treatment and continue for months or years are called late effects. Late effects of cancer treatment may include the following: Physical problems. Changes in mood, feelings, thinking, learning, or memory. Second cancers (new types of cancer). Some late effects may be treated or controlled. It is important to talk with your child's doctors about the effects cancer treatment can have on your child. (See the PDQ summary on Late Effects of Treatment for Childhood Cancer for more information.) Six types of treatment are used: Surgery Surgery is used to diagnose and treat childhood astrocytoma, as discussed in the General Information section of this summary. If cancer cells remain after surgery, further treatment depends on: Where the remaining cancer cells are. The grade of the tumor. The age of the child. Even if the doctor removes all the cancer that can be seen at the time of the surgery, some patients may be given chemotherapy or radiation therapy after surgery to kill any cancer cells that remain. Treatment given after the surgery, to lower the risk that the cancer will come back, is called adjuvant therapy. Observation Observation is closely monitoring a patients condition without giving any treatment until signs or symptoms appear or change. Observation may be used: If the patient has no symptoms, such as patients with neurofibromatosis type1. If the tumor is small and is found when a different health problem is being diagnosed or treated. After the tumor is removed by surgery until signs or symptoms appear or change. Radiation therapy Radiation therapy is a cancer treatment that uses highenergy xrays or other types of radiation to kill cancer cells or keep them from growing. There are two types of radiation therapy: External radiation therapy uses a machine outside the body to send radiation toward the cancer. Certain ways of giving radiation therapy can help keep radiation from damaging nearby healthy tissue. These types of radiation therapy include the following: Conformal radiation therapy: Conformal radiation therapy is a type of external radiation therapy that uses a computer to make a 3dimensional (3D) picture of the tumor and shapes the radiation beams to fit the tumor. Intensitymodulated radiation therapy (IMRT): IMRT is a type of 3dimensional (3D) external radiation therapy that uses a computer to make pictures of the size and shape of the tumor. Thin beams of radiation of different intensities (strengths) are aimed at the tumor from many angles. Stereotactic radiation therapy: Stereotactic radiation therapy is a type of external radiation therapy. A rigid head frame is attached to the skull to keep the head still during the radiation treatment. A machine aims radiation directly at the tumor. The total dose of radiation is divided into several smaller doses given over several days. This procedure is also called stereotactic externalbeam radiation therapy and stereotaxic radiation therapy. Proton beam radiation therapy: Protonbeam therapy is a type of highenergy, external radiation therapy. A radiation therapy machine aims streams of protons (tiny, invisible, positivelycharged particles) at the cancer cells to kill them. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. The way the radiation therapy is given depends on the type of tumor and where the tumor formed in the brain or spinal cord. External radiation therapy is used to treat childhood astrocytomas. Radiation therapy to the brain can affect growth and development, especially in young children. For children younger than 3 years, chemotherapy may be given instead, to delay or reduce the need for radiation therapy. Chemotherapy Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the cerebrospinal fluid, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). Combination chemotherapy is the use of more than one anticancer drug. The way the chemotherapy is given depends on the type of tumor and where the tumor formed in the brain or spinal cord. Systemic combination chemotherapy is used in the treatment of children with astrocytoma. Highdose chemotherapy may be used in the treatment of children with newly diagnosed highgrade astrocytoma. Highdose chemotherapy with stem cell transplant Highdose chemotherapy with stem cell transplant is a way of giving high doses of chemotherapy and replacing blood forming cells destroyed by the cancer treatment. Stem cells (immature blood cells) are removed from the blood or bone marrow of the patient or a donor and are frozen and stored. After the chemotherapy is completed, the stored stem cells are thawed and given back to the patient through an infusion. These reinfused stem cells grow into (and restore) the body's blood cells. For highgrade astrocytoma that has come back after treatment, highdose chemotherapy with stem cell transplant is used if there is only a small amount of tumor. Targeted therapy Targeted therapy is a type of treatment that uses drugs or other substances to identify and attack specific cancer cells without harming normal cells. There are different types of targeted therapy: Monoclonal antibody therapy uses antibodies made in the laboratory, from a single type of immune system cell, to stop cancer cells. These antibodies can identify substances on cancer cells or normal substances that may help cancer cells grow. The antibodies attach to the substances and kill the cancer cells, block their growth, or keep them from spreading. Monoclonal antibodies are given by infusion into a vein. They may be used alone or to carry drugs, toxins, or radioactive material directly to cancer cells. There are different types of monoclonal antibody therapy: Vascular endothelial growth factor (VEGF) inhibitor therapy: Cancer cells make a substance called VEGF, which causes new blood vessels to form (angiogenesis) and helps the cancer grow. VEGF inhibitors block VEGF and stop new blood vessels from forming. This may kill cancer cells because they need new blood vessels to grow. Bevacizumab is a VEGF inhibitor and angiogenesis inhibitor being used to treat childhood astrocytoma. Immune checkpoint inhibitor therapy: PD1 is a protein on the surface of T cells that helps keep the bodys immune responses in check. When PD1 attaches to another protein called PDL1 on a cancer cell, it stops the T cell from killing the cancer cell. PD1 inhibitors attach to PDL1 and allow the T cells to kill cancer cells. PD1 inhibitors are being studied to treat highgrade astrocytoma that has recurred. Protein kinase inhibitors work in different ways. There are several kinds of protein kinase inhibitors. mTOR inhibitors stop cells from dividing and may prevent the growth of new blood vessels that tumors need to grow. Everolimus and sirolimus are mTOR inhibitors used to treat childhood subependymal giant cell astrocytomas. mTOR inhibitors also are being studied to treat lowgrade astrocytoma that has recurred. BRAF inhibitors block proteins needed for cell growth and may kill cancer cells. The BRAF inhibitor dabrafenib is being studied to treat lowgrade astrocytoma that has recurred. Vemurafenib and dabrafenib have been used to treat highgrade astrocytomas that have recurred but more study is needed to know how well they work in children. MEK inhibitors block proteins needed for cell growth and may kill cancer cells. MEK inhibitors such as selumetinib are being studied to treat lowgrade astrocytoma that has recurred. See Drugs Approved for Brain Tumors for more information. New types of treatment are being tested in clinical trials. This summary section describes treatments that are being studied in clinical trials. It may not mention every new treatment being studied. Information about clinical trials is available from the NCI website. Other drug therapy Lenalidomide is a type of angiogenesis inhibitor. It prevents the growth of new blood vessels that are needed by a tumor to grow. If fluid builds up around the brain and spinal cord, a cerebrospinal fluid diversion procedure may be done. Cerebrospinal fluid diversion is a method used to drain fluid that has built up around the brain and spinal cord. A shunt (long, thin tube) is placed in a ventricle (fluidfilled space) of the brain and threaded under the skin to another part of the body, usually the abdomen. The shunt carries extra fluid away from the brain so it may be absorbed elsewhere in the body. Patients may want to think about taking part in a clinical trial. For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment. Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment. Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward. Patients can enter clinical trials before, during, or after starting their cancer treatment. Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring (coming back) or reduce the side effects of cancer treatment. Clinical trials are taking place in many parts of the country. See the Treatment Options section that follows for links to current treatment clinical trials. These have been retrieved from NCI's listing of clinical trials. Followup tests may be needed. Some of the tests that were done to diagnose the cancer or to find out the stage of the cancer may be repeated. (See the General Information section for a list of tests.) Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests. Regular MRIs will continue to be done after treatment has ended. The results of the MRI can show if your child's condition has changed or if the astrocytoma has recurred (come back). If the results of the MRI show a mass in the brain, a biopsy may be done to find out if it is made up of dead tumor cells or if new cancer cells are growing. Treatment Options for Childhood Astrocytomas Newly Diagnosed Childhood LowGrade Astrocytomas When the tumor is first diagnosed, treatment for childhood lowgrade astrocytoma depends on where the tumor is, and is usually surgery. An MRI is done after surgery to see if there is tumor remaining. If the tumor was completely removed by surgery, more treatment may not be needed and the child is closely watched to see if signs or symptoms appear or change. This is called observation. If there is tumor remaining after surgery, treatment may include the following: Observation. A second surgery to remove the tumor. Radiation therapy, which may include conformal radiation therapy, intensitymodulated radiation therapy, proton beam radiation therapy, or stereotactic radiation therapy, when the tumor begins to grow again. Combination chemotherapy with or without radiation therapy. In some cases, observation is used for children who have a visual pathway glioma. In other cases, treatment may include surgery to remove the tumor, radiation therapy, or chemotherapy. A goal of treatment is to save as much vision as possible. The effect of tumor growth on the child's vision will be closely followed during treatment. Children with neurofibromatosis type 1 (NF1) may not need treatment unless the tumor grows or signs or symptoms, such as vision problems, appear. When the tumor grows or signs or symptoms appear, treatment may include surgery to remove the tumor, radiation therapy, and/or chemotherapy. Children with tuberous sclerosis may develop benign (not cancer) tumors in the brain called subependymal giant cell astrocytomas (SEGAs). Targeted therapy with everolimus or sirolimus may be used instead of surgery, to shrink the tumors. Check the list of NCIsupported cancer clinical trials that are now accepting patients with childhood lowgrade untreated astrocytoma or other tumor of glial origin. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your child's doctor about clinical trials that may be right for your child. General information about clinical trials is available from the NCI website. Recurrent Childhood LowGrade Astrocytomas When lowgrade astrocytoma recurs after treatment, it usually comes back where the tumor first formed. Before more cancer treatment is given, imaging tests, biopsy, or surgery are done to find out if there is cancer and how much there is. Treatment of recurrent childhood lowgrade astrocytoma may include the following: A second surgery to remove the tumor, if surgery was the only treatment given when the tumor was first diagnosed. Radiation therapy to the tumor only, if radiation therapy was not used when the tumor was first diagnosed. Conformal radiation therapy may be given. Chemotherapy, if the tumor recurred where it cannot be removed by surgery or the patient had radiation therapy when the tumor was first diagnosed. Targeted therapy with a monoclonal antibody (bevacizumab) with or without chemotherapy. A clinical trial of targeted therapy with a BRAF inhibitor (dabrafenib), an mTOR inhibitor (everolimus), or a MEK inhibitor (selumetinib). A clinical trial of lenalidomide. Check the list of NCIsupported cancer clinical trials that are now accepting patients with recurrent childhood astrocytoma or other tumor of glial origin. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your child's doctor about clinical trials that may be right for your child. General information about clinical trials is available from the NCI website. Newly Diagnosed Childhood HighGrade Astrocytomas Treatment of childhood highgrade astrocytoma may include the following: Surgery to remove the tumor, followed by chemotherapy and/or radiation therapy. A clinical trial of a new treatment. Check the list of NCIsupported cancer clinical trials that are now accepting patients with childhood highgrade untreated astrocytoma or other tumor of glial origin. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your child's doctor about clinical trials that may be right for your child. General information about clinical trials is available from the NCI website. Recurrent Childhood HighGrade Astrocytomas When highgrade astrocytoma recurs after treatment, it usually comes back where the tumor first formed. Before more cancer treatment is given, imaging tests, biopsy, or surgery are done to find out if there is cancer and how much there is. Treatment of recurrent childhood highgrade astrocytoma may include the following: Surgery to remove the tumor. Highdose chemotherapy with stem cell transplant. Targeted therapy with a BRAF inhibitor (vemurafenib or dabrafenib). A clinical trial of targeted therapy with an immune checkpoint inhibitor. A clinical trial of a new treatment. Check the list of NCIsupported cancer clinical trials that are now accepting patients with recurrent childhood astrocytoma or other tumor of glial origin. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your child's doctor about clinical trials that may be right for your child. General information about clinical trials is available from the NCI website.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What is (are) Ovarian, Fallopian Tube, and Primary Peritoneal Cancer ? [/INST] Ovarian, fallopian tube, and primary peritoneal cancers are diseases in which malignant (cancer) cells form in the ovaries, fallopian tubes, or peritoneum. Ovarian cancer is the leading cause of death from cancer of the female reproductive system. Ovarian, fallopian tube, and primary peritoneal cancers are diseases in which malignant (cancer) cells form in the ovaries, fallopian tubes, or peritoneum. The ovaries are a pair of organs in the female reproductive system. They are in the pelvis, one on each side of the uterus (the hollow, pearshaped organ where a fetus grows). Each ovary is about the size and shape of an almond. The ovaries make eggs and female hormones (chemicals that control the way certain cells or organs work in the body). The fallopian tubes are a pair of long, slender tubes, one on each side of the uterus. Eggs pass from the ovaries, through the fallopian tubes, to the uterus. Cancer sometimes begins at the end of the fallopian tube near the ovary and spreads to the ovary. The peritoneum is the tissue that lines the abdominal wall and covers organs in the abdomen. Primary peritoneal cancer is cancer that forms in the peritoneum and has not spread there from another part of the body. Cancer sometimes begins in the peritoneum and spreads to the ovary. Ovarian cancer is the leading cause of death from cancer of the female reproductive system. In recent years, there has been a small decrease in the number of new cases of ovarian cancer and the number of deaths from ovarian cancer. New cases of ovarian cancer and deaths from ovarian cancer are higher among white women than black women, but have decreased in both groups. Women who have a family history of ovarian cancer and/or certain inherited gene changes, such as BRCA1 or BRCA2 gene changes, have a higher risk than women who do not have a family history or who have not inherited these gene changes. For women with inherited risk, genetic counseling and genetic testing can be used to find out more about how likely they are to develop ovarian cancer. It is hard to find ovarian cancer early. Early ovarian cancer may not cause any symptoms. When symptoms do appear, ovarian cancer is often advanced. See the following PDQ summaries for more information about ovarian, fallopian tube, and primary peritoneal cancers: Genetics of Breast and Gynecologic Cancers (written for health professionals) Ovarian, Fallopian Tube, and Primary Peritoneal Cancer Screening Ovarian Epithelial, Fallopian Tube, and Primary Peritoneal Cancer Treatment</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>How to prevent Ovarian, Fallopian Tube, and Primary Peritoneal Cancer ? [/INST] Avoiding risk factors and increasing protective factors may help prevent cancer. The following are risk factors for ovarian, fallopian tube, and primary peritoneal cancer: Family history of ovarian, fallopian tube, and primary peritoneal cancer Inherited risk Hormone replacement therapy Weight and height The following are protective factors for ovarian, fallopian tube, and primary peritoneal cancer: Oral contraceptives Tubal ligation Breastfeeding Riskreducing salpingooophorectomy It is not clear whether the following affect the risk of ovarian, fallopian tube, and primary peritoneal cancer: Diet Alcohol Aspirin and nonsteroidal antiinflammatory drugs Smoking Talc Infertility treatment Cancer prevention clinical trials are used to study ways to prevent cancer. New ways to prevent ovarian, fallopian tube, and primary peritoneal cancer are being studied in clinical trials. Avoiding risk factors and increasing protective factors may help prevent cancer. Avoiding cancer risk factors may help prevent certain cancers. Risk factors include smoking, being overweight, and not getting enough exercise. Increasing protective factors such as quitting smoking and exercising may also help prevent some cancers. Talk to your doctor or other health care professional about how you might lower your risk of cancer. The following are risk factors for ovarian, fallopian tube, and primary peritoneal cancer: Family history of ovarian, fallopian tube, and primary peritoneal cancer A woman whose mother or sister had ovarian cancer has an increased risk of ovarian cancer. A woman with two or more relatives with ovarian cancer also has an increased risk of ovarian cancer. Inherited risk The risk of ovarian cancer is increased in women who have inherited certain changes in the BRCA1, BRCA2, or other genes. The risk of ovarian cancer is also increased in women who have certain inherited syndromes that include: Familial sitespecific ovarian cancer syndrome. Familial breast/ovarian cancer syndrome. Hereditary nonpolyposis colorectal cancer (HNPCC; Lynch syndrome). Hormone replacement therapy The use of estrogen only hormone replacement therapy (HRT) after menopause is linked to a slightly increased risk of ovarian cancer in women who are taking HRT or have taken HRT within the past 3 years. The risk of ovarian cancer increases the longer a woman uses estrogenonly HRT. When hormone therapy is stopped, the risk of ovarian cancer decreases over time. It is not clear whether there is an increased risk of ovarian cancer with the use of HRT that has both estrogen and progestin. Weight and height Being overweight or obese during the teenage years is linked to an increased risk of ovarian cancer. Being obese is linked to an increased risk of death from ovarian cancer. Being tall (5'8" or taller) may also be linked to a slight increase in the risk of ovarian cancer. The following are protective factors for ovarian, fallopian tube, and primary peritoneal cancer: Oral contraceptives Taking oral contraceptives (the pill) lowers the risk of ovarian cancer. The longer oral contraceptives are used, the lower the risk may be. The decrease in risk may last up to 30 years after a woman has stopped taking oral contraceptives. Taking oral contraceptives increases the risk of blood clots. This risk is higher in women who also smoke. Tubal ligation The risk of ovarian cancer is decreased in women who have a tubal ligation (surgery to close both fallopian tubes). Breastfeeding Breastfeeding is linked to a decreased risk of ovarian cancer. The longer a woman breastfeeds, the lower her risk of ovarian cancer. Riskreducing salpingooophorectomy Some women who have a high risk of ovarian cancer may choose to have a riskreducing salpingooophorectomy (surgery to remove the fallopian tubes and ovaries when there are no signs of cancer). This includes women who have inherited certain changes in the BRCA1 and BRCA2 genes or have an inherited syndrome. (See the Riskreducing salpingooophorectomy section in the PDQ health professional summary on Genetics of Breast and Gynecologic Cancers for more information.) It is very important to have a cancer risk assessment and counseling before making this decision. These and other factors may be discussed: Infertility. Early menopause: The drop in estrogen levels caused by removing the ovaries can cause early menopause. Symptoms of menopause include the following: Hot flashes. Night sweats. Trouble sleeping. Mood changes. Decreased sex drive. Heart disease. Vaginal dryness. Frequent urination. Osteoporosis (decreased bone density). These symptoms may not be the same in all women. Hormone replacement therapy (HRT) may be used to lessen these symptoms. Risk of ovarian cancer in the peritoneum: Women who have had a riskreducing salpingooophorectomy continue to have a small risk of ovarian cancer in the peritoneum (thin layer of tissue that lines the inside of the abdomen). This may occur if ovarian cancer cells had already spread to the peritoneum before the surgery or if some ovarian tissue remains after surgery. It is not clear whether the following affect the risk of ovarian, fallopian tube, and primary peritoneal cancer: Diet Studies of dietary factors including various foods, teas, and nutrients have not found a strong link to ovarian cancer. Alcohol Studies have not shown a link between drinking alcohol and the risk of ovarian cancer. Aspirin and nonsteroidal antiinflammatory drugs Some studies of aspirin and nonsteroidal antiinflammatory drugs (NSAIDs) have found a decreased risk of ovarian cancer and others have not. Smoking Some studies found a very small increased risk of one rare type of ovarian cancer in women who were current smokers compared with women who never smoked. Talc Studies of women who used talcum powder (talc) dusted on the perineum (the area between the vagina and the anus) have not found clear evidence of an increased risk of ovarian cancer. Infertility treatment Overall, studies in women using fertility drugs have not found clear evidence of an increased risk of ovarian cancer. Risk of ovarian borderline malignant tumors may be higher in women who take fertility drugs. The risk of invasive ovarian cancer may be higher in women who do not get pregnant after taking fertility drugs. Cancer prevention clinical trials are used to study ways to prevent cancer. Cancer prevention clinical trials are used to study ways to lower the risk of developing certain types of cancer. Some cancer prevention trials are conducted with healthy people who have not had cancer but who have an increased risk for cancer. Other prevention trials are conducted with people who have had cancer and are trying to prevent another cancer of the same type or to lower their chance of developing a new type of cancer. Other trials are done with healthy volunteers who are not known to have any risk factors for cancer. The purpose of some cancer prevention clinical trials is to find out whether actions people take can prevent cancer. These may include eating fruits and vegetables, exercising, quitting smoking, or taking certain medicines, vitamins, minerals, or food supplements. New ways to prevent ovarian, fallopian tube, and primary peritoneal cancer are being studied in clinical trials. Clinical trials are taking place in many parts of the country. Information about clinical trials can be found in the Clinical Trials section of the NCI website. Check NCI's list of cancer clinical trials for ovarian cancer prevention trials that are now accepting patients.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>Who is at risk for Ovarian, Fallopian Tube, and Primary Peritoneal Cancer? ? [/INST] Avoiding risk factors and increasing protective factors may help prevent cancer. The following are risk factors for ovarian, fallopian tube, and primary peritoneal cancer: Family history of ovarian, fallopian tube, and primary peritoneal cancer Inherited risk Hormone replacement therapy Weight and height The following are protective factors for ovarian, fallopian tube, and primary peritoneal cancer: Oral contraceptives Tubal ligation Breastfeeding Riskreducing salpingooophorectomy It is not clear whether the following affect the risk of ovarian, fallopian tube, and primary peritoneal cancer: Diet Alcohol Aspirin and nonsteroidal antiinflammatory drugs Smoking Talc Infertility treatment Cancer prevention clinical trials are used to study ways to prevent cancer. New ways to prevent ovarian, fallopian tube, and primary peritoneal cancer are being studied in clinical trials. Avoiding risk factors and increasing protective factors may help prevent cancer. Avoiding cancer risk factors may help prevent certain cancers. Risk factors include smoking, being overweight, and not getting enough exercise. Increasing protective factors such as quitting smoking and exercising may also help prevent some cancers. Talk to your doctor or other health care professional about how you might lower your risk of cancer. The following are risk factors for ovarian, fallopian tube, and primary peritoneal cancer: Family history of ovarian, fallopian tube, and primary peritoneal cancer A woman whose mother or sister had ovarian cancer has an increased risk of ovarian cancer. A woman with two or more relatives with ovarian cancer also has an increased risk of ovarian cancer. Inherited risk The risk of ovarian cancer is increased in women who have inherited certain changes in the BRCA1, BRCA2, or other genes. The risk of ovarian cancer is also increased in women who have certain inherited syndromes that include: Familial sitespecific ovarian cancer syndrome. Familial breast/ovarian cancer syndrome. Hereditary nonpolyposis colorectal cancer (HNPCC; Lynch syndrome). Hormone replacement therapy The use of estrogen only hormone replacement therapy (HRT) after menopause is linked to a slightly increased risk of ovarian cancer in women who are taking HRT or have taken HRT within the past 3 years. The risk of ovarian cancer increases the longer a woman uses estrogenonly HRT. When hormone therapy is stopped, the risk of ovarian cancer decreases over time. It is not clear whether there is an increased risk of ovarian cancer with the use of HRT that has both estrogen and progestin. Weight and height Being overweight or obese during the teenage years is linked to an increased risk of ovarian cancer. Being obese is linked to an increased risk of death from ovarian cancer. Being tall (5'8" or taller) may also be linked to a slight increase in the risk of ovarian cancer. It is not clear whether the following affect the risk of ovarian, fallopian tube, and primary peritoneal cancer: Diet Studies of dietary factors including various foods, teas, and nutrients have not found a strong link to ovarian cancer. Alcohol Studies have not shown a link between drinking alcohol and the risk of ovarian cancer. Aspirin and nonsteroidal antiinflammatory drugs Some studies of aspirin and nonsteroidal antiinflammatory drugs (NSAIDs) have found a decreased risk of ovarian cancer and others have not. Smoking Some studies found a very small increased risk of one rare type of ovarian cancer in women who were current smokers compared with women who never smoked. Talc Studies of women who used talcum powder (talc) dusted on the perineum (the area between the vagina and the anus) have not found clear evidence of an increased risk of ovarian cancer. Infertility treatment Overall, studies in women using fertility drugs have not found clear evidence of an increased risk of ovarian cancer. Risk of ovarian borderline malignant tumors may be higher in women who take fertility drugs. The risk of invasive ovarian cancer may be higher in women who do not get pregnant after taking fertility drugs.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>what research (or clinical trials) is being done for Ovarian, Fallopian Tube, and Primary Peritoneal Cancer ? [/INST] Cancer prevention clinical trials are used to study ways to prevent cancer. Cancer prevention clinical trials are used to study ways to lower the risk of developing certain types of cancer. Some cancer prevention trials are conducted with healthy people who have not had cancer but who have an increased risk for cancer. Other prevention trials are conducted with people who have had cancer and are trying to prevent another cancer of the same type or to lower their chance of developing a new type of cancer. Other trials are done with healthy volunteers who are not known to have any risk factors for cancer. The purpose of some cancer prevention clinical trials is to find out whether actions people take can prevent cancer. These may include eating fruits and vegetables, exercising, quitting smoking, or taking certain medicines, vitamins, minerals, or food supplements. New ways to prevent ovarian, fallopian tube, and primary peritoneal cancer are being studied in clinical trials. Clinical trials are taking place in many parts of the country. Information about clinical trials can be found in the Clinical Trials section of the NCI website. Check NCI's list of cancer clinical trials for ovarian cancer prevention trials that are now accepting patients.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What is (are) Adult Hodgkin Lymphoma ? [/INST] Adult Hodgkin lymphoma is a disease in which malignant (cancer) cells form in the lymph system. There are two main types of Hodgkin lymphoma: classical and nodular lymphocytepredominant. Age, gender, and EpsteinBarr infection can affect the risk of adult Hodgkin lymphoma. Signs of adult Hodgkin lymphoma include swollen lymph nodes, fever, night sweats, and weight loss. Tests that examine the lymph nodes are used to detect (find) and diagnose adult Hodgkin lymphoma. Certain factors affect prognosis (chance of recovery) and treatment options. Adult Hodgkin lymphoma is a disease in which malignant (cancer) cells form in the lymph system. Adult Hodgkin lymphoma is a type of cancer that develops in the lymph system, part of the body's immune system. The immune system protects the body from foreign substances, infection, and diseases. The lymph system is made up of the following: Lymph: Colorless, watery fluid that carries white blood cells called lymphocytes through the lymph system. Lymphocytes protect the body against infections and the growth of tumors. Lymph vessels: A network of thin tubes that collect lymph from different parts of the body and return it to the bloodstream. Lymph nodes: Small, beanshaped structures that filter lymph and store white blood cells that help fight infection and disease. Lymph nodes are located along the network of lymph vessels found throughout the body. Clusters of lymph nodes are found in the neck, underarm, abdomen, pelvis, and groin. Spleen: An organ that makes lymphocytes, filters the blood, stores blood cells, and destroys old blood cells. It is located on the left side of the abdomen near the stomach. Thymus: An organ in which lymphocytes grow and multiply. The thymus is in the chest behind the breastbone. Tonsils: Two small masses of lymph tissue at the back of the throat. The tonsils make lymphocytes. Bone marrow: The soft, spongy tissue in the center of large bones. Bone marrow makes white blood cells, red blood cells, and platelets. Lymph tissue is also found in other parts of the body such as the stomach, thyroid gland, brain, and skin. Cancer can spread to the liver and lungs. Lymphomas are divided into two general types: Hodgkin lymphoma and nonHodgkin lymphoma. This summary is about the treatment of adult Hodgkin lymphoma. (See the PDQ summary on Adult NonHodgkin Lymphoma Treatment for more information.) Hodgkin lymphoma can occur in both adults and children. Treatment for adults is different than treatment for children. Hodgkin lymphoma may also occur in patients who have acquired immunodeficiency syndrome (AIDS); these patients require special treatment. See the following PDQ summaries for more information: Childhood Hodgkin Lymphoma Treatment AIDSRelated Lymphoma Treatment Hodgkin lymphoma in pregnant women is the same as the disease in nonpregnant women of childbearing age. However, treatment is different for pregnant women. This summary includes information about treating Hodgkin lymphoma during pregnancy. There are two main types of Hodgkin lymphoma: classical and nodular lymphocytepredominant. Most Hodgkin lymphomas are the classical type. The classical type is broken down into the following four subtypes: Nodular sclerosing Hodgkin lymphoma. Mixed cellularity Hodgkin lymphoma. Lymphocyte depletion Hodgkin lymphoma. Lymphocyterich classical Hodgkin lymphoma.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>Who is at risk for Adult Hodgkin Lymphoma? ? [/INST] Age, gender, and EpsteinBarr infection can affect the risk of adult Hodgkin lymphoma. Anything that increases your risk of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesn't mean that you will not get cancer. Talk with your doctor if you think you may be at risk. Risk factors for adult Hodgkin lymphoma include the following: Being in young or late adulthood. Being male. Being infected with the EpsteinBarr virus. Having a firstdegree relative (parent, brother, or sister) with Hodgkin lymphoma. Pregnancy is not a risk factor for Hodgkin lymphoma.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What are the symptoms of Adult Hodgkin Lymphoma ? [/INST] Signs of adult Hodgkin lymphoma include swollen lymph nodes, fever, night sweats, and weight loss. These and other signs and symptoms may be caused by adult Hodgkin lymphoma or by other conditions. Check with your doctor if any of the following do not go away: Painless, swollen lymph nodes in the neck, underarm, or groin. Fever for no known reason. Drenching night sweats. Weight loss for no known reason. Itchy skin. Feeling very tired.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>How to diagnose Adult Hodgkin Lymphoma ? [/INST] Tests that examine the lymph nodes are used to detect (find) and diagnose adult Hodgkin lymphoma. The following tests and procedures may be used: Physical exam and history : An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient's past illnesses and treatments will also be taken. Complete blood count (CBC): A procedure in which a sample of blood is drawn and checked for the following: The number of red blood cells, white blood cells, and platelets. The amount of hemoglobin (the protein that carries oxygen) in the red blood cells. The portion of the sample made up of red blood cells. Blood chemistry studies : A procedure in which a blood sample is checked to measure the amounts of certain substances released into the blood by organs and tissues in the body. An unusual (higher or lower than normal) amount of a substance can be a sign of disease. Sedimentation rate : A procedure in which a sample of blood is drawn and checked for the rate at which the red blood cells settle to the bottom of the test tube. The sedimentation rate is a measure of how much inflammation is in the body. A higher than normal sedimentation rate may be a sign of lymphoma or another condition. Also called erythrocyte sedimentation rate, sed rate, or ESR. Lymph node biopsy : The removal of all or part of a lymph node. One of the following types of biopsies may be done: Excisional biopsy : The removal of an entire lymph node. Incisional biopsy : The removal of part of a lymph node. Core biopsy : The removal of part of a lymph node using a wide needle. A pathologist views the tissue under a microscope to look for cancer cells, especially ReedSternberg cells. ReedSternberg cells are common in classical Hodgkin lymphoma. The following test may be done on tissue that was removed: Immunophenotyping : A laboratory test used to identify cells, based on the types of antigens or markers on the surface of the cell. This test is used to diagnose the specific type of lymphoma by comparing the cancer cells to normal cells of the immune system.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What is the outlook for Adult Hodgkin Lymphoma ? [/INST] Certain factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery) and treatment options depend on the following: The patient's signs and symptoms. The stage of the cancer. The type of Hodgkin lymphoma. Blood test results. The patient's age, gender, and general health. Whether the cancer is recurrent or progressive. For Hodgkin lymphoma during pregnancy, treatment options also depend on: The wishes of the patient. The age of the fetus. Adult Hodgkin lymphoma can usually be cured if found and treated early.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>what research (or clinical trials) is being done for Adult Hodgkin Lymphoma ? [/INST] New types of treatment are being tested in clinical trials. This summary section describes treatments that are being studied in clinical trials. It may not mention every new treatment being studied. Information about clinical trials is available from the NCI website. Chemotherapy and radiation therapy with stem cell transplant Highdose chemotherapy and radiation therapy with stem cell transplant is a way of giving high doses of chemotherapy and radiation therapy and replacing blood forming cells destroyed by the cancer treatment. Stem cells (immature blood cells) are removed from the blood or bone marrow of the patient or a donor and are frozen and stored. After therapy is completed, the stored stem cells are thawed and given back to the patient through an infusion. These reinfused stem cells grow into (and restore) the body's blood cells. The use of lowerdose chemotherapy and radiation therapy with stem cell transplant is also being studied. Monoclonal antibody therapy Monoclonal antibody therapy is a cancer treatment that uses antibodies made in the laboratory, from a single type of immune system cell. These antibodies can identify substances on cancer cells or normal substances that may help cancer cells grow. The antibodies attach to the substances and kill the cancer cells, block their growth, or keep them from spreading. Monoclonal antibodies are given by infusion. They may be used alone or to carry drugs, toxins, or radioactive material directly to cancer cells. Patients may want to think about taking part in a clinical trial. For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment. Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment. Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward. Patients can enter clinical trials before, during, or after starting their cancer treatment. Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring (coming back) or reduce the side effects of cancer treatment. Clinical trials are taking place in many parts of the country. See the Treatment Options section that follows for links to current treatment clinical trials. These have been retrieved from NCI's listing of clinical trials.</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What are the stages of Adult Hodgkin Lymphoma ? [/INST] After adult Hodgkin lymphoma has been diagnosed, tests are done to find out if cancer cells have spread within the lymph system or to other parts of the body. There are three ways that cancer spreads in the body. Stages of adult Hodgkin lymphoma may include A, B, E, and S. The following stages are used for adult Hodgkin lymphoma: Stage I Stage II Stage III Stage IV Adult Hodgkin lymphoma may be grouped for treatment as follows: Early Favorable Early Unfavorable Advanced After adult Hodgkin lymphoma has been diagnosed, tests are done to find out if cancer cells have spread within the lymph system or to other parts of the body. The process used to find out if cancer has spread within the lymph system or to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment. The following tests and procedures may be used in the staging process: CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an xray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography. For adult Hodgkin lymphoma, CT scans of the neck, chest, abdomen, and pelvis are taken. PETCT scan : A procedure that combines the pictures from a positron emission tomography (PET) scan and a computed tomography (CT) scan. The PET and CT scans are done at the same time on the same machine. The pictures from both scans are combined to make a more detailed picture than either test would make by itself. A PET scan is a procedure to find malignant tumor cells in the body. A small amount of radioactive glucose (sugar) is injected into a vein. The PET scanner rotates around the body and makes a picture of where glucose is being used in the body. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do. Bone marrow aspiration and biopsy : The removal of bone marrow, blood, and a small piece of bone by inserting a hollow needle into the hipbone or breastbone. A pathologist views the bone marrow, blood, and bone under a microscope to look for signs of cancer. For pregnant women with Hodgkin lymphoma, staging tests that protect the fetus from the harms of radiation are used. These include: MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI). Ultrasound exam: A procedure in which highenergy sound waves (ultrasound) are bounced off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram. There are three ways that cancer spreads in the body. Cancer can spread through tissue, the lymph system, and the blood: Tissue. The cancer spreads from where it began by growing into nearby areas. Lymph system. The cancer spreads from where it began by getting into the lymph system. The cancer travels through the lymph vessels to other parts of the body. Blood. The cancer spreads from where it began by getting into the blood. The cancer travels through the blood vessels to other parts of the body. Stages of adult Hodgkin lymphoma may include A, B, E, and S. Adult Hodgkin lymphoma may be described as follows: A: The patient does not have B symptoms (fever, weight loss, or night sweats). B: The patient has B symptoms. E: Cancer is found in an organ or tissue that is not part of the lymph system but which may be next to an involved area of the lymph system. S: Cancer is found in the spleen. The following stages are used for adult Hodgkin lymphoma: Stage I Stage I is divided into stage I and stage IE. Stage I: Cancer is found in one of the following places in the lymph system: One or more lymph nodes in one lymph node group. Waldeyer's ring. Thymus. Spleen. Stage IE: Cancer is found outside the lymph system in one organ or area. Stage II Stage II is divided into stage II and stage IIE. Stage II: Cancer is found in two or more lymph node groups either above or below the diaphragm (the thin muscle below the lungs that helps breathing and separates the chest from the abdomen). Stage IIE: Cancer is found in one or more lymph node groups either above or below the diaphragm and outside the lymph nodes in a nearby organ or area. Stage III Stage III is divided into stage III, stage IIIE, stage IIIS, and stage IIIE,S. Stage III: Cancer is found in lymph node groups above and below the diaphragm (the thin muscle below the lungs that helps breathing and separates the chest from the abdomen). Stage IIIE: Cancer is found in lymph node groups above and below the diaphragm and outside the lymph nodes in a nearby organ or area. Stage IIIS: Cancer is found in lymph node groups above and below the diaphragm, and in the spleen. Stage IIIE,S: Cancer is found in lymph node groups above and below the diaphragm, outside the lymph nodes in a nearby organ or area, and in the spleen. Stage IV In stage IV, the cancer: is found outside the lymph nodes throughout one or more organs, and may be in lymph nodes near those organs; or is found outside the lymph nodes in one organ and has spread to areas far away from that organ; or is found in the lung, liver, bone marrow, or cerebrospinal fluid (CSF). The cancer has not spread to the lung, liver, bone marrow, or CSF from nearby areas. Adult Hodgkin lymphoma may be grouped for treatment as follows: Early Favorable Early favorable adult Hodgkin lymphoma is stage I or stage II, without risk factors. Early Unfavorable Early unfavorable adult Hodgkin lymphoma is stage I or stage II with one or more of the following risk factors: A tumor in the chest that is larger than 1/3 of the width of the chest or at least 10 centimeters. Cancer in an organ other than the lymph nodes. A high sedimentation rate (in a sample of blood, the red blood cells settle to the bottom of the test tube more quickly than normal). Three or more lymph nodes with cancer. Symptoms such as fever, weight loss, or night sweats. Advanced Advanced Hodgkin lymphoma includes some or all of the following risk factors: Being male. Being aged 45 years or older. Having stage IV disease. Having a low blood albumin (protein) level (below 4). Having a low hemoglobin level (below 10.5). Having a high white blood cell count (15,000 or higher). Having a low lymphocyte count (below 600 or less than 8% of the white blood cell count).</s>

<s>[INST] <<SYS>>You are MediTalk, a Cool Medical Assitant Voice Bot. You helps the people by answering their medical related questions in many language. Don't answer the question which are not medical related and Don't make up the answer if you don't know. Make sure the answer is in four to five sentences<</SYS>>What are the treatments for Adult Hodgkin Lymphoma ? [/INST] There are different types of treatment for patients with adult Hodgkin lymphoma. Patients with Hodgkin lymphoma should have their treatment planned by a team of health care providers with expertise in treating lymphomas. Patients may develop late effects that appear months or years after their treatment for Hodgkin lymphoma. Three types of standard treatment are used: Chemotherapy Radiation therapy Surgery For pregnant patients with Hodgkin lymphoma, treatment options also include: Watchful waiting Steroid therapy New types of treatment are being tested in clinical trials. Chemotherapy and radiation therapy with stem cell transplant Monoclonal antibody therapy Patients may want to think about taking part in a clinical trial. Patients can enter clinical trials before, during, or after starting their cancer treatment. Followup tests may be needed. There are different types of treatment for patients with adult Hodgkin lymphoma. Different types of treatment are available for patients with adult Hodgkin lymphoma. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment. For pregnant women with Hodgkin lymphoma, treatment is carefully chosen to protect the fetus. Treatment decisions are based on the mothers wishes, the stage of the Hodgkin lymphoma, and the age of the fetus. The treatment plan may change as the signs and symptoms, cancer, and pregnancy change. Choosing the most appropriate cancer treatment is a decision that ideally involves the patient, family, and health care team. Patients with Hodgkin lymphoma should have their treatment planned by a team of health care providers with expertise in treating lymphomas. Treatment will be overseen by a medical oncologist, a doctor who specializes in treating cancer. The medical oncologist may refer you to other health care providers who have experience and expertise in treating adult Hodgkin lymphoma and who specialize in certain areas of medicine. These may include the following specialists: Neurosurgeon. Neurologist. Rehabilitation specialist. Radiation oncologist. Endocrinologist. Hematologist. Other oncology specialists. Patients may develop late effects that appear months or years after their treatment for Hodgkin lymphoma. Treatment with chemotherapy and/or radiation therapy for Hodgkin lymphoma may increase the risk of second cancers and other health problems for many months or years after treatment. These late effects depend on the type of treatment and the patient's age when treated, and may include: Acute myelogenous leukemia. Cancer of the breast, bone, cervix, gastrointestinal tract, head and neck, lung, soft tissue, and thyroid. Heart, lung, and thyroid disease. Avascular necrosis of bone (death of bone cells caused by lack of blood flow). Herpes zoster (shingles) or severe infection. Depression and fatigue. Infertility. Hypogonadism (low levels of testosterone and estrogen). Regular followup by doctors who are expert in finding and treating late effects is important for the longterm health of patients treated for Hodgkin lymphoma. Three types of standard treatment are used: Chemotherapy Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the cerebrospinal fluid, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). The way the chemotherapy is given depends on the type and stage of the cancer being treated. Combination chemotherapy is treatment with more than one anticancer drug. When a pregnant woman is treated with chemotherapy for Hodgkin lymphoma, it isn't possible to protect the fetus from being exposed to the chemotherapy. Some chemotherapy regimens may cause birth defects if given in the first trimester. Vinblastine is an anticancer drug that has not been linked with birth defects when given in the second half of pregnancy. See Drugs Approved for Hodgkin Lymphoma for more information. Radiation therapy Radiation therapy is a cancer treatment that uses highenergy xrays or other types of radiation to kill cancer cells or keep them from growing. There are two types of radiation therapy: External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. The way the radiation therapy is given depends on the type and stage of the cancer being treated. External radiation therapy is used to treat adult Hodgkin lymphoma. For a pregnant woman with Hodgkin lymphoma, radiation therapy should be postponed until after delivery, if possible, to avoid any risk to the fetus. If immediate treatment is needed, the woman may decide to continue the pregnancy and receive radiation therapy. However, lead used to shield the fetus may not protect it from scattered radiation that could possibly cause cancer in the future. Surgery Laparotomy is a procedure in which an incision (cut) is made in the wall of the abdomen to check the inside of the abdomen for signs of disease. The size of the incision depends on the reason the laparotomy is being done. Sometimes organs are removed or tissue samples are taken and checked under a microscope for signs of disease. If cancer is found, the tissue or organ is removed during the laparotomy. For pregnant patients with Hodgkin lymphoma, treatment options also include: Watchful waiting Watchful waiting is closely monitoring a patients condition without giving any treatment unless signs or symptoms appear or change. Delivery may be induced when the fetus is 32 to 36 weeks old, so that the mother can begin treatment. Steroid therapy Steroids are hormones made naturally in the body by the adrenal glands and by reproductive organs. Some types of steroids are made in a laboratory. Certain steroid drugs have been found to help chemotherapy work better and help stop the growth of cancer cells. Steroids can also help the lungs of the fetus develop faster than normal. This is important when delivery is induced early. See Drugs Approved for Hodgkin Lymphoma for more information. New types of treatment are being tested in clinical trials. This summary section describes treatments that are being studied in clinical trials. It may not mention every new treatment being studied. Information about clinical trials is available from the NCI website. Chemotherapy and radiation therapy with stem cell transplant Highdose chemotherapy and radiation therapy with stem cell transplant is a way of giving high doses of chemotherapy and radiation therapy and replacing blood forming cells destroyed by the cancer treatment. Stem cells (immature blood cells) are removed from the blood or bone marrow of the patient or a donor and are frozen and stored. After therapy is completed, the stored stem cells are thawed and given back to the patient through an infusion. These reinfused stem cells grow into (and restore) the body's blood cells. The use of lowerdose chemotherapy and radiation therapy with stem cell transplant is also being studied. Monoclonal antibody therapy Monoclonal antibody therapy is a cancer treatment that uses antibodies made in the laboratory, from a single type of immune system cell. These antibodies can identify substances on cancer cells or normal substances that may help cancer cells grow. The antibodies attach to the substances and kill the cancer cells, block their growth, or keep them from spreading. Monoclonal antibodies are given by infusion. They may be used alone or to carry drugs, toxins, or radioactive material directly to cancer cells. Patients may want to think about taking part in a clinical trial. For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment. Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment. Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward. Patients can enter clinical trials before, during, or after starting their cancer treatment. Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring (coming back) or reduce the side effects of cancer treatment. Clinical trials are taking place in many parts of the country. See the Treatment Options section that follows for links to current treatment clinical trials. These have been retrieved from NCI's listing of clinical trials. Followup tests may be needed. Some of the tests that were done to diagnose the cancer or to find out the stage of the cancer may be repeated. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests. Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your condition has changed or if the cancer has recurred (come back). These tests are sometimes called followup tests or checkups. Treatment Options for Adult Hodgkin Lymphoma Early Favorable Hodgkin Lymphoma Treatment of early favorable Hodgkin lymphoma may include the following: Combination chemotherapy. Combination chemotherapy with radiation therapy to parts of the body with cancer. Radiation therapy alone to areas of the body with cancer or to the mantle field (neck, chest, armpits). Check the list of NCIsupported cancer clinical trials that are now accepting patients with stage I adult Hodgkin lymphoma and stage II adult Hodgkin lymphoma. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the NCI website. Early Unfavorable Hodgkin Lymphoma Treatment of early unfavorable Hodgkin lymphoma may include the following: Combination chemotherapy. Combination chemotherapy with radiation therapy to parts of the body with cancer. Check the list of NCIsupported cancer clinical trials that are now accepting patients with stage I adult Hodgkin lymphoma and stage II adult Hodgkin lymphoma. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the NCI website. Advanced Hodgkin Lymphoma Treatment of advanced Hodgkin lymphoma may include the following: Combination chemotherapy. Check the list of NCIsupported cancer clinical trials that are now accepting patients with stage III adult Hodgkin lymphoma and stage IV adult Hodgkin lymphoma. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the NCI website. Recurrent Adult Hodgkin Lymphoma Treatment of recurrent Hodgkin lymphoma may include the following: Combination chemotherapy. Combination chemotherapy followed by highdose chemotherapy and stem cell transplant with or without radiation therapy. Combination chemotherapy with radiation therapy to parts of the body with cancer in patients older than 60 years. Radiation therapy with or without chemotherapy. Chemotherapy as palliative therapy to relieve symptoms and improve quality of life. A clinical trial of highdose chemotherapy and stem cell transplant. A clinical trial of lowerdose chemotherapy and radiation therapy followed by stem cell transplant. A clinical trial of a monoclonal antibody. A clinical trial of chemotherapy. Check the list of NCIsupported cancer clinical trials that are now accepting patients with recurrent adult Hodgkin lymphoma. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the NCI website. Treatment Options for Hodgkin Lymphoma During Pregnancy Hodgkin Lymphoma During the First Trimester of Pregnancy When Hodgkin lymphoma is diagnosed in the first trimester of pregnancy, it does not necessarily mean that the woman will be advised to end the pregnancy. Each woman's treatment will depend on the stage of the lymphoma, how fast it is growing, and her wishes. For women who choose to continue the pregnancy, treatment of Hodgkin lymphoma during the first trimester of pregnancy may include the following: Watchful waiting when the cancer is above the diaphragm and is slowgrowing. Delivery may be induced when the fetus is 32 to 36 weeks old so the mother can begin treatment. Radiation therapy above the diaphragm. (A lead shield is used to protect the fetus from the radiation as much as possible.) Systemic chemotherapy using one or more drugs. Hodgkin Lymphoma During the Second Half of Pregnancy When Hodgkin lymphoma is diagnosed in the second half of pregnancy, most women can delay treatment until after the baby is born. Treatment of Hodgkin lymphoma during the second half of pregnancy may include the following: Watchful waiting, with plans to induce delivery when the fetus is 32 to 36 weeks old. Systemic chemotherapy using one or more drugs. Steroid therapy. Radiation therapy to relieve breathing problems caused by a large tumor in the chest.</s>