Input: What are the treatments for Small Intestine Cancer ?

Output:
Key Points
                    - 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.    - Follow-up 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 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.            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.

                    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 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 NCI-supported 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 NCI-supported 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 NCI-supported 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>


Input: What is (are) Testicular Cancer ?

Output:
Key Points
                    - Testicular cancer is a disease in which malignant (cancer) cells form in the tissues of one or both testicles.    - Testicular cancer is the most common cancer in men aged 15 to 34 years.    - Testicular cancer can usually be cured.    - A condition called cryptorchidism (an undescended testicle) is a risk factor for testicular cancer.

                    Testicular cancer is a disease in which malignant (cancer) cells form in the tissues of one or both testicles.
                    The testicles are 2 egg-shaped glands inside the scrotum (a sac of loose skin that lies directly below the penis). The testicles are held within the scrotum by the spermatic cord. The spermatic cord also contains the vas deferens and vessels and nerves of the testicles.     The testicles are the male sex glands and make testosterone and sperm. Germ cells in the testicles make immature sperm. These sperm travel through a network of tubules (tiny tubes) and larger tubes into the epididymis (a long coiled tube next to the testicles). This is where the sperm mature and are stored.   Almost all testicular cancers start in the germ cells. The two main types of testicular germ cell tumors are seminomas and nonseminomas.    See the PDQ summary on Testicular Cancer Treatment for more information about testicular cancer. </s>


Input: Who is at risk for Testicular Cancer? ?

Output: Testicular cancer is the most common cancer in men aged 15 to 34 years. Testicular cancer is very rare, but it is the most common cancer found in men between the ages of 15 and 34. White men are four times more likely than black men to have testicular cancer </s>


Input: What is the outlook for Testicular Cancer ?

Output: Testicular cancer can usually be cured. Although the number of new cases of testicular cancer has doubled in the last 40 years, the number of deaths caused by testicular cancer has decreased greatly because of better treatments. Testicular cancer can usually be cured, even in late stages of the disease. (See the PDQ summary on Testicular Cancer Treatment for more information.) </s>


Input: Who is at risk for Testicular Cancer? ?

Output: A condition called cryptorchidism (an undescended testicle) is a risk factor for testicular 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 doesn't mean that you will not get cancer. Talk to your doctor if you think you may be at risk. Risk factors for testicular cancer include the following:          - Having cryptorchidism (an undescended testicle).    - Having a testicle that is not normal, such as a small testicle that does not work the way it should.    - Having testicular carcinoma in situ.    - Being white.    - Having a personal or family history of testicular cancer.    - Having Klinefelter syndrome.        Men who have cryptorchidism, a testicle that is not normal, or testicular carcinoma in situ have an increased risk of testicular cancer in one or both testicles, and need to be followed closely. </s>


Input: Who is at risk for Testicular Cancer? ?

Output:
Health history can affect the risk of testicular 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. Risk factors for testicular cancer include:          - Having had an undescended testicle.    - Having had abnormal development of the testicles.    - Having a personal history of testicular cancer.    - Having a family history of testicular cancer (especially in a father or brother).    - Being white.

	                    Treatment for testicular cancer can cause infertility.
	                    Certain treatments for testicular cancer can cause infertility that may be permanent. Patients who may wish to have children should consider sperm banking before having treatment. Sperm banking is the process of freezing sperm and storing it for later use. </s>


Input: What are the stages of Testicular Cancer ?

Output:
Key Points
                    - After testicular cancer has been diagnosed, tests are done to find out if cancer cells have spread within the testicles 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 testicular cancer:         - Stage 0 (Testicular Intraepithelial Neoplasia)     - Stage I     - Stage II     - Stage III

                    After testicular cancer has been diagnosed, tests are done to find out if cancer cells have spread within the testicles or to other parts of the body.
                    The process used to find out if cancer has spread within the testicles 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 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, 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.     -   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).    -   Abdominal lymph node dissection : A surgical procedure in which lymph nodes in the abdomen are removed and a sample of tissue is checked under a microscope for signs of cancer. This procedure is also called lymphadenectomy. For patients with nonseminoma, removing the lymph nodes may help stop the spread of disease. Cancer cells in the lymph nodes of seminoma patients can be treated with radiation therapy.     -   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. The following 3 tumor markers are used in staging testicular cancer:               -  Alpha-fetoprotein (AFP)      -  Beta-human chorionic gonadotropin (-hCG).       -  Lactate dehydrogenase (LDH).         Tumor marker levels are measured again, after inguinal orchiectomy and biopsy, in order to determine the stage of the cancer. This helps to show if all of the cancer has been removed or if more treatment is needed. Tumor marker levels are also measured during follow-up as a way of checking if the cancer has come back.

                    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 testicular cancer spreads to the lung, the cancer cells in the lung are actually testicular cancer cells. The disease is metastatic testicular cancer, not lung cancer.

                    The following stages are used for testicular cancer:
                    Stage 0 (Testicular Intraepithelial Neoplasia)    In stage 0, abnormal cells are found in the tiny tubules where the sperm cells begin to develop. These abnormal cells may become cancer and spread into nearby normal tissue. All tumor marker levels are normal. Stage 0 is also called testicular intraepithelial neoplasia and testicular intratubular germ cell neoplasia.        Stage I    In stage I, cancer has formed. Stage I is divided into stage IA, stage IB, and stage IS and is determined after an inguinal orchiectomy is done.            - In stage IA, cancer is in the testicle and epididymis and may have spread to the inner layer of the membrane surrounding the testicle. All tumor marker levels are normal.     - In stage IB, cancer:                   -  is in the testicle and the epididymis and has spread to the blood vessels or lymph vessels in the testicle; or       - has spread to the outer layer of the membrane surrounding the testicle; or       - is in the spermatic cord or the scrotum and may be in the blood vessels or lymph vessels of the testicle.           All tumor marker levels are normal.     - In stage IS, cancer is found anywhere within the testicle, spermatic cord, or the scrotum and either:                  - all tumor marker levels are slightly above normal; or       - one or more tumor marker levels are moderately above normal or high.                          Stage II     Stage II is divided into stage IIA, stage IIB, and stage IIC and is determined after an inguinal orchiectomy is done.            - In stage IIA, cancer:                   - is anywhere within the testicle, spermatic cord, or scrotum; and       - has spread to up to 5 lymph nodes in the abdomen, none larger than 2 centimeters.           All tumor marker levels are normal or slightly above normal.     - In stage IIB, cancer is anywhere within the testicle, spermatic cord, or scrotum; and either:                  - has spread to up to 5 lymph nodes in the abdomen; at least one of the lymph nodes is larger than 2 centimeters, but none are larger than 5 centimeters; or       - has spread to more than 5 lymph nodes; the lymph nodes are not larger than 5 centimeters.           All tumor marker levels are normal or slightly above normal.     - In stage IIC, cancer:                  - is anywhere within the testicle, spermatic cord, or scrotum; and       - has spread to a lymph node in the abdomen that is larger than 5 centimeters.           All tumor marker levels are normal or slightly above normal.              Stage III     Stage III is divided into stage IIIA, stage IIIB, and stage IIIC and is determined after an inguinal orchiectomy is done.            - In stage IIIA, cancer:                  - is anywhere within the testicle, spermatic cord, or scrotum; and       - may have spread to one or more lymph nodes in the abdomen; and       - has spread to distant lymph nodes or to the lungs.            Tumor marker levels may range from normal to slightly above normal.     - In stage IIIB, cancer:                  - is anywhere within the testicle, spermatic cord, or scrotum; and       - may have spread to one or more lymph nodes in the abdomen, to distant lymph nodes, or to the lungs.           The level of one or more tumor markers is moderately above normal.     - In stage IIIC, cancer:                  - is anywhere within the testicle, spermatic cord, or scrotum; and       - may have spread to one or more lymph nodes in the abdomen, to distant lymph nodes, or to the lungs.            The level of one or more tumor markers is high. or Cancer:                  - is anywhere within the testicle, spermatic cord, or scrotum; and       - may have spread to one or more lymph nodes in the abdomen; and       - has not spread to distant lymph nodes or the lung but has spread to other parts of the body.           Tumor marker levels may range from normal to high. </s>


Input: What are the treatments for Testicular Cancer ?

Output:
Key Points
                    - There are different types of treatment for patients with testicular cancer.    - Testicular tumors are divided into 3 groups, based on how well the tumors are expected to respond to treatment.          - Good Prognosis     - Intermediate Prognosis     - Poor Prognosis        - Five types of standard treatment are used:         - Surgery     - Radiation therapy     - Chemotherapy     - Surveillance     - High-dose 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.    - Follow-up tests may be needed.

                    There are different types of treatment for patients with testicular cancer.
                    Different types of treatments are available for patients with testicular 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.

                    Testicular tumors are divided into 3 groups, based on how well the tumors are expected to respond to treatment.
                    Good Prognosis    For nonseminoma, all of the following must be true:            - The tumor is found only in the testicle or in the retroperitoneum (area outside or behind the abdominal wall); and     - The tumor has not spread to organs other than the lungs; and     - The levels of all the tumor markers are slightly above normal.           For seminoma, all of the following must be true:            - The tumor has not spread to organs other than the lungs; and     - The level of alpha-fetoprotein (AFP) is normal. Beta-human chorionic gonadotropin (-hCG) and lactate dehydrogenase (LDH) may be at any level.              Intermediate Prognosis    For nonseminoma, all of the following must be true:            - The tumor is found in one testicle only or in the retroperitoneum (area outside or behind the abdominal wall); and      - The tumor has not spread to organs other than the lungs; and     - The level of any one of the tumor markers is more than slightly above normal.           For seminoma, all of the following must be true:            - The tumor has spread to organs other than the lungs; and     - The level of AFP is normal. -hCG and LDH may be at any level.              Poor Prognosis    For nonseminoma, at least one of the following must be true:            - The tumor is in the center of the chest between the lungs; or     - The tumor has spread to organs other than the lungs; or     - The level of any one of the tumor markers is high.           There is no poor prognosis grouping for seminoma testicular tumors.

                    Five types of standard treatment are used:
                    Surgery     Surgery to remove the testicle (inguinal orchiectomy) and some of the lymph nodes may be done at diagnosis and staging. (See the General Information and Stages sections of this summary.) Tumors that have spread to other places in the body may be partly or entirely removed by surgery.     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 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.           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 testicular 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.    See Drugs Approved for Testicular Cancer for more information.       Surveillance     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 cancer has recurred (come back). In surveillance, patients are given certain exams and tests on a regular schedule.       High-dose chemotherapy with stem cell transplant     High-dose chemotherapy with stem cell transplant is a method 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.    See Drugs Approved for Testicular Cancer 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.

                    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.   Men who have had testicular cancer have an increased risk of developing cancer in the other testicle. A patient is advised to regularly check the other testicle and report any unusual symptoms to a doctor right away.    Long-term clinical exams are very important. The patient will probably have check-ups frequently during the first year after surgery and less often after that.

		            Treatment Options by Stage

		                    Stage 0 (Testicular Intraepithelial Neoplasia)
		                    Treatment of stage 0 may include the following:         -  Radiation therapy.    -  Surveillance.    -  Surgery to remove the testicle.        Check the list of NCI-supported cancer clinical trials that are now accepting patients with testicular 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 Testicular Cancer
		                    Treatment of stage I testicular cancer depends on whether the cancer is a seminoma or a nonseminoma.    Treatment of seminoma may include the following:         -  Surgery to remove the testicle, followed by surveillance.    - For patients who want active treatment rather than surveillance, treatment may include:               -       - Surgery to remove the testicle, followed by chemotherapy.                 Treatment of nonseminoma may include the following:         - Surgery to remove the testicle, with long-term follow-up.     - Surgery to remove the testicle and lymph nodes in the abdomen, with long-term follow-up.    - Surgery followed by chemotherapy for patients at high risk of recurrence, with long-term follow-up.        Check the list of NCI-supported cancer clinical trials that are now accepting patients with stage I testicular 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 Testicular Cancer
		                    Treatment of stage II testicular cancer depends on whether the cancer is a seminoma or a nonseminoma.    Treatment of seminoma may include the following:         - When the tumor is 5 centimeters or smaller:               -  Surgery to remove the testicle, followed by radiation therapy to lymph nodes in the abdomen and pelvis.      -  Combination chemotherapy.      - Surgery to remove the testicle and lymph nodes in the abdomen.             - When the tumor is larger than 5 centimeters:               - Surgery to remove the testicle, followed by combination chemotherapy or radiation therapy to lymph nodes in the abdomen and pelvis, with long-term follow-up.                 Treatment of nonseminoma may include the following:         - Surgery to remove the testicle and lymph nodes, with long-term follow-up.     - Surgery to remove the testicle and lymph nodes, followed by combination chemotherapy and long-term follow-up.    - Surgery to remove the testicle, followed by combination chemotherapy and a second surgery if cancer remains, with long-term follow-up.    - Combination chemotherapy before surgery to remove the testicle, for cancer that has spread and is thought to be life-threatening.        Check the list of NCI-supported cancer clinical trials that are now accepting patients with stage II testicular 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 Testicular Cancer
		                    Treatment of stage III testicular cancer depends on whether the cancer is a seminoma or a nonseminoma.    Treatment of seminoma may include the following:         -  Surgery to remove the testicle, followed by combination chemotherapy. If there are tumors remaining after chemotherapy, treatment may be one of the following:               -  Surveillance with no treatment unless tumors grow.      - Surveillance for tumors smaller than 3 centimeters and surgery to remove tumors larger than 3 centimeters.       - A PET scan two months after chemotherapy and surgery to remove tumors that show up with cancer on the scan.             - A clinical trial of chemotherapy.        Treatment of nonseminoma may include the following:         - Surgery to remove the testicle, followed by combination chemotherapy.    - Combination chemotherapy followed by surgery to remove the testicle and all remaining tumors. Additional chemotherapy may be given if the tumor tissue removed contains cancer cells that are growing or if follow-up tests show that cancer is progressing.     - Combination chemotherapy before surgery to remove the testicle, for cancer that has spread and is thought to be life-threatening.    - A clinical trial of chemotherapy.        Check the list of NCI-supported cancer clinical trials that are now accepting patients with stage III testicular 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 research (or clinical trials) is being done for Testicular Cancer ?

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) Hairy Cell Leukemia ?

Output:
Key Points
                    - Hairy cell leukemia is a type of cancer in which the bone marrow makes too many lymphocytes (a type of white blood cell).    - Leukemia may affect red blood cells, white blood cells, and platelets.    - Gender and age may affect the risk of hairy cell leukemia.     - Signs and symptoms of hairy cell leukemia include infections, tiredness, and pain below the ribs.     - Tests that examine the blood and bone marrow are used to detect (find) and diagnose hairy cell leukemia.    - Certain factors affect treatment options and prognosis (chance of recovery).

                    Hairy cell leukemia is a type of cancer in which the bone marrow makes too many lymphocytes (a type of white blood cell).
                    Hairy cell leukemia is a cancer of the blood and bone marrow. This rare type of leukemia gets worse slowly or does not get worse at all. The disease is called hairy cell leukemia because the leukemia cells look "hairy" when viewed under a microscope.

                    Leukemia may affect red blood cells, white blood cells, and 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 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.        A lymphoid stem cell becomes a lymphoblast cell and then into one of three types of lymphocytes (white blood cells):          -  B lymphocytes that make antibodies to help fight infection.    -  T lymphocytes that help B lymphocytes make antibodies to help fight infection.    -  Natural killer cells that attack cancer cells and viruses.         In hairy cell leukemia, too many blood stem cells become lymphocytes. These lymphocytes are abnormal and do not become healthy white blood cells. They are also called leukemia cells. The leukemia cells can build up in the blood and bone marrow so there is less room for healthy white blood cells, red blood cells, and platelets. This may cause infection, anemia, and easy bleeding. Some of the leukemia cells may collect in the spleen and cause it to swell.   This summary is about hairy cell leukemia. See the following PDQ summaries for information about other types of leukemia:         -  Adult Acute Lymphoblastic Leukemia Treatment.    -  Childhood Acute Lymphoblastic Leukemia Treatment.    -  Chronic Lymphocytic Leukemia Treatment.    -  Adult Acute Myeloid Leukemia Treatment.    -  Childhood Acute Myeloid Leukemia/Other Myeloid Malignancies Treatment.    -  Chronic Myelogenous Leukemia Treatment. </s>


Input: Who is at risk for Hairy Cell Leukemia? ?

Output: Gender and age may affect the risk of hairy cell leukemia. 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 with your doctor if you think you may be at risk. The cause of hairy cell leukemia is unknown. It occurs more often in older men. </s>


Input: What are the symptoms of Hairy Cell Leukemia ?

Output: Signs and symptoms of hairy cell leukemia include infections, tiredness, and pain below the ribs. These and other signs and symptoms may be caused by hairy cell leukemia or by other conditions. Check with your doctor if you have any of the following:          - Weakness or feeling tired.    -  Fever or frequent infections.    - Easy bruising or bleeding.    - Shortness of breath.    - Weight loss for no known reason.    - Pain or a feeling of fullness below the ribs.    - Painless lumps in the neck, underarm, stomach, or groin. </s>


Input: How to diagnose Hairy Cell Leukemia ?

Output: Tests that examine the blood and bone marrow are used to detect (find) and diagnose hairy cell leukemia. 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 a swollen spleen, 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): 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.             -   Peripheral blood smear : A procedure in which a sample of blood is checked for cells that look "hairy," 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 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.    -   Immunophenotyping : A laboratory test in which the antigens or markers on the surface of a blood or bone marrow cell are checked to see what type of cell it is. This test is done to diagnose the specific type of leukemia by comparing the cancer cells to normal cells of the immune system.    -   Flow cytometry : A laboratory test that measures the number of cells in a sample, the percentage of live cells in a sample, and certain characteristics of cells, such as size, shape, and the presence of tumor markers on the cell surface. The cells are stained with a light-sensitive dye, placed in a fluid, and passed in a stream before a laser or other type of light. The measurements are based on how the light-sensitive dye reacts to the light.    -   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 mutation test: A laboratory test done on a bone marrow or blood sample to check for mutations in the BRAF gene. A BRAF gene mutation is often found in patients with hairy cell leukemia.    -   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 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. A CT scan of the abdomen may be done to check for swollen lymph nodes or a swollen spleen. </s>


Input: What is the outlook for Hairy Cell Leukemia ?

Output: Certain factors affect treatment options and prognosis (chance of recovery). The treatment options may depend on the following:         - The number of hairy (leukemia) cells and healthy blood cells in the blood and bone marrow.    - Whether the spleen is swollen.    - Whether there are signs or symptoms of leukemia, such as infection.    - Whether the leukemia has recurred (come back) after previous treatment.        The prognosis (chance of recovery) depends on the following:         - Whether the hairy cell leukemia does not grow or grows so slowly it does not need treatment.    - Whether the hairy cell leukemia responds to treatment.        Treatment often results in a long-lasting remission (a period during which some or all of the signs and symptoms of the leukemia are gone). If the leukemia returns after it has been in remission, retreatment often causes another remission. </s>


Input: What are the stages of Hairy Cell Leukemia ?

Output:
Key Points
                    - There is no standard staging system for hairy cell leukemia.

                    There is no standard staging system for hairy cell leukemia.
                    Staging is the process used to find out how far the cancer has spread. Groups are used in place of stages for hairy cell leukemia. The disease is grouped as untreated, progressive, or refractory.       Untreated hairy cell leukemia     The hairy cell leukemia is newly diagnosed and has not been treated except to relieve signs or symptoms such as weight loss and infections. In untreated hairy cell leukemia, some or all of the following conditions occur:            - Hairy (leukemia) cells are found in the blood and bone marrow.     - The number of red blood cells, white blood cells, or platelets may be lower than normal.     - The spleen may be larger than normal.                Progressive hairy cell leukemia     In progressive hairy cell leukemia, the leukemia has been treated with either chemotherapy or splenectomy (removal of the spleen) and one or both of the following conditions occur:            - There is an increase in the number of hairy cells in the blood or bone marrow.     - The number of red blood cells, white blood cells, or platelets in the blood is lower than normal. </s>


Input: what research (or clinical trials) is being done for Hairy Cell Leukemia ?

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 are the treatments for Hairy Cell Leukemia ?

Output:
Key Points
                    - There are different types of treatment for patients with hairy cell leukemia.     - Five types of standard treatment are used:         - Watchful waiting     - Chemotherapy      - Biologic therapy     - Surgery      - 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.    - Follow-up tests may be needed.

                    There are different types of treatment for patients with hairy cell leukemia.
                    Different types of treatment are available for patients with hairy cell leukemia. 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:
                    Watchful waiting     Watchful waiting is closely monitoring a patient's condition, without giving any treatment until signs or symptoms appear or change.       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. Cladribine and pentostatin are anticancer drugs commonly used to treat hairy cell leukemia. These drugs may increase the risk of other types of cancer, especially Hodgkin lymphoma and non-Hodgkin lymphoma. Long-term follow up for second cancers is very important.       Biologic therapy     Biologic therapy is a cancer treatment that uses the patients immune system to fight cancer. Substances made by the body or made in a laboratory are used to boost, direct, or restore the bodys natural defenses against cancer. This type of cancer treatment is also called biotherapy or immunotherapy. Interferon alfa is a biologic agent commonly used to treat hairy cell leukemia.    See Drugs Approved for Hairy Cell Leukemia for more information.       Surgery      Splenectomy is a surgical procedure to remove the spleen.        Targeted therapy     Targeted therapy is a treatment that uses drugs or other substances to identify and attack specific cancer cells without harming normal cells. Monoclonal antibody therapy is a type of targeted therapy used to treat hairy cell leukemia.    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.    A monoclonal antibody called rituximab may be used for certain patients with hairy cell leukemia.    Other types of targeted therapies are being studied.

                    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.

                    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 Hairy Cell Leukemia

															                    Untreated Hairy Cell Leukemia
															                    If the patient's blood cell counts are not too low and there are no signs or symptoms, treatment may not be needed and the patient is carefully watched for changes in his or her condition. If blood cell counts become too low or if signs or symptoms appear, initial treatment may include the following:         -  Chemotherapy.    -  Splenectomy.        Check the list of NCI-supported cancer clinical trials that are now accepting patients with untreated hairy cell 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.

															                    Progressive Hairy Cell Leukemia
															                    Treatment for progressive hairy cell leukemia may include the following:         -  Chemotherapy.    -  Biologic therapy.    -  Splenectomy.    - A clinical trial of chemotherapy and targeted therapy with a monoclonal antibody (rituximab).        Check the list of NCI-supported cancer clinical trials that are now accepting patients with progressive hairy cell leukemia, initial treatment. 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.

															                    Relapsed or Refractory Hairy Cell Leukemia
															                    Treatment of relapsed or refractory hairy cell leukemia may include the following:         -  Chemotherapy.    -  Biologic therapy.    -  Targeted therapy with a monoclonal antibody (rituximab).    -  High-dose chemotherapy.    - A clinical trial of a new biologic therapy.    - A clinical trial of a new targeted therapy.    - A clinical trial of chemotherapy and targeted therapy with a monoclonal antibody (rituximab).        Check the list of NCI-supported cancer clinical trials that are now accepting patients with refractory hairy cell 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>


Input: What is (are) Adult Central Nervous System Tumors ?

Output:
Key Points
                    - An adult central nervous system tumor is a disease in which abnormal cells form in the tissues of the brain and/or spinal cord.    - A tumor that starts in another part of the body and spreads to the brain is called a metastatic brain tumor.    - The brain controls many important body functions.     - The spinal cord connects the brain to nerves in most parts of the body.    - There are different types of brain and spinal cord tumors.          - Astrocytic Tumors     - Oligodendroglial Tumors     - Mixed Gliomas     - Ependymal Tumors     - Medulloblastomas     - Pineal Parenchymal Tumors     - Meningeal Tumors     - Germ Cell Tumors     - Craniopharyngioma (Grade I)        - Having certain genetic syndromes may increase the risk of a central nervous system tumor.     - The cause of most adult brain and spinal cord tumors is not known.    - The signs and symptoms of adult brain and spinal cord tumors are not the same in every person.     - Tests that examine the brain and spinal cord are used to diagnose adult brain and spinal cord tumors.    - A biopsy is also used to diagnose a brain tumor.         - Sometimes a biopsy or surgery cannot be done.        - Certain factors affect prognosis (chance of recovery) and treatment options.

                    An adult central nervous system tumor is a disease in which abnormal cells form in the tissues of the brain and/or spinal cord.
                    There are many types of brain and spinal cord tumors. The tumors are formed by the abnormal growth of cells and may begin in different parts of the brain or spinal cord. Together, the brain and spinal cord make up the central nervous system (CNS).   The tumors may be either benign (not cancer) or malignant (cancer):         - Benign brain and spinal cord tumors grow and press on nearby areas of the brain. They rarely spread into other tissues and may recur (come back).     - Malignant brain and spinal cord 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 cause signs and symptoms and need treatment.   Brain and spinal cord tumors can occur in both adults and children. However, treatment for children may be different than treatment for adults. (See the PDQ summary on Childhood Brain and Spinal Cord Tumors Treatment Overview for more information on the treatment of children.)   For information about lymphoma that begins in the brain, see the PDQ summary on Primary CNS Lymphoma Treatment.

                    A tumor that starts in another part of the body and spreads to the brain is called a metastatic brain tumor.
                    Tumors that start in the brain are called primary brain tumors. Primary brain tumors may spread to other parts of the brain or to the spine. They rarely spread to other parts of the body.   Often, tumors found in the brain have started somewhere else in the body and spread to one or more parts of the brain. These are called metastatic brain tumors (or brain metastases). Metastatic brain tumors are more common than primary brain tumors.    Up to half of metastatic brain tumors are from lung cancer. Other types of cancer that commonly spread to the brain include:         -  Melanoma.    -  Breast cancer.    -  Colon cancer.    -  Kidney cancer.    -  Nasopharyngeal cancer.    -  Cancer of unknown primary site.        Cancer may spread to the leptomeninges (the two innermost membranes covering the brain and spinal cord). This is called leptomeningeal carcinomatosis. The most common cancers that spread to the leptomeninges include:         -  Breast cancer.    - Lung cancer.    -  Leukemia.    -  Lymphoma.        See the following for more information from PDQ about cancers that commonly spread to the brain or spinal cord:         -  Adult Hodgkin Lymphoma Treatment     -  Adult Non-Hodgkin Lymphoma Treatment     -  Breast Cancer Treatment     -  Carcinoma of Unknown Primary Treatment     -  Colon Cancer Treatment     -  Leukemia Home Page     -  Melanoma Treatment     -  Nasopharyngeal Cancer Treatment     -  Non-Small Cell Lung Cancer Treatment     -  Renal Cell Cancer Treatment     -  Small Cell Lung Cancer Treatment

                    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 to see, hear, walk, talk, and eat.

                    The spinal cord connects the brain to 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.

                    There are different types of brain and spinal cord tumors.
                    Brain and spinal cord tumors are named based on the type of cell they formed in and where the tumor first formed in the CNS. The grade of a tumor may be used to tell the difference between slow-growing and fast-growing types of the tumor. The World Health Organization (WHO) tumor grades are based on how abnormal the cancer cells look under a microscope and how quickly the tumor is likely to grow and spread.      WHO Tumor Grading System       - Grade I (low-grade)  The tumor cells look more like normal cells under a microscope and grow and spread more slowly than grade II, III, and IV tumor cells. They rarely spread into nearby tissues. Grade I brain tumors may be cured if they are completely removed by surgery.    - Grade II  The tumor cells grow and spread more slowly than grade III and IV tumor cells. They may spread into nearby tissue and may recur (come back). Some tumors may become a higher-grade tumor.    - Grade III  The tumor cells look very different from normal cells under a microscope and grow more quickly than grade I and II tumor cells. They are likely to spread into nearby tissue.    - Grade IV (high-grade)  The tumor cells do not look like normal cells under a microscope and grow and spread very quickly. There may be areas of dead cells in the tumor. Grade IV tumors usually cannot be cured.        The following types of primary tumors can form in the brain or spinal cord:     Astrocytic Tumors    An astrocytic tumor begins in star-shaped brain cells called astrocytes, which help keep nerve cells healthy. An astrocyte is a type of glial cell. Glial cells sometimes form tumors called gliomas. Astrocytic tumors include the following:            -  Brain stem glioma (usually high grade): A brain stem glioma forms in the brain stem, which is the part of the brain connected to the spinal cord. It is often a high-grade tumor, which spreads widely through the brain stem and is hard to cure. Brain stem gliomas are rare in adults. (See the PDQ summary on Childhood Brain Stem Glioma Treatment for more information.)     -  Pineal astrocytic tumor (any grade): A pineal astrocytic tumor forms in tissue around the pineal gland and may be any grade. The pineal gland is a tiny organ in the brain that makes melatonin, a hormone that helps control the sleeping and waking cycle.      -  Pilocytic astrocytoma (grade I): A pilocytic astrocytoma grows slowly in the brain or spinal cord. It may be in the form of a cyst and rarely spreads into nearby tissues. Pilocytic astrocytomas can often be cured.      -  Diffuse astrocytoma (grade II): A diffuse astrocytoma grows slowly, but often spreads into nearby tissues. The tumor cells look something like normal cells. In some cases, a diffuse astrocytoma can be cured. It is also called a low-grade diffuse astrocytoma.      -  Anaplastic astrocytoma (grade III): An anaplastic astrocytoma grows quickly and spreads into nearby tissues. The tumor cells look different from normal cells. This type of tumor usually cannot be cured. An anaplastic astrocytoma is also called a malignant astrocytoma or high-grade astrocytoma.      -  Glioblastoma (grade IV): A glioblastoma grows and spreads very quickly. The tumor cells look very different from normal cells. This type of tumor usually cannot be cured. It is also called glioblastoma multiforme.            See the PDQ summary on Childhood Astrocytomas Treatment for more information about astrocytomas in children.       Oligodendroglial Tumors    An oligodendroglial tumor begins in brain cells called oligodendrocytes, which help keep nerve cells healthy. An oligodendrocyte is a type of glial cell. Oligodendrocytes sometimes form tumors called oligodendrogliomas. Grades of oligodendroglial tumors include the following:            -  Oligodendroglioma (grade II): An oligodendroglioma grows slowly, but often spreads into nearby tissues. The tumor cells look something like normal cells. In some cases, an oligodendroglioma can be cured.      -  Anaplastic oligodendroglioma (grade III): An anaplastic oligodendroglioma grows quickly and spreads into nearby tissues. The tumor cells look different from normal cells. This type of tumor usually cannot be cured.             See the PDQ summary on Childhood Astrocytomas Treatment for more information about oligodendroglial tumors in children.       Mixed Gliomas    A mixed glioma is a brain tumor that has two types of tumor cells in it  oligodendrocytes and astrocytes. This type of mixed tumor is called an oligoastrocytoma.            -  Oligoastrocytoma (grade II): An oligoastrocytoma is a slow-growing tumor. The tumor cells look something like normal cells. In some cases, an oligoastrocytoma can be cured.     -  Anaplastic oligoastrocytoma (grade III): An anaplastic oligoastrocytoma grows quickly and spreads into nearby tissues. The tumor cells look different from normal cells. This type of tumor has a worse prognosis than oligoastrocytoma (grade II).             See the PDQ summary on Childhood Astrocytomas Treatment for more information about mixed gliomas in children.       Ependymal Tumors    An ependymal tumor usually begins in cells that line the fluid -filled spaces in the brain and around the spinal cord. An ependymal tumor may also be called an ependymoma. Grades of ependymomas include the following:            -  Ependymoma (grade I or II): A grade I or II ependymoma grows slowly and has cells that look something like normal cells. There are two types of grade I ependymoma  myxopapillary ependymoma and subependymoma. A grade II ependymoma grows in a ventricle (fluid-filled space in the brain) and its connecting paths or in the spinal cord. In some cases, a grade I or II ependymoma can be cured.     -  Anaplastic ependymoma (grade III): An anaplastic ependymoma grows quickly and spreads into nearby tissues. The tumor cells look different from normal cells. This type of tumor usually has a worse prognosis than a grade I or II ependymoma.             See the PDQ summary on Childhood Ependymoma Treatment for more information about ependymoma in children.       Medulloblastomas    A medulloblastoma is a type of embryonal tumor. Medulloblastomas are most common in children or young adults.      See the PDQ summary on Childhood Central Nervous System Embryonal Tumors Treatment for more information about medulloblastomas in children.       Pineal Parenchymal Tumors     A pineal parenchymal tumor forms in parenchymal cells or pineocytes, which are the cells that make up most of the pineal gland. These tumors are different from pineal astrocytic tumors. Grades of pineal parenchymal tumors include the following:            -  Pineocytoma (grade II): A pineocytoma is a slow-growing pineal tumor.     -  Pineoblastoma (grade IV): A pineoblastoma is a rare tumor that is very likely to spread.            See the PDQ summary on Childhood Central Nervous System Embryonal Tumors Treatment for more information about pineal parenchymal tumors in children.       Meningeal Tumors    A meningeal tumor, also called a meningioma, forms in the meninges (thin layers of tissue that cover the brain and spinal cord). It can form from different types of brain or spinal cord cells. Meningiomas are most common in adults. Types of meningeal tumors include the following:            -  Meningioma (grade I): A grade I meningioma is the most common type of meningeal tumor. A grade I meningioma is a slow-growing tumor. It forms most often in the dura mater. A grade I meningioma can be cured if it is completely removed by surgery.     -  Meningioma (grade II and III): This is a rare meningeal tumor. It grows quickly and is likely to spread within the brain and spinal cord. The prognosis is worse than a grade I meningioma because the tumor usually cannot be completely removed by surgery.            A hemangiopericytoma is not a meningeal tumor but is treated like a grade II or III meningioma. A hemangiopericytoma usually forms in the dura mater. The prognosis is worse than a grade I meningioma because the tumor usually cannot be completely removed by surgery.        Germ Cell Tumors    A germ cell tumor forms in germ cells, which are the cells that develop into sperm in men or ova (eggs) in women. There are different types of germ cell tumors. These include germinomas, teratomas, embryonal yolk sac carcinomas, and choriocarcinomas. Germ cell tumors can be either benign or malignant.     See the PDQ summary on Childhood Central Nervous System Germ Cell Tumors Treatment for more information about childhood germ cell tumors in the brain.       Craniopharyngioma (Grade I)    A craniopharyngioma is a rare tumor that usually forms in the center of the brain just above the pituitary gland (a pea-sized organ at the bottom of the brain that controls other glands). Craniopharyngiomas can form from different types of brain or spinal cord cells.     See the PDQ summary on Childhood Craniopharyngioma Treatment for more information about craniopharyngioma in children. </s>


Input: Who is at risk for Adult Central Nervous System Tumors? ?

Output: Having certain genetic syndromes may increase the risk of a central nervous system tumor. 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 with your doctor if you think you may be at risk. There are few known risk factors for brain tumors. The following conditions may increase the risk of certain types of brain tumors:          - Being exposed to vinyl chloride may increase the risk of glioma.    -  Infection with the Epstein-Barr virus, having AIDS (acquired immunodeficiency syndrome), or receiving an organ transplant may increase the risk of primary CNS lymphoma. (See the PDQ summary on Primary CNS Lymphoma for more information.)    - Having certain genetic syndromes may increase the risk brain tumors:               -  Neurofibromatosis type 1 (NF1) or 2 (NF2).      -  von Hippel-Lindau disease.      -  Tuberous sclerosis.      -  Li-Fraumeni syndrome.      - Turcot syndrome type 1 or 2.      -  Nevoid basal cell carcinoma syndrome. </s>


Input: What causes Adult Central Nervous System Tumors ?

Output: The cause of most adult brain and spinal cord tumors is not known. </s>


Input: What are the symptoms of Adult Central Nervous System Tumors ?

Output: The signs and symptoms of adult brain and spinal cord tumors are not the same in every person. Signs and symptoms depend on the following:         - Where the tumor forms in the brain or spinal cord.    - What the affected part of the brain controls.    - The size of the tumor.        Signs and symptoms may be caused by CNS tumors or by other conditions, including cancer that has spread to the brain. Check with your doctor if you have any of the following:      Brain Tumor Symptoms       - Morning headache or headache that goes away after vomiting.    -  Seizures.    - Vision, hearing, and speech problems.    - Loss of appetite.    - Frequent nausea and vomiting.     - Changes in personality, mood, ability to focus, or behavior.    - Loss of balance and trouble walking.    - Weakness.    - Unusual sleepiness or change in activity level.            Spinal Cord Tumor Symptoms       - Back pain or pain that spreads from the back towards the arms or legs.    - A change in bowel habits or trouble urinating.    - Weakness or numbness in the arms or legs.    - Trouble walking. </s>


Input: How to diagnose Adult Central Nervous System Tumors ?

Output:
Tests that examine the brain and spinal cord are used to diagnose adult 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.     -  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). Any loss of vision may be a sign of a tumor that has damaged or pressed on the parts of the brain that affect eyesight.     -   Tumor marker test : A procedure in which a sample of blood, urine, or tissue is checked to measure the amounts of certain substances made 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 body. These are called tumor markers. This test may be done to diagnose a germ cell tumor.    -   Gene testing : A laboratory test in which a sample of blood or tissue is tested for changes in a chromosome that has been linked with a certain type of brain tumor. This test may be done to diagnose an inherited syndrome.    -   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 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.    -   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). MRI is often used to diagnose tumors in the spinal cord. Sometimes a procedure called magnetic resonance spectroscopy (MRS) is done during the MRI scan. An MRS is used to diagnose tumors, based on their chemical make-up.     -   SPECT scan (single photon emission computed tomography scan): A procedure that uses a special camera linked to a computer to make a 3-dimensional (3-D) picture of the brain. A very small amount of a radioactive substance is injected into a vein or inhaled through the nose. As the substance travels through the blood, the camera rotates around the head and takes pictures of the brain. Blood flow and metabolism are higher than normal in areas where cancer cells are growing. These areas will show up brighter in the picture. This procedure may be done just before or after a CT scan. SPECT is used to tell the difference between a primary tumor and a tumor that has spread to the brain from somewhere else in the body.    -   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 brain. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do. PET is used to tell the difference between a primary tumor and a tumor that has spread to the brain from somewhere else in the body.
                    A biopsy is also used to diagnose a brain tumor. If imaging tests show there may be a brain tumor, a biopsy is usually done. One of the following types of biopsies may be used:          -   Stereotactic biopsy : When imaging tests show there may be a tumor deep in the brain in a hard to reach place, a stereotactic brain biopsy may be done. This kind of biopsy uses a computer and a 3-dimensional (3-D) scanning device to find the tumor and guide the needle used to remove the tissue. A small incision is made in the scalp and a small hole is drilled through the skull. A biopsy needle is inserted through the hole to remove cells or tissues so they can be viewed under a microscope by a pathologist to check for signs of cancer.    -   Open biopsy : When imaging tests show that there may be a tumor that can be removed by surgery, an open biopsy may be done. A part of the skull is removed in an operation called a craniotomy. A sample of brain tissue is removed and viewed under a microscope by a pathologist. If cancer cells are found, some or all of the tumor may be removed during the same surgery. Tests are done before surgery to find the areas around the tumor that are important for normal brain function. There are also ways to test brain function during surgery. The doctor will use the results of these tests to remove as much of the tumor as possible with the least damage to normal tissue in the brain.         The pathologist checks the biopsy sample to find out the type and grade of brain tumor. The grade of the tumor is based on how the tumor cells look under a microscope and how quickly the tumor is likely to grow and spread.    The following tests may be done on the tumor 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.    -   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.     -   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.           Sometimes a biopsy or surgery cannot be done.    For some tumors, a biopsy or surgery cannot be done safely because of where the tumor formed in the brain or spinal cord. These tumors are diagnosed and treated based on the results of imaging tests and other procedures.    Sometimes the results of imaging tests and other procedures show that the tumor is very likely to be benign and a biopsy is not done. </s>


Input: What is the outlook for Adult Central Nervous System Tumors ?

Output: Certain factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery) and treatment options for primary brain and spinal cord tumors depend on the following:         - The type and grade of the tumor.    -  Where the tumor is in the brain or spinal cord.    - Whether the tumor can be removed by surgery.    - Whether cancer cells remain after surgery.    - Whether there are certain changes in the chromosomes.    - Whether the cancer has just been diagnosed or has recurred (come back).    - The patient's general health.        The prognosis and treatment options for metastatic brain and spinal cord tumors depend on the following:         - Whether there are more than two tumors in the brain or spinal cord.    - Where the tumor is in the brain or spinal cord.    - How well the tumor responds to treatment.    - Whether the primary tumor continues to grow or spread. </s>


Input: What are the stages of Adult Central Nervous System Tumors ?

Output:
Key Points
                    - There is no standard staging system for adult brain and spinal cord tumors.    - Imaging tests may be repeated after surgery to help plan more treatment.

                    There is no standard staging system for adult brain and spinal cord tumors.
                    The extent or spread of cancer is usually described as stages. There is no standard staging system for brain and spinal cord tumors. Brain tumors that begin in the brain may spread to other parts of the brain and spinal cord, but they rarely spread to other parts of the body. Treatment of primary brain and spinal cord tumors is based on the following:         - The type of cell in which the tumor began.    - Where the tumor formed in the brain or spinal cord.    - The amount of cancer left after surgery.    - The grade of the tumor.        Treatment of tumors that have spread to the brain from other parts of the body is based on the number of tumors in the brain.

                    Imaging tests may be repeated after surgery to help plan more treatment.
                    Some of the tests and procedures used to diagnose a brain or spinal cord tumor may be repeated after treatment to find out how much tumor is left. </s>


Input: what research (or clinical trials) is being done for Adult Central Nervous System Tumors ?

Output:
New types of treatment are being tested in clinical trials.
                    This summary section refers to new treatments being studied in clinical trials, but it may not mention every new treatment being studied. Information about clinical trials is available from the NCI website.     Proton beam radiation therapy     Proton beam radiation therapy is a type of high-energy, external radiation therapy that uses streams of protons (small, positively-charged pieces of matter) to make radiation. This type of radiation kills tumor cells with little damage to nearby tissues. It is used to treat cancers of the head, neck, and spine and organs such as the brain, eye, lung, and prostate. Proton beam radiation is different from x-ray radiation.        Biologic therapy     Biologic therapy is a treatment that uses the patients immune system to fight cancer. Substances made by the body or made in a laboratory are used to boost, direct, or restore the bodys natural defenses against cancer. This type of cancer treatment is also called biotherapy or immunotherapy.    Biologic therapy is being studied for the treatment of some types of brain tumors. Treatments may include the following:            -  Dendritic cell vaccine therapy.     -  Gene 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>