Input: What are the stages of Bile Duct Cancer (Cholangiocarcinoma) ?

Output:
Key Points
                    - The results of diagnostic and staging tests are used to find out if cancer cells have spread.    - There are three ways that cancer spreads in the body.    - Cancer may spread from where it began to other parts of the body.    - Stages are used to describe the different types of bile duct cancer.         - Intrahepatic bile duct cancer     - Perihilar bile duct cancer     - Distal extrahepatic bile duct cancer        - The following groups are used to plan treatment:         - Resectable (localized) bile duct cancer     - Unresectable, metastatic, or recurrent bile duct cancer

                    The results of diagnostic and staging tests are used to find out if cancer cells have spread.
                    The process used to find out if cancer has spread to other parts of the body is called staging. For bile duct cancer, the information gathered from tests and procedures is used to plan treatment, including whether the tumor can be removed by surgery.

                    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 bile duct cancer spreads to the liver, the cancer cells in the liver are actually bile duct cancer cells. The disease is metastatic bile duct cancer, not liver cancer.

                    Stages are used to describe the different types of bile duct cancer.
                    Intrahepatic bile duct cancer            -  Stage 0: Abnormal cells are found in the innermost layer of tissue lining the intrahepatic bile duct. These abnormal cells may become cancer and spread into nearby normal tissue. Stage 0 is also called carcinoma in situ.     -  Stage I: There is one tumor that has spread into the intrahepatic bile duct and it has not spread into any blood vessels.     -  Stage II: There is one tumor that has spread through the wall of the bile duct and into a blood vessel, or there are multiple tumors that may have spread into a blood vessel.      -  Stage III: The tumor has spread through the tissue that lines the abdominal wall or has spread to organs or tissues near the liver such as the duodenum, colon, and stomach.      -  Stage IV: Stage IV is divided into stage IVA and stage IVB.                  - Stage IVA: The cancer has spread along the outside of the intrahepatic bile ducts or the cancer has spread to nearby lymph nodes.       - Stage IVB: The cancer has spread to organs in other parts of the body.                         Perihilar bile duct cancer            -  Stage 0: Abnormal cells are found in the innermost layer of tissue lining the perihilar bile duct. These abnormal cells may become cancer and spread into nearby normal tissue. Stage 0 is also called carcinoma in situ.     -  Stage I: Cancer has formed in the innermost layer of the wall of the perihilar bile duct and has spread into the muscle layer or fibrous tissue layer of the wall.     -  Stage II: Cancer has spread through the wall of the perihilar bile duct to nearby fatty tissue or to the liver.     -  Stage III: Stage III is divided into stage IIIA and stage IIIB.                  - Stage IIIA: Cancer has spread to branches on one side of the hepatic artery or of the portal vein.        - Stage IIIB: Cancer has spread to nearby lymph nodes. Cancer may have spread into the wall of the perihilar bile duct or through the wall to nearby fatty tissue, the liver, or to branches on one side of the hepatic artery or of the portal vein.                -  Stage IV: Stage IV is divided into stage IVA and stage IVB.                   - Stage IVA: Cancer has spread to one or more of the following:                           - the main part of the portal vein and/or common hepatic artery;          - the branches of the portal vein and/or common hepatic artery on both sides;           - the right hepatic duct and the left branch of the hepatic artery or of the portal vein;          - the left hepatic duct and the right branch of the hepatic artery or of the portal vein.                  Cancer may have spread to nearby lymph nodes.       - Stage IVB: Cancer has spread to lymph nodes in more distant parts of the abdomen, or to organs in other parts of the body.                         Distal extrahepatic bile duct cancer            -  Stage 0: Abnormal cells are found in the innermost layer of tissue lining the distal extrahepatic bile duct. These abnormal cells may become cancer and spread into nearby normal tissue. Stage 0 is also called carcinoma in situ.     -  Stage I: Stage I is divided into stage IA and stage IB.                  - Stage IA: Cancer has formed and is found in the distal extrahepatic bile duct wall only.       - Stage IB: Cancer has formed and has spread through the wall of the distal extrahepatic bile duct but has not spread to nearby organs.                -  Stage II: Stage II is divided into stage IIA and stage IIB.                  - Stage IIA: Cancer has spread from the distal extrahepatic bile duct to the gallbladder, pancreas, duodenum, or other nearby organs.       - Stage IIB: Cancer has spread from the distal extrahepatic bile duct to nearby lymph nodes. Cancer may have spread through the wall of the duct or to nearby organs.                -  Stage III: Cancer has spread to the large vessels that carry blood to the organs in the abdomen. Cancer may have spread to nearby lymph nodes.     -  Stage IV:  Cancer has spread to organs in distant parts of the body.

                    The following groups are used to plan treatment:
                    Resectable (localized) bile duct cancer    The cancer is in an area, such as the lower part of the common bile duct or perihilar area, where it can be removed completely by surgery.       Unresectable, metastatic, or recurrent bile duct cancer     Unresectable cancer cannot be removed completely by surgery. Most patients with bile duct cancer cannot have their cancer completely removed by surgery.     Metastasis is the spread of cancer from the primary site (place where it started) to other places in the body. Metastatic bile duct cancer may have spread to the liver, other parts of the abdominal cavity, or to distant parts of the body.      Recurrent bile duct cancer is cancer that has recurred (come back) after it has been treated. The cancer may come back in the bile ducts, liver, or gallbladder. Less often, it may come back in distant parts of the body. </s>


Input: What are the treatments for Bile Duct Cancer (Cholangiocarcinoma) ?

Output:
Key Points
                    - There are different types of treatment for patients with bile duct cancer.    - Three types of standard treatment are used:         - Surgery     - Radiation therapy     - Chemotherapy        - New types of treatment are being tested in clinical trials.         - Liver 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.    - Follow-up tests may be needed.

                    There are different types of treatment for patients with bile duct cancer.
                    Different types of treatments are available for patients with bile duct 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    The following types of surgery are used to treat bile duct cancer:            - Removal of the bile duct: A surgical procedure to remove part of the bile duct if the tumor is small and in the bile duct only. Lymph nodes are removed and tissue from the lymph nodes is viewed under a microscope to see if there is cancer.      -  Partial hepatectomy: A surgical procedure in which the part of the liver where cancer is found is removed. The part removed may be a wedge of tissue, an entire lobe, or a larger part of the liver, along with some normal tissue around it.      -  Whipple procedure: A surgical procedure in which the head of the pancreas, the gallbladder, part of the stomach, part of the small intestine, and the bile duct are removed. Enough of the pancreas is left to make digestive juices and insulin.           Even if the doctor removes all the cancer that can be seen at the time of the operation, 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. It is not yet known whether chemotherapy or radiation therapy given after surgery helps keep the cancer from coming back.    The following types of palliative surgery may be done to relieve symptoms caused by a blocked bile duct and improve quality of life:            -  Biliary bypass: A surgical procedure in which the part of the bile duct before the blockage is connected with part of the bile duct that is past the blockage or to the small intestine. This allows bile to flow to the gallbladder or small intestine.     -  Stent placement: A surgical procedure in which a stent (a thin, flexible tube or metal tube) is placed in the bile duct to open it and allow bile to flow into the small intestine or through a catheter that goes to a collection bag outside of the body.      -  Percutaneous transhepatic biliary drainage: A procedure used to x-ray 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 x-ray is taken. If the bile duct is blocked, a thin, flexible tube called a stent may be left in the liver to drain bile into the small intestine or a collection bag outside the body.              Radiation therapy     Radiation therapy is a cancer treatment that uses high-energy x-rays 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.           External and internal radiation therapy are used to treat bile duct cancer.    It is not yet known whether external radiation therapy helps in the treatment of resectable bile duct cancer. In unresectable, metastatic, or recurrent bile duct cancer, new ways to improve the effect of external radiation therapy on cancer cells are being studied:            -  Hyperthermia therapy: A treatment in which body tissue is exposed to high temperatures to make cancer cells more sensitive to the effects of radiation therapy and certain anticancer drugs.     -  Radiosensitizers: Drugs that make cancer cells more sensitive to radiation therapy. Combining radiation therapy with radiosensitizers may kill more cancer cells.              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).     Systemic chemotherapy is used to treat unresectable, metastatic, or recurrent bile duct cancer. It is not yet known whether systemic chemotherapy helps in the treatment of resectable bile duct cancer.     In unresectable, metastatic, or recurrent bile duct cancer, intra-arterial embolization is being studied. It is a procedure in which the blood supply to a tumor is blocked after anticancer drugs are given in blood vessels near the tumor. Sometimes, the anticancer drugs are attached to small beads that are injected into an artery that feeds the tumor. The beads block blood flow to the tumor as they release the drug. This allows a higher amount of drug to reach the tumor for a longer period of time, which may kill more cancer cells.

                    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.     Liver transplant    In a liver transplant, the entire liver is removed and replaced with a healthy donated liver. A liver transplant may be done in patients with perihilar bile duct cancer. If the patient has to wait for a donated liver, other treatment is given as needed.

                    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.

                    Follow-up 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 follow-up tests or check-ups.

							            Treatment Options for Bile Duct Cancer

							                    Intrahepatic Bile Duct Cancer
							                    Resectable Intrahepatic Bile Duct Cancer    Treatment of resectable intrahepatic bile duct cancer may include:            -  Surgery to remove the cancer, which may include partial hepatectomy. Embolization may be done before surgery.     - Surgery followed by chemotherapy and/or radiation therapy.           Check the list of NCI-supported cancer clinical trials that are now accepting patients with stage I intrahepatic bile duct cancer and stage II intrahepatic bile duct 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 Intrahepatic Bile Duct Cancer    Treatment of unresectable, recurrent, or metastatic intrahepatic bile duct cancer may include the following:            -  Stent placement as palliative treatment to relieve symptoms and improve quality of life.     -  External or internal radiation therapy as palliative treatment to relieve symptoms and improve the quality of life.     -  Chemotherapy.     - A clinical trial of external radiation therapy combined with hyperthermia therapy, radiosensitizer drugs, or chemotherapy.           Check the list of NCI-supported cancer clinical trials that are now accepting patients with stage III intrahepatic bile duct cancer, stage IV intrahepatic bile duct cancer and recurrent intrahepatic bile duct 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.

							                    Perihilar Bile Duct Cancer
							                    Resectable Perihilar Bile Duct Cancer    Treatment of resectable perihilar bile duct cancer may include the following:            -  Surgery to remove the cancer, which may include partial hepatectomy.     -  Stent placement or percutaneous transhepatic biliary drainage as palliative therapy, to relieve jaundice and other symptoms and improve the quality of life.     - Surgery followed by radiation therapy and/or chemotherapy.           Check the list of NCI-supported cancer clinical trials that are now accepting patients with stage I perihilar bile duct cancer and stage II perihilar bile duct 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 Perihilar Bile Duct Cancer    Treatment of unresectable, recurrent, or metastatic perihilar bile duct cancer may include the following:            -  Stent placement or biliary bypass as palliative treatment to relieve symptoms and improve the quality of life.     -  External or internal radiation therapy as palliative treatment to relieve symptoms and improve the quality of life.     -  Chemotherapy.     - A clinical trial of external radiation therapy combined with hyperthermia therapy, radiosensitizer drugs, or chemotherapy.     - A clinical trial of chemotherapy and radiation therapy followed by a liver transplant.           Check the list of NCI-supported cancer clinical trials that are now accepting patients with stage III perihilar bile duct cancer, stage IV perihilar bile duct cancer and recurrent perihilar bile duct 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.

							                    Distal Extrahepatic Bile Duct Cancer
							                    Resectable Distal Extrahepatic Bile Duct Cancer    Treatment of resectable distal extrahepatic bile duct cancer may include the following:            -  Surgery to remove the cancer, which may include a Whipple procedure.     -  Stent placement or percutaneous transhepatic biliary drainage as palliative therapy, to relieve jaundice and other symptoms and improve the quality of life.     - Surgery followed by radiation therapy and/or chemotherapy.           Check the list of NCI-supported cancer clinical trials that are now accepting patients with localized extrahepatic bile duct 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 Distal Extrahepatic Bile Duct Cancer    Treatment of unresectable, recurrent, or metastatic distal extrahepatic bile duct cancer may include the following:            -  Stent placement or biliary bypass as palliative treatment to relieve symptoms and improve the quality of life.     -  External or internal radiation therapy as palliative treatment to relieve symptoms and improve the quality of life.     -  Chemotherapy.     - A clinical trial of external radiation therapy combined with hyperthermia therapy, radiosensitizer drugs, or chemotherapy.           Check the list of NCI-supported cancer clinical trials that are now accepting patients with unresectable extrahepatic bile duct cancer, recurrent extrahepatic bile duct cancer and metastatic extrahepatic bile duct 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>


Input: What is (are) Intraocular (Uveal) Melanoma ?

Output:
Key Points
                    - Intraocular melanoma is a disease in which malignant (cancer) cells form in the tissues of the eye.    - Being older and having fair skin may increase the risk of intraocular melanoma.    - Signs of intraocular melanoma include blurred vision or a dark spot on the iris.     - Tests that examine the eye are used to help detect (find) and diagnose intraocular melanoma.    - A biopsy of the tumor is rarely needed to diagnose intraocular melanoma.    - Certain factors affect prognosis (chance of recovery) and treatment options.

                    Intraocular melanoma is a disease in which malignant (cancer) cells form in the tissues of the eye.
                    Intraocular melanoma begins in the middle of three layers of the wall of the eye. The outer layer includes the white sclera (the "white of the eye") and the clear cornea at the front of the eye. The inner layer has a lining of nerve tissue, called the retina, which senses light and sends images along the optic nerve to the brain.   The middle layer, where intraocular melanoma forms, is called the uvea or uveal tract, and has three main parts:         -  Iris  The iris is the colored area at the front of the eye (the "eye color"). It can be seen through the clear cornea. The pupil is in the center of the iris and it changes size to let more or less light into the eye. Intraocular melanoma of the iris is usually a small tumor that grows slowly and rarely spreads to other parts of the body.    -  Ciliary body  The ciliary body is a ring of tissue with muscle fibers that change the size of the pupil and the shape of the lens. It is found behind the iris. Changes in the shape of the lens help the eye focus. The ciliary body also makes the clear fluid that fills the space between the cornea and the iris. Intraocular melanoma of the ciliary body is often larger and more likely to spread to other parts of the body than intraocular melanoma of the iris.      -  Choroid  The choroid is a layer of blood vessels that bring oxygen and nutrients to the eye. Most intraocular melanomas begin in the choroid. Intraocular melanoma of the choroid is often larger and more likely to spread to other parts of the body than intraocular melanoma of the iris.          Intraocular melanoma is a rare cancer that forms from cells that make melanin in the iris, ciliary body, and choroid. It is the most common eye cancer in adults. </s>


Input: Who is at risk for Intraocular (Uveal) Melanoma? ?

Output: Being older and having fair skin may increase the risk of intraocular melanoma. 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 doctor if you think you may be at risk.    Risk factors for intraocular melanoma include the following:         - 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 light-colored eyes.             - Older age.    - Being white. </s>


Input: What are the symptoms of Intraocular (Uveal) Melanoma ?

Output: Signs of intraocular melanoma include blurred vision or a dark spot on the iris. Intraocular melanoma may not cause early signs or symptoms. It is sometimes found during a regular eye exam when the doctor dilates the pupil and looks into the eye. Signs and symptoms may be caused by intraocular melanoma or by other conditions. Check with your doctor if you have any of the following:         - Blurred vision or other change in vision.    - Floaters (spots that drift in your field of vision) or flashes of light.    - A dark spot on the iris.    - A change in the size or shape of the pupil.    - A change in the position of the eyeball in the eye socket. </s>


Input: How to diagnose Intraocular (Uveal) Melanoma ?

Output:
Tests that examine the eye are used to help detect (find) and diagnose intraocular melanoma.
                    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.    -  Eye exam with dilated pupil: An exam of the eye in which the pupil is dilated (enlarged) with medicated eye drops to allow the doctor to look through the lens and pupil to the retina. The inside of the eye, including the retina and the optic nerve, is checked. Pictures may be taken over time to keep track of changes in the size of the tumor. There are several types of eye exams:               -  Ophthalmoscopy : An exam of the inside of the back of the eye to check the retina and optic nerve using a small magnifying lens and a light.      -  Slit-lamp biomicroscopy : An exam of the inside of the eye to check the retina, optic nerve, and other parts of the eye using a strong beam of light and a microscope.      -  Gonioscopy : An exam of the front part of the eye between the cornea and iris. A special instrument is used to see if the area where fluid drains out of the eye is blocked.             -   Ultrasound exam of the eye: A procedure in which high-energy sound waves (ultrasound) are bounced off the internal tissues of the eye to make echoes. Eye drops are used to numb the eye and a small probe that sends and receives sound waves is placed gently on the surface of the eye. The echoes make a picture of the inside of the eye and the distance from the cornea to the retina is measured. The picture, called a sonogram, shows on the screen of the ultrasound monitor.     -  High-resolution ultrasound biomicroscopy : A procedure in which high-energy sound waves (ultrasound) are bounced off the internal tissues of the eye to make echoes. Eye drops are used to numb the eye and a small probe that sends and receives sound waves is placed gently on the surface of the eye. The echoes make a more detailed picture of the inside of the eye than a regular ultrasound. The tumor is checked for its size, shape, and thickness, and for signs that the tumor has spread to nearby tissue.    -  Transillumination of the globe and iris: An exam of the iris, cornea, lens, and ciliary body with a light placed on either the upper or lower lid.    -  Fluorescein angiography : A procedure to look at blood vessels and the flow of blood inside the eye. An orange fluorescent dye (fluorescein) is injected into a blood vessel in the arm and goes into the bloodstream. As the dye travels through blood vessels of the eye, a special camera takes pictures of the retina and choroid to find any areas that are blocked or leaking.     -  Indocyanine green angiography: A procedure to look at blood vessels in the choroid layer of the eye. A green dye (indocyanine green) is injected into a blood vessel in the arm and goes into the bloodstream. As the dye travels through blood vessels of the eye, a special camera takes pictures of the retina and choroid to find any areas that are blocked or leaking.     -  Ocular coherence tomography : An imaging test that uses light waves to take cross-section pictures of the retina, and sometimes the choroid, to see if there is swelling or fluid beneath the retina.

                    A biopsy of the tumor is rarely needed to diagnose intraocular melanoma.
                    A biopsy is the removal of cells or tissues so they can be viewed under a microscope to check for signs of cancer. Rarely, a biopsy of the tumor is needed to diagnose intraocular melanoma. Tissue that is removed during a biopsy or surgery to remove the tumor may be tested to get more information about prognosis and which treatment options are best.    The following tests may be done on the sample of tissue:         -   Cytogenetic analysis: A laboratory test in which cells in a sample of tissue are viewed under a microscope to look for certain changes in the chromosomes.    -   Gene expression profiling : A laboratory test in which cells in a sample of tissue are checked for certain types of RNA.        A biopsy may result in retinal detachment (the retina separates from other tissues in the eye). This can be repaired by surgery. </s>


Input: What is the outlook for Intraocular (Uveal) Melanoma ?

Output: Certain factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery) and treatment options depend on the following:          - How the melanoma cells look under a microscope.    - The size and thickness of the tumor.    - The part of the eye the tumor is in (the iris, ciliary body, or choroid).    - Whether the tumor has spread within the eye or to other places in the body.    - Whether there are certain changes in the genes linked to intraocular melanoma.    - The patient's age and general health.    - Whether the tumor has recurred (come back) after treatment. </s>


Input: What are the stages of Intraocular (Uveal) Melanoma ?

Output:
Key Points
                    - After intraocular melanoma has been diagnosed, tests are done to find out if cancer cells have spread to other parts of the body.     - The following sizes are used to describe intraocular melanoma:          - Small     - Medium     - Large        - There are three ways that cancer spreads in the body.    - Cancer may spread from where it began to other parts of the body.    - There are two staging systems for intraocular melanoma.    - The following stages are used for intraocular melanoma of the iris:         - Stage I     - Stage II     - Stage III     - Stage IV        - The following stages are used for intraocular melanoma of the ciliary body and choroid:         - Stage I     - Stage II     - Stage III     - Stage IV

                    After intraocular melanoma 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 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:         -   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 the cancer has spread to the liver.    -   Ultrasound exam: A procedure in which high-energy sound waves (ultrasound) are bounced off internal tissues or organs, such as the liver, and make echoes. The echoes form a picture of body tissues called a sonogram.    -   Chest x-ray : An x-ray of the organs and bones inside the chest. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.    -   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, such as the chest, abdomen, or pelvis, taken from different angles. The pictures are made by a computer linked to an x-ray 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 very 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. 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.

                    The following sizes are used to describe intraocular melanoma:
                    Small    The tumor is 5 to 16 millimeters in diameter and from 1 to 3 millimeters thick.           Medium    The tumor is 16 millimeters or smaller in diameter and from 3.1 to 8 millimeters thick.       Large    The tumor is:            - more than 8 millimeters thick and any diameter; or     - at least 2 millimeters thick and more than 16 millimeters in diameter.            Though most intraocular melanoma tumors are raised, some are flat. These diffuse tumors grow widely across the uvea.

                    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 intraocular melanoma spreads to the liver, the cancer cells in the liver are actually intraocular melanoma cells. The disease is metastatic intraocular melanoma, not liver cancer.

                    There are two staging systems for intraocular melanoma.
                    Intraocular melanoma has two staging systems. The staging system used depends on where in the eye the cancer first formed:         -  Iris.    -  Ciliary body and choroid.         If intraocular melanoma spreads to the optic nerve or nearby tissue of the eye socket, it is called extraocular extension.

                    The following stages are used for intraocular melanoma of the iris:
                    Stage I    In stage I, the tumor is in the iris only and is not more than one fourth the size of the iris.       Stage II     Stage II is divided into stages IIA and IIB.            - In stage IIA, the tumor:                   - is in the iris only and is more than one fourth the size of the iris; or       - is in the iris only and has caused glaucoma; or       - has spread next to and/or into the ciliary body, choroid, or both. The tumor has caused glaucoma.                - In stage IIB, the tumor has spread next to and/or into the ciliary body, choroid, or both, and has also spread into the sclera. The tumor has caused glaucoma.              Stage III     Stage III is divided into stages IIIA and IIIB.            - In stage IIIA, the tumor has spread through the sclera to the outside of the eyeball. The part of the tumor outside the eyeball is not more than 5 millimeters thick.     - In stage IIIB, the tumor has spread through the sclera to the outside of the eyeball. The part of the tumor outside the eyeball is more than 5 millimeters thick.              Stage IV    In stage IV, the tumor may be any size and has spread:            - to nearby lymph nodes; or     - to other parts of the body, such as the liver, lung, or bone, or to areas under the skin.

                    The following stages are used for intraocular melanoma of the ciliary body and choroid:
                    Intraocular melanoma of the ciliary body and choroid is grouped into four size categories. The category depends on how wide and thick the tumor is. Category 1 tumors are the smallest and category 4 tumors are the biggest.   Category 1:         - The tumor is not more than 12 millimeters wide and not more than 3 millimeters thick; or    - the tumor is not more than 9 millimeters wide and 3.1 to 6 millimeters thick.        Category 2:         - The tumor is 12.1 to 18 millimeters wide and not more than 3 millimeters thick; or    - the tumor is 9.1 to 15 millimeters wide and 3.1 to 6 millimeters thick; or    - the tumor is not more than 12 millimeters wide and 6.1 to 9 millimeters thick.        Category 3:         - The tumor is 15.1 to 18 millimeters wide and 3.1 to 6 millimeters thick; or    - the tumor is 12.1 to 18 millimeters wide and 6.1 to 9 millimeters thick; or    - the tumor is 3.1 to 18 millimeters wide and 9.1 to 12 millimeters thick; or    - the tumor is 9.1 to 15 millimeters wide and 12.1 to 15 millimeters thick.        Category 4:         - The tumor is more than 18 millimeters wide and may be any thickness; or    - the tumor is 15.1 to 18 millimeters wide and more than 12 millimeters thick; or    - the tumor is 12.1 to 15 millimeters wide and more than 15 millimeters thick.          Stage I    In stage I, the tumor is size category 1 and is in the choroid only.       Stage II     Stage II is divided into stages IIA and IIB.            - In stage IIA, the tumor:                   - is size category 1 and has spread to the ciliary body; or       - is size category 1 and has spread through the sclera to the outside of the eyeball. The part of the tumor outside the eyeball is not more than 5 millimeters thick. The tumor may have spread to the ciliary body; or       - is size category 2 and is in the choroid only.                - In stage IIB, the tumor:                  - is size category 2 and has spread to the ciliary body; or       - is size category 3 and is in the choroid only.                         Stage III     Stage III is divided into stages IIIA, IIIB, and IIIC.            - In stage IIIA, the tumor:                  - is size category 2 and has spread through the sclera to the outside of the eyeball. The part of the tumor outside the eyeball is not more than 5 millimeters thick. The tumor may have spread to the ciliary body; or       - is size category 3 and has spread to the ciliary body; or       - is size category 3 and has spread through the sclera to the outside of the eyeball. The part of the tumor outside the eyeball is not more than 5 millimeters thick. The tumor has not spread to the ciliary body; or       - is size category 4 and is in the choroid only.                - In stage IIIB, the tumor:                  - is size category 3 and has spread through the sclera to the outside of the eyeball. The part of the tumor outside the eyeball is not more than 5 millimeters thick. The tumor has spread to the ciliary body; or       - is size category 4 and has spread to the ciliary body; or       - is size category 4 and has spread through the sclera to the outside of the eyeball. The part of the tumor outside the eyeball is not more than 5 millimeters thick. The tumor has not spread to the ciliary body.                - In stage IIIC, the tumor:                  - is size category 4 and has spread through the sclera to the outside of the eyeball. The part of the tumor outside the eyeball is not more than 5 millimeters thick. The tumor has spread to the ciliary body; or       - may be any size and has spread through the sclera to the outside of the eyeball. The part of the tumor outside the eyeball is more than 5 millimeters thick. The tumor has not spread to the ciliary body.                         Stage IV    In stage IV, the tumor may be any size and has spread:            - to nearby lymph nodes; or     - to other parts of the body, such as the liver, lung, or bone, or to areas under the skin. </s>


Input: What are the treatments for Intraocular (Uveal) Melanoma ?

Output:
Key Points
                    - There are different types of treatments for patients with intraocular melanoma.     - Five types of standard treatment are used:         - Surgery     - Watchful Waiting     - Radiation therapy     -  Photocoagulation     -  Thermotherapy        - New types of treatment are being tested in clinical trials.     - Treatment for intraocular (uveal) melanoma may cause side effects.    - 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.    - Follow-up tests may be needed.

                    There are different types of treatments for patients with intraocular melanoma.
                    Different types of treatments are available for patients with intraocular melanoma. 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 intraocular melanoma. The following types of surgery may be used:            -  Resection: Surgery to remove the tumor and a small amount of healthy tissue around it.     -  Enucleation: Surgery to remove the eye and part of the optic nerve. This is done if vision cannot be saved and the tumor is large, has spread to the optic nerve, or causes high pressure inside the eye. After surgery, the patient is usually fitted for an artificial eye to match the size and color of the other eye.      -  Exenteration: Surgery to remove the eye and eyelid, and muscles, nerves, and fat in the eye socket. After surgery, the patient may be fitted for an artificial eye to match the size and color of the other eye or a facial prosthesis.              Watchful Waiting     Watchful waiting is closely monitoring a patients condition without giving any treatment until signs or symptoms appear or change. Pictures are taken over time to keep track of changes in the size of the tumor and how fast it is growing.    Watchful waiting is used for patients who do not have signs or symptoms and the tumor is not growing. It is also used when the tumor is in the only eye with useful vision.       Radiation therapy     Radiation therapy is a cancer treatment that uses high-energy x-rays 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 external radiation therapy include the following:                  -  Charged-particle external beam radiation therapy is a type of external-beam radiation therapy. A special radiation therapy machine aims tiny, invisible particles, called protons or helium ions, at the cancer cells to kill them with little damage to nearby normal tissues. Charged-particle radiation therapy uses a different type of radiation than the x-ray type of radiation therapy.       -  Gamma Knife therapy is a type of stereotactic radiosurgery used for some melanomas. This treatment can be given in one treatment. It aims tightly focused gamma rays directly at the tumor so there is little damage to healthy tissue. Gamma Knife therapy does not use a knife to remove the tumor and is not an operation.                -  Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. Certain ways of giving radiation therapy can help keep radiation from damaging healthy tissue. This type of internal radiation therapy may include the following:                  -  Localized plaque radiation therapy is a type of internal radiation therapy that may be used for tumors of the eye. Radioactive seeds are attached to one side of a disk, called a plaque, and placed directly on the outside wall of the eye near the tumor. The side of the plaque with the seeds on it faces the eyeball, aiming radiation at the tumor. The plaque helps protect other nearby tissue from the radiation.                       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 intraocular melanoma.        Photocoagulation     Photocoagulation is a procedure that uses laser light to destroy blood vessels that bring nutrients to the tumor, causing the tumor cells to die. Photocoagulation may be used to treat small tumors. This is also called light coagulation.        Thermotherapy     Thermotherapy is the use of heat from a laser to destroy cancer cells and shrink the tumor.

                    New types of treatment are being tested in clinical trials.
                    Information about clinical trials is available from the NCI website.

                    Treatment for intraocular (uveal) melanoma may cause side effects.
                    For information about side effects caused by treatment for cancer, see our Side Effects page.

                    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.

                    Follow-up 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 follow-up tests or check-ups.

		            Treatment Options for Intraocular (Uveal) Melanoma

		                    Iris Melanoma
		                    Treatment of iris melanoma may include the following:         -  Watchful waiting.     -  Surgery (resection or enucleation).    -  Plaque radiation therapy, for tumors that cannot be removed by surgery.        Check the list of NCI-supported cancer clinical trials that are now accepting patients with iris melanoma. 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.

		                    Ciliary Body Melanoma
		                    Treatment of tumors in the ciliary body and choroid may include the following:         -  Plaque radiation therapy.    -  Charged-particle external-beam radiation therapy.    -  Surgery (resection or enucleation).        Check the list of NCI-supported cancer clinical trials that are now accepting patients with ciliary body and choroid melanoma, small size. 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.

		                    Choroid Melanoma
		                    Treatment of small choroid melanoma may include the following:         -  Watchful waiting.    -  Plaque radiation therapy.    -  Charged-particle external-beam radiation therapy.    -  Gamma Knife therapy.    -  Thermotherapy.    -  Surgery (resection or enucleation).        Treatment of medium choroid melanoma may include the following:         - Plaque radiation therapy with or without photocoagulation or thermotherapy.     - Charged-particle external-beam radiation therapy.    - Surgery (resection or enucleation).        Treatment of large choroid melanoma may include the following:         - Enucleation when the tumor is too large for treatments that save the eye.        Check the list of NCI-supported cancer clinical trials that are now accepting patients with ciliary body and choroid melanoma, small size. 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.

		                    Extraocular Extension Melanoma and Metastatic Intraocular (Uveal) Melanoma
		                    Treatment of extraocular extension melanoma that has spread to the bone around the eye may include the following:         -  Surgery (exenteration).    - A clinical trial.        An effective treatment for metastatic intraocular melanoma has not been found. A clinical trial may be a treatment option. Talk with your doctor about your treatment options.   Check the list of NCI-supported cancer clinical trials that are now accepting patients with extraocular extension melanoma and metastatic intraocular melanoma. 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 Intraocular (Uveal) Melanoma
		                    An effective treatment for recurrent intraocular melanoma has not been found. A clinical trial may be a treatment option. Talk with your doctor about your treatment options.   Check the list of NCI-supported cancer clinical trials that are now accepting patients with recurrent intraocular melanoma. 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>


Input: what research (or clinical trials) is being done for Intraocular (Uveal) Melanoma ?

Output:
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>


Input: What is (are) Non-Small Cell Lung Cancer ?

Output:
Key Points
                    - Non-small cell lung cancer is a disease in which malignant (cancer) cells form in the tissues of the lung.     - There are several types of non-small cell lung cancer.    - Smoking is the major risk factor for non-small cell lung cancer.    - Signs of non-small cell lung cancer include a cough that doesn't go away and shortness of breath.    - Tests that examine the lungs are used to detect (find), diagnose, and stage non-small cell lung cancer.    - Certain factors affect prognosis (chance of recovery) and treatment options.    - For most patients with non-small cell lung cancer, current treatments do not cure the cancer.

                    Non-small cell lung cancer is a disease in which malignant (cancer) cells form in the tissues of the lung.
                    The lungs are a pair of cone-shaped breathing organs in the chest. The lungs bring oxygen into the body as you breathe in. They release carbon dioxide, a waste product of the bodys cells, as you breathe out. Each lung has sections called lobes. The left lung has two lobes. The right lung is slightly larger and has three lobes. Two tubes called bronchi lead from the trachea (windpipe) to the right and left lungs. The bronchi are sometimes also involved in lung cancer. Tiny air sacs called alveoli and small tubes called bronchioles make up the inside of the lungs.     A thin membrane called the pleura covers the outside of each lung and lines the inside wall of the chest cavity. This creates a sac called the pleural cavity. The pleural cavity normally contains a small amount of fluid that helps the lungs move smoothly in the chest when you breathe.    There are two main types of lung cancer: non-small cell lung cancer and small cell lung cancer.    See the following PDQ summaries for more information about lung cancer:         -  Small Cell Lung Cancer Treatment     -  Unusual Cancers of Childhood Treatment     -  Lung Cancer Prevention     -  Lung Cancer Screening

                    There are several types of non-small cell lung cancer.
                    Each type of non-small cell lung cancer has different kinds of cancer cells. The cancer cells of each type grow and spread in different ways. The types of non-small cell lung cancer are named for the kinds of cells found in the cancer and how the cells look under a microscope:         -  Squamous cell carcinoma: Cancer that begins in squamous cells, which are thin, flat cells that look like fish scales. This is also called epidermoid carcinoma.    -  Large cell carcinoma: Cancer that may begin in several types of large cells.    -  Adenocarcinoma: Cancer that begins in the cells that line the alveoli and make substances such as mucus.         Other less common types of non-small cell lung cancer are: pleomorphic, carcinoid tumor, salivary gland carcinoma, and unclassified carcinoma.

                    For most patients with non-small cell lung cancer, current treatments do not cure the cancer.
                    If lung cancer is found, taking part in one of the many clinical trials being done to improve treatment should be considered. Clinical trials are taking place in most parts of the country for patients with all stages of non-small cell lung cancer. Information about ongoing clinical trials is available from the NCI website. </s>


Input: Who is at risk for Non-Small Cell Lung Cancer? ?

Output: Smoking is the major risk factor for non-small cell lung 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 to your doctor if you think you may be at risk for lung cancer.    Risk factors for lung cancer include the following:            -  Smoking cigarettes, pipes, or cigars, now or in the past. This is the most important risk factor for lung cancer. The earlier in life a person starts smoking, the more often a person smokes, and the more years a person smokes, the greater the risk of lung cancer.      -  Being exposed to secondhand smoke.     - Being exposed to radiation from any of the following:                  -  Radiation therapy to the breast or chest.       -  Radon in the home or workplace.       -  Imaging tests such as CT scans.       - Atomic bomb radiation.                 -  Being exposed to asbestos, chromium, nickel, beryllium, arsenic, soot, or tar in the workplace.     -  Living where there is air pollution.     -  Having a family history of lung cancer.     -  Being infected with the human immunodeficiency virus (HIV).     -  Taking beta carotene supplements and being a heavy smoker.           Older age is the main risk factor for most cancers. The chance of getting cancer increases as you get older.     When smoking is combined with other risk factors, the risk of lung cancer is increased. </s>


Input: What are the symptoms of Non-Small Cell Lung Cancer ?

Output: Signs of non-small cell lung cancer include a cough that doesn't go away and shortness of breath. Sometimes lung cancer does not cause any signs or symptoms. It may be found during a chest x-ray done for another condition. Signs and symptoms may be caused by lung cancer or by other conditions. Check with your doctor if you have any of the following:         - Chest discomfort or pain.    - A cough that doesnt go away or gets worse over time.     - Trouble breathing.     - Wheezing.     -  Blood in sputum (mucus coughed up from the lungs).     - Hoarseness.     - Loss of appetite.    - Weight loss for no known reason.     - Feeling very tired.    - Trouble swallowing.    - Swelling in the face and/or veins in the neck. </s>


Input: How to diagnose Non-Small Cell Lung Cancer ?

Output: Tests that examine the lungs are used to detect (find), diagnose, and stage non-small cell lung cancer. Tests and procedures to detect, diagnose, and stage non-small cell lung cancer are often done at the same time. Some of 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, including smoking, and past jobs, illnesses, and treatments will also be taken.    -   Laboratory tests : Medical procedures that test samples of tissue, blood, urine, or other substances in the body. These tests help to diagnose disease, plan and check treatment, or monitor the disease over time.    -  Chest x-ray: An x-ray of the organs and bones inside the chest. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.     -   CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, such as the chest, taken from different angles. The pictures are made by a computer linked to an x-ray 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.     -   Sputum cytology : A procedure in which a pathologist views a sample of sputum (mucus coughed up from the lungs) under a microscope, to check for cancer cells.    -   Fine-needle aspiration (FNA) biopsy of the lung: The removal of tissue or fluid from the lung using a thin needle. A CT scan, ultrasound, or other imaging procedure is used to locate the abnormal tissue or fluid in the lung. A small incision may be made in the skin where the biopsy needle is inserted into the abnormal tissue or fluid. A sample is removed with the needle and sent to the laboratory. A pathologist then views the sample under a microscope to look for cancer cells. A chest x-ray is done after the procedure to make sure no air is leaking from the lung into the chest.    -   Bronchoscopy : A procedure to look inside the trachea and large airways in the lung for abnormal areas. A bronchoscope is inserted through the nose or mouth into the trachea and lungs. A bronchoscope is a thin, tube-like 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.    -   Thoracoscopy : A surgical procedure to look at the organs inside the chest to check for abnormal areas. An incision (cut) is made between two ribs, and a thoracoscope is inserted into the chest. A thoracoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue or lymph node samples, which are checked under a microscope for signs of cancer. In some cases, this procedure is used to remove part of the esophagus or lung. If certain tissues, organs, or lymph nodes cant be reached, a thoracotomy may be done. In this procedure, a larger incision is made between the ribs and the chest is opened.     -   Thoracentesis : The removal of fluid from the space between the lining of the chest and the lung, using a needle. A pathologist views the fluid under a microscope to look for cancer cells.    -   Light and electron microscopy : A laboratory test in which cells in a sample of tissue are viewed under regular and high-powered microscopes to look for certain changes in the cells.    -   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. </s>


Input: What is the outlook for Non-Small Cell Lung Cancer ?

Output: 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 (the size of the tumor and whether it is in the lung only or has spread to other places in the body).    - The type of lung cancer.    - Whether the cancer has mutations (changes) in certain genes, such as the epidermal growth factor receptor (EGFR) gene or the anaplastic lymphoma kinase (ALK) gene.    - Whether there are signs and symptoms such as coughing or trouble breathing.    - The patients general health. </s>


Input: What are the stages of Non-Small Cell Lung Cancer ?

Output:
Key Points
                    - After lung cancer has been diagnosed, tests are done to find out if cancer cells have spread within the lungs 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 non-small cell lung cancer:         - Occult (hidden) stage     - Stage 0 (carcinoma in situ)     - Stage I     - Stage II     - Stage IIIA     - Stage IIIB     - Stage IV

                    After lung cancer has been diagnosed, tests are done to find out if cancer cells have spread within the lungs or to other parts of the body.
                    The process used to find out if cancer has spread within the lungs 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. Some of the tests used to diagnose non-small cell lung cancer are also used to stage the disease. (See the General Information section.)    Other tests and procedures that may be used in the staging process include the following:         -   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, such as the brain. 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, such as the brain and abdomen, taken from different angles. The pictures are made by a computer linked to an x-ray 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.    -   Radionuclide bone scan : A procedure to check if there are rapidly dividing cells, such as cancer cells, in the bone. A very small amount of radioactive material is injected into a vein and travels through the bloodstream. The radioactive material collects in the bones and is detected by a scanner.     -   Pulmonary function test (PFT): A test to see how well the lungs are working. It measures how much air the lungs can hold and how quickly air moves into and out of the lungs. It also measures how much oxygen is used and how much carbon dioxide is given off during breathing. This is also called lung function test.    -   Endoscopic ultrasound (EUS): A procedure in which an endoscope is inserted into the body. An endoscope is a thin, tube-like instrument with a light and a lens for viewing. A probe at the end of the endoscope is used to bounce high-energy sound waves (ultrasound) off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram. This procedure is also called endosonography. EUS may be used to guide fine needle aspiration (FNA) biopsy of the lung, lymph nodes, or other areas.     -   Mediastinoscopy : A surgical procedure to look at the organs, tissues, and lymph nodes between the lungs for abnormal areas. An incision (cut) is made at the top of the breastbone and a mediastinoscope is inserted into the chest. A mediastinoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue or lymph node samples, which are checked under a microscope for signs of cancer.    -   Anterior mediastinotomy : A surgical procedure to look at the organs and tissues between the lungs and between the breastbone and heart for abnormal areas. An incision (cut) is made next to the breastbone and a mediastinoscope is inserted into the chest. A mediastinoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue or lymph node samples, which are checked under a microscope for signs of cancer. This is also called the Chamberlain procedure.    -  Lymph node biopsy : The removal of all or part of a lymph node. A pathologist views the tissue under a microscope to look for cancer cells.     -   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.

                    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 non-small cell lung cancer spreads to the brain, the cancer cells in the brain are actually lung cancer cells. The disease is metastatic lung cancer, not brain cancer.

                    The following stages are used for non-small cell lung cancer:
                    Occult (hidden) stage    In the occult (hidden) stage, cancer cannot be seen by imaging or bronchoscopy. Cancer cells are found in sputum (mucus coughed up from the lungs) or bronchial washing (a sample of cells taken from inside the airways that lead to the lung). Cancer may have spread to other parts of the body.       Stage 0 (carcinoma in situ)    In stage 0, abnormal cells are found in the lining of the airways. 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. Stage I is divided into stages IA and IB:            -  Stage IA: The tumor is in the lung only and is 3 centimeters or smaller.     -  Stage IB: Cancer has not spread to the lymph nodes and one or more of the following is true:                  - The tumor is larger than 3 centimeters but not larger than 5 centimeters.       - Cancer has spread to the main bronchus and is at least 2 centimeters below where the trachea joins the bronchus.       - Cancer has spread to the innermost layer of the membrane that covers the lung.       - Part of the lung has collapsed or developed pneumonitis (inflammation of the lung) in the area where the trachea joins the bronchus.                          Stage II    Stage II is divided into stages IIA and IIB. Stage IIA and IIB are each divided into two sections depending on the size of the tumor, where the tumor is found, and whether there is cancer in the lymph nodes.            -  Stage IIA:  (1) Cancer has spread to lymph nodes on the same side of the chest as the tumor. The lymph nodes with cancer are within the lung or near the bronchus. Also, one or more of the following is true:                  - The tumor is not larger than 5 centimeters.       -  Cancer has spread to the main bronchus and is at least 2 centimeters below where the trachea joins the bronchus.       -  Cancer has spread to the innermost layer of the membrane that covers the lung.       - Part of the lung has collapsed or developed pneumonitis (inflammation of the lung) in the area where the trachea joins the bronchus.            or  (2) Cancer has not spread to lymph nodes and one or more of the following is true:                  - The tumor is larger than 5 centimeters but not larger than 7 centimeters.       - Cancer has spread to the main bronchus and is at least 2 centimeters below where the trachea joins the bronchus.       - Cancer has spread to the innermost layer of the membrane that covers the lung.       - Part of the lung has collapsed or developed pneumonitis (inflammation of the lung) in the area where the trachea joins the bronchus.                -  Stage IIB:  (1) Cancer has spread to nearby lymph nodes on the same side of the chest as the tumor. The lymph nodes with cancer are within the lung or near the bronchus. Also, one or more of the following is true:                  - The tumor is larger than 5 centimeters but not larger than 7 centimeters.       - Cancer has spread to the main bronchus and is at least 2 centimeters below where the trachea joins the bronchus.       -  Cancer has spread to the innermost layer of the membrane that covers the lung.       - Part of the lung has collapsed or developed pneumonitis (inflammation of the lung) in the area where the trachea joins the bronchus.             or (2) Cancer has not spread to lymph nodes and one or more of the following is true:                  - The tumor is larger than 7 centimeters.       - Cancer has spread to the main bronchus (and is less than 2 centimeters below where the trachea joins the bronchus), the chest wall, the diaphragm, or the nerve that controls the diaphragm.        - Cancer has spread to the membrane around the heart or lining the chest wall.       - The whole lung has collapsed or developed pneumonitis (inflammation of the lung).       - There are one or more separate tumors in the same lobe of the lung.                         Stage IIIA     Stage IIIA is divided into three sections depending on the size of the tumor, where the tumor is found, and which lymph nodes have cancer (if any).     (1) Cancer has spread to lymph nodes on the same side of the chest as the tumor. The lymph nodes with cancer are near the sternum (chest bone) or where the bronchus enters the lung. Also:            - The tumor may be any size.     - Part of the lung (where the trachea joins the bronchus) or the whole lung may have collapsed or developed pneumonitis (inflammation of the lung).     - There may be one or more separate tumors in the same lobe of the lung.     - Cancer may have spread to any of the following:                  - Main bronchus, but not the area where the trachea joins the bronchus.       -  Chest wall.       -  Diaphragm and the nerve that controls it.       -  Membrane around the lung or lining the chest wall.       - Membrane around the heart.                        or       (2) Cancer has spread to lymph nodes on the same side of the chest as the tumor. The lymph nodes with cancer are within the lung or near the bronchus. Also:            - The tumor may be any size.     - The whole lung may have collapsed or developed pneumonitis (inflammation of the lung).     - There may be one or more separate tumors in any of the lobes of the lung with cancer.     - Cancer may have spread to any of the following:                  - Main bronchus, but not the area where the trachea joins the bronchus.       - Chest wall.       - Diaphragm and the nerve that controls it.       - Membrane around the lung or lining the chest wall.       - Heart or the membrane around it.       - Major blood vessels that lead to or from the heart.        - Trachea.       -  Esophagus.        - Nerve that controls the larynx (voice box).       -  Sternum (chest bone) or backbone.       -  Carina (where the trachea joins the bronchi).                        or       (3) Cancer has not spread to the lymph nodes and the tumor may be any size. Cancer has spread to any of the following:            - Heart.      - Major blood vessels that lead to or from the heart.      - Trachea.      - Esophagus.      - Nerve that controls the larynx (voice box).     - Sternum (chest bone) or backbone.      - Carina (where the trachea joins the bronchi).              Stage IIIB     Stage IIIB is divided into two sections depending on the size of the tumor, where the tumor is found, and which lymph nodes have cancer.     (1) Cancer has spread to lymph nodes above the collarbone or to lymph nodes on the opposite side of the chest as the tumor. Also:            - The tumor may be any size.     - Part of the lung (where the trachea joins the bronchus) or the whole lung may have collapsed or developed pneumonitis (inflammation of the lung).     - There may be one or more separate tumors in any of the lobes of the lung with cancer.     - Cancer may have spread to any of the following:                  - Main bronchus.       -  Chest wall.       -  Diaphragm and the nerve that controls it.       -  Membrane around the lung or lining the chest wall.       - Heart or the membrane around it.       - Major blood vessels that lead to or from the heart.       - Trachea.       -  Esophagus.       - Nerve that controls the larynx (voice box).       -  Sternum (chest bone) or backbone.       -  Carina (where the trachea joins the bronchi).                         or       (2) Cancer has spread to lymph nodes on the same side of the chest as the tumor. The lymph nodes with cancer are near the sternum (chest bone) or where the bronchus enters the lung. Also:            - The tumor may be any size.     - There may be separate tumors in different lobes of the same lung.     - Cancer has spread to any of the following:                  - Heart.        - Major blood vessels that lead to or from the heart.        - Trachea.        - Esophagus.       - Nerve that controls the larynx (voice box).       - Sternum (chest bone) or backbone.        - Carina (where the trachea joins the bronchi).                         Stage IV     In stage IV, the tumor may be any size and cancer may have spread to lymph nodes. One or more of the following is true:            - There are one or more tumors in both lungs.     - Cancer is found in fluid around the lungs or the heart.     - Cancer has spread to other parts of the body, such as the brain, liver, adrenal glands, kidneys, or bone. </s>