Input: What are the treatments for Langerhans Cell Histiocytosis ?

Output:
Key Points
                    - There are different types of treatment for patients with Langerhans cell histiocytosis (LCH).    - Children with LCH should have their treatment planned by a team of health care providers who are experts in treating childhood cancer.     - Some cancer treatments cause side effects months or years after treatment for childhood cancer has ended.    - Nine types of standard treatment are used:         - Chemotherapy     - Surgery     - Radiation therapy     - Photodynamic therapy     - Biologic therapy     - Targeted therapy     - Other drug therapy     - Stem cell transplant     - Observation        - 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 treatment.    - When treatment of LCH stops, new lesions may appear or old lesions may come back.    - Follow-up tests may be needed.

                    There are different types of treatment for patients with Langerhans cell histiocytosis (LCH).
                    Different types of treatments are available for patients with LCH. 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. Whenever possible, patients should take part in a clinical trial in order to receive new types of treatment for LCH. Some clinical trials are open only to patients who have not started treatment.   Clinical trials are taking place in many parts of the country. Information about ongoing clinical trials is available from the NCI website. Choosing the most appropriate treatment is a decision that ideally involves the patient, family, and health care team.

                    Children with LCH should have their treatment planned by a team of health care providers who are experts in treating childhood cancer.
                    Treatment will be overseen by a pediatric oncologist, a doctor who specializes in treating children with cancer. The pediatric oncologist works with other pediatric healthcare providers who are experts in treating children with LCH and who specialize in certain areas of medicine. These may include the following specialists:          -  Pediatrician.    -  Primary care physician.    -  Pediatric surgeon.    -  Pediatric hematologist.    -  Radiation oncologist.    -  Neurologist.    -  Endocrinologist.    -  Pediatric nurse specialist.    -  Rehabilitation specialist.    -  Psychologist.    -  Social worker.

                    Some cancer treatments cause side effects months or years after treatment for childhood cancer has ended.
                    Side effects from cancer treatment that begin during or after treatment and continue for months or years are called late effects. Late effects of cancer treatment may include the following:         - Slow growth and development.    - Hearing loss.    - Bone, tooth, liver, and lung problems.    - Changes in mood, feeling, learning, thinking, or memory.    -  Second cancers, such as leukemia, retinoblastoma, Ewing sarcoma, brain or liver cancer.        Some late effects may be treated or controlled. It is important to talk with your child's doctors about the effects cancer treatment can have on your child. (See the PDQ summary on Late Effects of Treatment for Childhood Cancer for more information.)   Many patients with multisystem LCH have late effects caused by treatment or by the disease itself. These patients often have long-term health problems that affect their quality of life.

                    Nine types of standard treatment are used:
                    Chemotherapy     Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly onto the skin or 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).     Chemotherapy agents given by injection or by mouth are used to treat LCH. Chemotherapy agents include vinblastine, cytarabine, cladribine, and methotrexate. Nitrogen mustard is a drug that is put directly on the skin to treat small LCH lesions.       Surgery     Surgery may be used to remove LCH lesions and a small amount of nearby healthy tissue. Curettage is a type of surgery that uses a curette (a sharp, spoon-shaped tool) to scrape LCH cells from bone.    When there is severe liver or lung damage, the entire organ may be removed and replaced with a healthy liver or lung from a donor.        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. External radiation therapy uses a machine outside the body to send radiation toward the cancer. In LCH, a special lamp may be used to send ultraviolet B (UVB) radiation toward LCH skin lesions.       Photodynamic therapy     Photodynamic therapy is a cancer treatment that uses a drug and a certain type of laser light to kill cancer cells. A drug that is not active until it is exposed to light is injected into a vein. The drug collects more in cancer cells than in normal cells. For LCH, laser light is aimed at the skin and the drug becomes active and kills the cancer cells. Photodynamic therapy causes little damage to healthy tissue. Patients who have photodynamic therapy should not spend too much time in the sun.    In one type of photodynamic therapy, called psoralen and ultraviolet A (PUVA) therapy, the patient receives a drug called psoralen and then ultraviolet A radiation is directed to the skin.       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.     Interferon is a type of biologic therapy used to treat LCH of the skin. Immunomodulators are also a type of biologic therapy. Thalidomide is an immunomodulator used to treat LCH.        Targeted therapy     Targeted therapy is a type of treatment that uses drugs or other substances to find and attack LCH cells without harming normal cells. Imatinib mesylate is a type of targeted therapy called a tyrosine kinase inhibitor. It stops blood stem cells from turning into dendritic cells that may become cancer cells. Other types of kinase inhibitors that affect cells with mutations (changes) in the BRAF gene, such as dabrafenib and vemurafenib, are being studied in clinical trials for LCH.     A family of genes, called ras genes, may cause cancer when they are mutated. Ras genes make proteins that are involved in cell signaling pathways, cell growth, and cell death. Ras pathway inhibitors are a type of targeted therapy being studied in clinical trials. They block the actions of a mutated ras gene or its protein and may stop the growth of cancer.        Other drug therapy    Other drugs used to treat LCH include the following:            -  Steroid therapy, such as prednisone, is used to treat LCH lesions.     -  Bisphosphonate therapy (such as pamidronate, zoledronate, or alendronate) is used to treat LCH lesions of the bone and to lessen bone pain.      -  Nonsteroidal anti-inflammatory drugs (NSAIDs) are drugs (such as aspirin and ibuprofen) that are commonly used to decrease fever, swelling, pain, and redness. Sometimes an NSAID called indomethacin is used to treat LCH.     -  Retinoids, such as isotretinoin, are drugs related to vitamin A that can slow the growth of LCH cells in the skin. The retinoids are taken by mouth.              Stem cell transplant     Stem cell transplant is a method of giving chemotherapy and replacing blood-forming cells destroyed by the LCH treatment. Stem cells (immature blood cells) are removed from the blood or bone marrow of the patient or a donor and are frozen and stored. After the chemotherapy is completed, the stored stem cells are thawed and given back to the patient through an infusion. These reinfused stem cells grow into (and restore) the body's blood cells.        Observation     Observation is closely monitoring a patient's condition without giving any treatment until signs or symptoms appear or change.

                    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 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 for Childhood LCH and the Treatment Options for Adult LCH sections for links to current treatment clinical trials. These have been retrieved from NCI's clinical trials database.

                    When treatment of LCH stops, new lesions may appear or old lesions may come back.
                    Many patients with LCH get better with treatment. However, when treatment stops, new lesions may appear or old lesions may come back. This is called reactivation (recurrence) and may occur within one year after stopping treatment. Patients with multisystem disease are more likely to have a reactivation. More common sites of reactivation are bone, ears, or skin. Diabetes insipidus also may develop. Less common sites of reactivation include lymph nodes, bone marrow, spleen, liver, or lung. Some patients may have more than one reactivation over a number of years.

                    Follow-up tests may be needed.
                    Some of the tests that were done to diagnose LCH may be repeated. This is to see how well the treatment is working and if there are any new lesions. These tests may include:         -  Physical exam.    -  Neurological exam.    -  Ultrasound exam.    -  MRI.    -  CT scan.    -  PET scan.        Other tests that may be needed include:         -  Brain stem auditory evoked response (BAER) test: A test that measures the brain's response to clicking sounds or certain tones.     -  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 a lung function test.    -  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.        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 LCH in Children

		                    Treatment of Low-Risk Disease in Children
		                    Skin Lesions    Treatment of childhood Langerhans cell histiocytosis (LCH) skin lesions may include the following:            -  Observation.            When severe rashes, pain, ulceration, or bleeding occur, treatment may include the following:            -  Steroid therapy.     -  Chemotherapy, given by mouth.     - Nitrogen mustard applied to the skin.     -  Photodynamic therapy with psoralen and ultraviolet A (PUVA) therapy.     -  UVB radiation therapy.              Lesions in Bones or Other Low-Risk Organs    Treatment of childhood LCH bone lesions in the front, sides, or back of the skull, or in any other single bone may include the following:            -  Surgery (curettage) with or without steroid therapy.     - Low-dose radiation therapy for lesions that affect nearby organs.           Treatment of childhood LCH lesions in bones around the ears or eyes is done to lower the risk of diabetes insipidus and other long-term problems. Treatment may include:            -  Chemotherapy and steroid therapy.     - Surgery (curettage).           Treatment of childhood LCH lesions of the spine or thigh bone lesions may include:            -  Observation.     - Low-dose radiation therapy.     - Chemotherapy, for lesions that spread from the spine into nearby tissue.     - Surgery to strengthen the weakened bone by bracing or fusing the bones together.           Treatment of two or more bone lesions may include:             - Chemotherapy and steroid therapy.           Treatment of two or more bone lesions combined with childhood LCH skin lesions, lymph node lesions, or diabetes insipidus may include:             - Chemotherapy with or without steroid therapy.     -  Bisphosphonate therapy.

		                    Treatment of High-Risk Disease in Children
		                    Treatment of childhood LCH multisystem disease lesions in the spleen, liver, or bone marrow (with or without skin, bone, lymph node, lung, or pituitary gland lesions) may include:         -  Chemotherapy and steroid therapy. Higher doses of combination chemotherapy and steroid therapy may be given to patients whose tumors do not respond to initial chemotherapy.    - A liver transplant for patients with severe liver damage.        Treatment of childhood LCH central nervous system (CNS) lesions may include:         - Chemotherapy with or without steroid therapy.    - Steroid therapy.        Treatment of LCH CNS neurodegenerative syndrome may include:         -  Retinoid therapy.    - Chemotherapy.

		                    Treatment Options for Recurrent, Refractory, and Progressive Childhood LCH in Children
		                    Recurrent LCH is cancer that cannot be detected for some time after treatment and then comes back. Treatment of recurrent childhood LCH in the skin, bone, lymph nodes, gastrointestinal tract, pituitary gland, or central nervous system (low-risk organs) may include:         -  Chemotherapy with or without steroid therapy.    -  Bisphosphonate therapy.    -  Nonsteroidal anti-inflammatory drug (NSAID) therapy with indomethacin.    - A clinical trial of a targeted therapy.         Refractory LCH is cancer that does not get better with treatment. Treatment of refractory childhood LCH in high-risk organs and in multisystem low-risk organs may include high-dose chemotherapy. Treatment of childhood LCH in multisystem high-risk organs that did not respond to chemotherapy may include stem cell transplant.     Progressive LCH is cancer that continues to grow during treatment. Treatment of progressive childhood LCH in patients with multisystem disease may include anticancer drugs that have not been given to the patient before.

		            Treatment Options for LCH in Adults

		                    Treatment Options for LCH of the Lung in Adults
		                    Treatment for LCH of the lung in adults may include:         - Quitting smoking for all patients who smoke. Lung damage will get worse over time in patients who do not quit smoking. In patients who quit smoking, lung damage may get better or it may get worse over time.    -  Chemotherapy.    - Lung transplant for patients with severe lung damage.        Sometimes LCH of the lung will go away or not get worse even if it's not treated.

		                    Treatment Options for LCH of the Bone in Adults
		                    Treatment for LCH that affects only the bone in adults may include:         -  Surgery with or without steroid therapy.    -  Chemotherapy with or without low-dose radiation therapy.    - Radiation therapy.    -  Bisphosphonate therapy, for severe bone pain.

		                    Treatment Options for LCH of the Skin in Adults
		                    Treatment for LCH that affects only the skin in adults may include:         -  Surgery.    -  Steroid or other drug therapy applied or injected into the skin.    -  Photodynamic therapy with psoralen and ultraviolet A (PUVA) radiation.    -  UVB radiation therapy.    -  Chemotherapy or biologic therapy given by mouth, such as methotrexate, thalidomide, or interferon.    -  Retinoid therapy may be used if the skin lesions do not get better with other treatment.        Treatment for LCH that affects the skin and other body systems in adults may include:         - Chemotherapy.

		                    Treatment Options for Single-System and Multisystem LCH in Adults
		                    Treatment of single-system and multisystem disease in adults may include:         -  Chemotherapy with or without a drug given to weaken the immune system.     -  Bisphosphonate therapy, for severe bone pain.    - A clinical trial of a targeted therapy. </s>


Input: what research (or clinical trials) is being done for Langerhans Cell Histiocytosis ?

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 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 for Childhood LCH and the Treatment Options for Adult LCH sections for links to current treatment clinical trials. These have been retrieved from NCI's clinical trials database. </s>


Input: What is (are) Laryngeal Cancer ?

Output:
Key Points
                    - Laryngeal cancer is a disease in which malignant (cancer) cells form in the tissues of the larynx.    - Use of tobacco products and drinking too much alcohol can affect the risk of laryngeal cancer.    - Signs and symptoms of laryngeal cancer include a sore throat and ear pain.     - Tests that examine the throat and neck are used to help detect (find), diagnose, and stage laryngeal cancer.    - Certain factors affect prognosis (chance of recovery) and treatment options.

                    Laryngeal cancer is a disease in which malignant (cancer) cells form in the tissues of the larynx.
                    The larynx is a part of the throat, between the base of the tongue and the trachea. The larynx contains the vocal cords, which vibrate and make sound when air is directed against them. The sound echoes through the pharynx, mouth, and nose to make a person's voice.   There are three main parts of the larynx:          -  Supraglottis: The upper part of the larynx above the vocal cords, including the epiglottis.    -  Glottis: The middle part of the larynx where the vocal cords are located.    -  Subglottis: The lower part of the larynx between the vocal cords and the trachea (windpipe).         Most laryngeal cancers form in squamous cells, the thin, flat cells lining the inside of the larynx.    Laryngeal cancer is a type of head and neck cancer. </s>


Input: Who is at risk for Laryngeal Cancer? ?

Output: Use of tobacco products and drinking too much alcohol can affect the risk of laryngeal cancer.Anything that increases your risk of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesn't mean that you will not get cancer. Talk with your doctor if you think you may be at risk. </s>


Input: What are the symptoms of Laryngeal Cancer ?

Output: Signs and symptoms of laryngeal cancer include a sore throat and ear pain. These and other signs and symptoms may be caused by laryngeal cancer or by other conditions. Check with your doctor if you have any of the following:         - A sore throat or cough that does not go away.    - Trouble or pain when swallowing.    - Ear pain.    - A lump in the neck or throat.    - A change or hoarseness in the voice. </s>


Input: How to diagnose Laryngeal Cancer ?

Output: Tests that examine the throat and neck are used to help detect (find), diagnose, and stage laryngeal cancer.The following tests and procedures may be used:         -   Physical exam of the throat and neck: An exam to check the throat and neck for abnormal areas. The doctor will feel the inside of the mouth with a gloved finger and examine the mouth and throat with a small long-handled mirror and light. This will include checking the insides of the cheeks and lips; the gums; the back, roof, and floor of the mouth; the top, bottom, and sides of the tongue; and the throat. The neck will be felt for swollen lymph nodes. A history of the patients health habits and past illnesses and medical treatments will also be taken.    -   Biopsy : The removal of cells or tissues so they can be viewed under a microscope by a pathologist to check for signs of cancer. The sample of tissue may be removed during one of the following procedures:               -  Laryngoscopy : A procedure to look at the larynx (voice box) for abnormal areas. A mirror or a laryngoscope (a thin, tube-like instrument with a light and a lens for viewing) is inserted through the mouth to see the larynx. A special tool on the laryngoscope may be used to remove samples of tissue.      -  Endoscopy : A procedure to look at organs and tissues inside the body, such as the throat, esophagus, and trachea to check for abnormal areas. An endoscope (a thin, lighted tube with a light and a lens for viewing) is inserted through an opening in the body, such as the mouth. A special tool on the endoscope may be used to remove samples of tissue.             -   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): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI).     -   PET scan (positron emission tomography scan): A procedure to find malignant tumor cells in the body. A small amount of radioactive glucose (sugar) is injected into a vein. The PET scanner rotates around the body and makes a picture of where glucose is being used in the body. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do.     -   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.    -   Barium swallow : A series of x-rays of the esophagus and stomach. The patient drinks a liquid that contains barium (a silver-white metallic compound). The liquid coats the esophagus and stomach, and x-rays are taken. This procedure is also called an upper GI series. </s>


Input: What is the outlook for Laryngeal Cancer ?

Output: Certain factors affect prognosis (chance of recovery) and treatment options. Prognosis (chance of recovery) depends on the following:         - The stage of the disease.    - The location and size of the tumor.    - The grade of the tumor.    - The patient's age, gender, and general health, including whether the patient is anemic.         Treatment options depend on the following:         - The stage of the disease.    - The location and size of the tumor.    - Keeping the patient's ability to talk, eat, and breathe as normal as possible.    - Whether the cancer has come back (recurred).        Smoking tobacco and drinking alcohol decrease the effectiveness of treatment for laryngeal cancer. Patients with laryngeal cancer who continue to smoke and drink are less likely to be cured and more likely to develop a second tumor. After treatment for laryngeal cancer, frequent and careful follow-up is important. </s>


Input: What are the stages of Laryngeal Cancer ?

Output:
Key Points
                    - After laryngeal cancer has been diagnosed, tests are done to find out if cancer cells have spread within the larynx 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 laryngeal cancer:         - Stage 0 (Carcinoma in Situ)     - Stage I     - Stage II     - Stage III     - Stage IV

                    After laryngeal cancer has been diagnosed, tests are done to find out if cancer cells have spread within the larynx or to other parts of the body.
                    The process used to find out if cancer has spread within the larynx 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 of the disease in order to plan treatment. The results of some of the tests used to diagnose laryngeal cancer are often also used to stage the disease.

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

                    The following stages are used for laryngeal cancer:
                    Stage 0 (Carcinoma in Situ)    In stage 0, abnormal cells are found in the lining of the larynx. 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 laryngeal cancer depends on where cancer began in the larynx:            -  Supraglottis: Cancer is in one area of the supraglottis only and the vocal cords can move normally.     -  Glottis: Cancer is in one or both vocal cords and the vocal cords can move normally.     -  Subglottis: Cancer is in the subglottis only.              Stage II    In stage II, cancer is in the larynx only. Stage II laryngeal cancer depends on where cancer began in the larynx:            -  Supraglottis: Cancer is in more than one area of the supraglottis or surrounding tissues.     -  Glottis: Cancer has spread to the supraglottis and/or the subglottis and/or the vocal cords cannot move normally.     - Subglottis: Cancer has spread to one or both vocal cords, which may not move normally.               Stage III     Stage III laryngeal cancer depends on whether cancer has spread from the supraglottis, glottis, or subglottis.    In stage III cancer of the supraglottis:            -  cancer is in the larynx only and the vocal cords cannot move, and/or cancer is in tissues next to the larynx. Cancer may have spread to one lymph node on the same side of the neck as the original tumor and the lymph node is 3 centimeters or smaller; or     - cancer is in one area of the supraglottis and in one lymph node on the same side of the neck as the original tumor; the lymph node is 3 centimeters or smaller and the vocal cords can move normally; or     - cancer is in more than one area of the supraglottis or surrounding tissues and in one lymph node on the same side of the neck as the original tumor; the lymph node is 3 centimeters or smaller.           In stage III cancer of the glottis:            - cancer is in the larynx only and the vocal cords cannot move, and/or cancer is in tissues next to the larynx; cancer may have spread to one lymph node on the same side of the neck as the original tumor and the lymph node is 3 centimeters or smaller; or     - cancer is in one or both vocal cords and in one lymph node on the same side of the neck as the original tumor; the lymph node is 3 centimeters or smaller and the vocal cords can move normally; or     - cancer has spread to the supraglottis and/or the subglottis and/or the vocal cords cannot move normally. Cancer has also spread to one lymph node on the same side of the neck as the original tumor and the lymph node is 3 centimeters or smaller.           In stage III cancer of the subglottis:            - cancer is in the larynx and the vocal cords cannot move; cancer may have spread to one lymph node on the same side of the neck as the original tumor and the lymph node is 3 centimeters or smaller; or     - cancer is in the subglottis and in one lymph node on the same side of the neck as the original tumor; the lymph node is 3 centimeters or smaller; or     - cancer has spread to one or both vocal cords, which may not move normally. Cancer has also spread to one lymph node on the same side of the neck as the original tumor and the lymph node is 3 centimeters or smaller.              Stage IV     Stage IV is divided into stage IVA, stage IVB, and stage IVC. Each substage is the same for cancer in the supraglottis, glottis, or subglottis.            - In stage IVA:                   - cancer has spread through the thyroid cartilage and/or has spread to tissues beyond the larynx such as the neck, trachea, thyroid, or esophagus. Cancer may have spread to one lymph node on the same side of the neck as the original tumor and the lymph node is 3 centimeters or smaller; or       - cancer has spread to one lymph node on the same side of the neck as the original tumor and the lymph node is larger than 3 centimeters but not larger than 6 centimeters, or has spread to more than one lymph node anywhere in the neck with none larger than 6 centimeters. Cancer may have spread to tissues beyond the larynx, such as the neck, trachea, thyroid, or esophagus. The vocal cords may not move normally.                 - In stage IVB:                   -  cancer has spread to the space in front of the spinal column, surrounds the carotid artery, or has spread to parts of the chest. Cancer may have spread to one or more lymph nodes anywhere in the neck and the lymph nodes may be any size; or       -  cancer has spread to a lymph node that is larger than 6 centimeters and may have spread as far as the space in front of the spinal column, around the carotid artery, or to parts of the chest. The vocal cords may not move normally.                - In stage IVC, cancer has spread to other parts of the body, such as the lungs, liver, or bone. </s>


Input: What are the treatments for Laryngeal Cancer ?

Output:
Key Points
                    - There are different types of treatment for patients with laryngeal cancer.     - Three types of standard treatment are used:         - Radiation therapy      - Surgery     - Chemotherapy         - New types of treatment are being tested in clinical trials.          - Chemoprevention     - 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 laryngeal cancer.
                    Different types of treatment are available for patients with laryngeal cancer. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.

                    Three types of standard treatment are used:
                    Radiation therapy      Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells. 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.        Radiation therapy may work better in patients who have stopped smoking before beginning treatment. External radiation therapy to the thyroid or the pituitary gland may change the way the thyroid gland works. The doctor may test the thyroid gland before and after therapy to make sure it is working properly.      Hyperfractionated radiation therapy and new types of radiation therapy are being studied in the treatment of laryngeal cancer.       Surgery     Surgery (removing the cancer in an operation) is a common treatment for all stages of laryngeal cancer. The following surgical procedures may be used:            -  Cordectomy: Surgery to remove the vocal cords only.     -  Supraglottic laryngectomy: Surgery to remove the supraglottis only.      -  Hemilaryngectomy: Surgery to remove half of the larynx (voice box). A hemilaryngectomy saves the voice.     -  Partial laryngectomy: Surgery to remove part of the larynx (voice box). A partial laryngectomy helps keep the patient's ability to talk.     -  Total laryngectomy: Surgery to remove the whole larynx. During this operation, a hole is made in the front of the neck to allow the patient to breathe. This is called a tracheostomy.     -  Thyroidectomy: The removal of all or part of the thyroid gland.     -  Laser surgery: A surgical procedure that uses a laser beam (a narrow beam of intense light) as a knife to make bloodless cuts in tissue or to remove a surface lesion such as a tumor            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.       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 Head and Neck Cancer for more information. (Laryngeal cancer is a type of head and neck cancer.)

                    New types of treatment are being tested in clinical trials.
                    This summary section describes treatments that are being studied in clinical trials. It may not mention every new treatment being studied. Information about clinical trials is available from the NCI Web site.     Chemoprevention     Chemoprevention is the use of drugs, vitamins, or other substances to reduce the risk of developing cancer or to reduce the risk cancer will recur (come back). The drug isotretinoin is being studied to prevent the development of a second cancer in patients who have had cancer of the head or neck.        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 by Stage

		                    Stage I Laryngeal Cancer
		                    Treatment of stage I laryngeal cancer depends on where cancer is found in the larynx.   If cancer is in the supraglottis, treatment may include the following:         -  Radiation therapy.    -  Supraglottic laryngectomy.        If cancer is in the glottis, treatment may include the following:         - Radiation therapy.    -  Cordectomy.    -  Partial laryngectomy, hemilaryngectomy, or total laryngectomy.    -  Laser surgery.        If cancer is in the subglottis, treatment may include the following:         - Radiation therapy with or without surgery.    - Surgery alone.        Check the list of NCI-supported cancer clinical trials that are now accepting patients with stage I laryngeal 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 Laryngeal Cancer
		                    Treatment of stage II laryngeal cancer depends on where cancer is found in the larynx.   If cancer is in the supraglottis, treatment may include the following:         -  Radiation therapy     -  Supraglottic laryngectomy or total laryngectomy with or without radiation therapy.    - A clinical trial of radiation therapy.    - A clinical trial of chemoprevention.        If cancer is in the glottis, treatment may include the following:         - Radiation therapy.    -  Partial laryngectomy, hemilaryngectomy, or total laryngectomy.    -  Laser surgery.    - A clinical trial of radiation therapy.    - A clinical trial of chemoprevention.        If cancer is in the subglottis, treatment may include the following:         - Radiation therapy with or without surgery.    - Surgery alone.    - A clinical trial of radiation therapy.    - A clinical trial of chemoprevention.        Check the list of NCI-supported cancer clinical trials that are now accepting patients with stage II laryngeal 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 Laryngeal Cancer
		                    Treatment of stage III laryngeal cancer depends on where cancer is found in the larynx.   If cancer is in the supraglottis or glottis, treatment may include the following:         -  Chemotherapy and radiation therapy given together.    - Chemotherapy followed by chemotherapy and radiation therapy given together. Laryngectomy may be done if cancer remains.    - Radiation therapy for patients who cannot be treated with chemotherapy and surgery.For tumors that do not respond to radiation, total laryngectomy may be done.    - Surgery, which may be followed by radiation therapy.    - A clinical trial of radiation therapy.    - A clinical trial of chemotherapy, radiosensitizers, or radiation therapy.    - A clinical trial of chemoprevention.        If cancer is in the subglottis, treatment may include the following:         - Laryngectomy plus total thyroidectomy and removal of lymph nodes in the throat, usually followed by radiation therapy.    - Radiation therapy with or without surgery.    - A clinical trial of chemotherapy, radiosensitizers, or radiation therapy.    - A clinical trial of chemoprevention.        Check the list of NCI-supported cancer clinical trials that are now accepting patients with stage III laryngeal cancer. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the NCI website.

		                    Stage IV Laryngeal Cancer
		                    Treatment of stage IV laryngeal cancer depends on where cancer is found in the larynx.   If cancer is in the supraglottis or glottis, treatment may include the following:         -  Chemotherapy and radiation therapy given together.    - Chemotherapy followed by chemotherapy and radiation therapy given together. Laryngectomy may be done if cancer remains.    - Radiation therapy for patients who cannot be treated with chemotherapy and surgery. For tumors that do not respond to radiation, total laryngectomy may be done.    - Surgery followed by radiation therapy. Chemotherapy may be given with the radiation therapy.    - A clinical trial of radiation therapy.    - A clinical trial of chemotherapy, radiosensitizers, or radiation therapy.    - A clinical trial of chemoprevention.        If cancer is in the subglottis, treatment may include the following:         - Laryngectomy plus total thyroidectomy and removal of lymph nodes in the throat, usually with radiation therapy.     - Radiation therapy.    - A clinical trial of radiation therapy.    - A clinical trial of chemotherapy, radiosensitizers, or radiation therapy.    - A clinical trial of chemoprevention.        Check the list of NCI-supported cancer clinical trials that are now accepting patients with stage IV laryngeal 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 Laryngeal Cancer ?

Output:
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 Web site.     Chemoprevention     Chemoprevention is the use of drugs, vitamins, or other substances to reduce the risk of developing cancer or to reduce the risk cancer will recur (come back). The drug isotretinoin is being studied to prevent the development of a second cancer in patients who have had cancer of the head or neck.        Radiosensitizers     Radiosensitizers are drugs that make tumor cells more sensitive to radiation therapy. Combining radiation therapy with radiosensitizers may kill more tumor cells.

                    Patients may want to think about taking part in a clinical trial.
                    For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment.   Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment.   Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward.

                    Patients can enter clinical trials before, during, or after starting their cancer treatment.
                    Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring (coming back) or reduce the side effects of cancer treatment.   Clinical trials are taking place in many parts of the country. See the Treatment Options section that follows for links to current treatment clinical trials. These have been retrieved from NCI's listing of clinical trials. </s>


Input: What is (are) Liver (Hepatocellular) Cancer ?

Output:
Key Points
                    - Liver cancer is a disease in which malignant (cancer) cells form in the tissues of the liver.    - Liver cancer is not common in the United States.    - Being infected with certain types of the hepatitis virus can cause hepatitis and increase the risk of liver cancer.         - Hepatitis A     - Hepatitis B     - Hepatitis C     - Hepatitis D     - Hepatitis E     - Hepatitis G

                    Liver cancer is a disease in which malignant (cancer) cells form in the tissues of the liver.
                    The liver is one of the largest organs in the body. It has four lobes and fills the upper right side of the abdomen inside the rib cage. Three of the many important functions of the liver are:         - To filter harmful substances from the blood so they can be passed from the body in stools and urine.    - To make bile to help digest fats from food.     - To store glycogen (sugar), which the body uses for energy.          See the following PDQ summaries for more information about liver (hepatocellular) cancer:         -  Liver (Hepatocellular) Cancer Screening     -  Adult Primary Liver Cancer Treatment     -  Childhood Liver Cancer Treatment

                    Liver cancer is not common in the United States.
                    Liver cancer is the fourth most common cancer and the third leading cause of cancer death in the world. In the United States, men, especially Asian/Pacific Islander men, have an increased risk of liver cancer. The number of new cases of liver cancer and the number of deaths from liver cancer continue to increase, especially among middle-aged black, Hispanic, and white men. People are usually older than 40 years when they develop this cancer.    Finding and treating liver cancer early may prevent death from liver cancer. </s>


Input: Who is at risk for Liver (Hepatocellular) Cancer? ?

Output:
Being infected with certain types of the hepatitis virus can cause hepatitis and increase the risk of liver cancer.
                    Hepatitis is most commonly caused by the hepatitis virus. Hepatitis is a disease that causes inflammation (swelling) of the liver. Damage to the liver from hepatitis that lasts a long time can increase the risk of liver cancer.    There are six types of the hepatitis virus. Hepatitis A (HAV), hepatitis B (HBV), and hepatitis C (HCV) are the three most common types. These three viruses cause similar symptoms, but the ways they spread and affect the liver are different.    The Hepatitis A vaccine and the hepatitis B vaccine prevent infection with hepatitis A and hepatitis B. There is no vaccine to prevent infection with hepatitis C. If a person has had one type of hepatitis in the past, it is still possible to get the other types.   Hepatitis viruses include:     Hepatitis A    Hepatitis A is caused by eating food or drinking water infected with hepatitis A virus. It does not lead to chronic disease. People with hepatitis A usually get better without treatment.       Hepatitis B    Hepatitis B is caused by contact with the blood, semen, or other body fluid of a person infected with hepatitis B virus. It is a serious infection that may become chronic and cause scarring of the liver (cirrhosis). This may lead to liver cancer. Blood banks test all donated blood for hepatitis B, which greatly lowers the risk of getting the virus from blood transfusions.       Hepatitis C    Hepatitis C is caused by contact with the blood of a person infected with hepatitis C virus. Hepatitis C may range from a mild illness that lasts a few weeks to a serious, lifelong illness. Most people who have hepatitis C develop a chronic infection that may cause scarring of the liver (cirrhosis). This may lead to liver cancer. Blood banks test all donated blood for hepatitis C, which greatly lowers the risk of getting the virus from blood transfusions.       Hepatitis D    Hepatitis D develops in people already infected with hepatitis B. It is caused by hepatitis D virus (HDV) and is spread through contact with infected blood or dirty needles, or by having unprotected sex with a person infected with HDV. Hepatitis D causes acute hepatitis.       Hepatitis E    Hepatitis E is caused by hepatitis E virus (HEV). Hepatitis E can be spread through oral- anal contact or by drinking infected water. Hepatitis E is rare in the United States.       Hepatitis G    Being infected with hepatitis G virus (HGV) has not been shown to cause liver cancer.

                    Key Points
                    - Avoiding risk factors and increasing protective factors may help prevent cancer.    - The following risk factors may increase the risk of liver cancer:         - Hepatitis B and C     - Cirrhosis     - Aflatoxin        - The following protective factor may decrease the risk of liver cancer:         - Hepatitis B vaccine        - Cancer prevention clinical trials are used to study ways to prevent cancer.     - New ways to prevent liver cancer are being studied in clinical trials.

                    Avoiding risk factors and increasing protective factors may help prevent cancer.
                    Avoiding cancer risk factors may help prevent certain cancers. Risk factors include smoking, being overweight, and not getting enough exercise. Increasing protective factors such as quitting smoking and exercising may also help prevent some cancers. Talk to your doctor or other health care professional about how you might lower your risk of cancer.

                    The following risk factors may increase the risk of liver cancer:
                    Hepatitis B and C    Having chronic hepatitis B or chronic hepatitis C increases the risk of developing liver cancer. The risk is even greater for people with both hepatitis B and C. Also, the longer the hepatitis infection lasts (especially hepatitis C), the greater the risk.    In a study of patients with chronic hepatitis C, those who were treated to lower their iron levels by having blood drawn and eating a low-iron diet were less likely to develop liver cancer than those who did not have this treatment.       Cirrhosis    The risk of developing liver cancer is increased for people who have cirrhosis, a disease in which healthy liver tissue is replaced by scar tissue. The scar tissue blocks the flow of blood through the liver and keeps it from working as it should. Chronic alcoholism and chronic hepatitis C are the most common causes of cirrhosis.       Aflatoxin    The risk of developing liver cancer may be increased by eating foods that contain aflatoxin (poison from a fungus that can grow on foods, such as grains and nuts, that have not been stored properly). </s>


Input: How to prevent Liver (Hepatocellular) Cancer ?

Output:
Key Points
                    - Avoiding risk factors and increasing protective factors may help prevent cancer.    - The following risk factors may increase the risk of liver cancer:         - Hepatitis B and C     - Cirrhosis     - Aflatoxin        - The following protective factor may decrease the risk of liver cancer:         - Hepatitis B vaccine        - Cancer prevention clinical trials are used to study ways to prevent cancer.     - New ways to prevent liver cancer are being studied in clinical trials.

                    Avoiding risk factors and increasing protective factors may help prevent cancer.
                    Avoiding cancer risk factors may help prevent certain cancers. Risk factors include smoking, being overweight, and not getting enough exercise. Increasing protective factors such as quitting smoking and exercising may also help prevent some cancers. Talk to your doctor or other health care professional about how you might lower your risk of cancer.

                    The following risk factors may increase the risk of liver cancer:
                    Hepatitis B and C    Having chronic hepatitis B or chronic hepatitis C increases the risk of developing liver cancer. The risk is even greater for people with both hepatitis B and C. Also, the longer the hepatitis infection lasts (especially hepatitis C), the greater the risk.    In a study of patients with chronic hepatitis C, those who were treated to lower their iron levels by having blood drawn and eating a low-iron diet were less likely to develop liver cancer than those who did not have this treatment.       Cirrhosis    The risk of developing liver cancer is increased for people who have cirrhosis, a disease in which healthy liver tissue is replaced by scar tissue. The scar tissue blocks the flow of blood through the liver and keeps it from working as it should. Chronic alcoholism and chronic hepatitis C are the most common causes of cirrhosis.       Aflatoxin    The risk of developing liver cancer may be increased by eating foods that contain aflatoxin (poison from a fungus that can grow on foods, such as grains and nuts, that have not been stored properly).

                    The following protective factor may decrease the risk of liver cancer:
                    Hepatitis B vaccine    Preventing hepatitis B infection (by being vaccinated for hepatitis B) has been shown to lower the risk of liver cancer in children. It is not yet known if it lowers the risk in adults.

                    Cancer prevention clinical trials are used to study ways to prevent cancer.
                    Cancer prevention clinical trials are used to study ways to lower the risk of developing certain types of cancer. Some cancer prevention trials are conducted with healthy people who have not had cancer but who have an increased risk for cancer. Other prevention trials are conducted with people who have had cancer and are trying to prevent another cancer of the same type or to lower their chance of developing a new type of cancer. Other trials are done with healthy volunteers who are not known to have any risk factors for cancer.    The purpose of some cancer prevention clinical trials is to find out whether actions people take can prevent cancer. These may include eating fruits and vegetables, exercising, quitting smoking, or taking certain medicines, vitamins, minerals, or food supplements.

                    New ways to prevent liver cancer are being studied in clinical trials.
                    Clinical trials are taking place in many parts of the country. Information about clinical trials can be found in the Clinical Trials section of the NCI website. Check NCI's list of cancer clinical trials for liver cancer prevention trials that are now accepting patients. </s>


Input: what research (or clinical trials) is being done for Liver (Hepatocellular) Cancer ?

Output:
Cancer prevention clinical trials are used to study ways to prevent cancer.
                    Cancer prevention clinical trials are used to study ways to lower the risk of developing certain types of cancer. Some cancer prevention trials are conducted with healthy people who have not had cancer but who have an increased risk for cancer. Other prevention trials are conducted with people who have had cancer and are trying to prevent another cancer of the same type or to lower their chance of developing a new type of cancer. Other trials are done with healthy volunteers who are not known to have any risk factors for cancer.    The purpose of some cancer prevention clinical trials is to find out whether actions people take can prevent cancer. These may include eating fruits and vegetables, exercising, quitting smoking, or taking certain medicines, vitamins, minerals, or food supplements.

                    New ways to prevent liver cancer are being studied in clinical trials.
                    Clinical trials are taking place in many parts of the country. Information about clinical trials can be found in the Clinical Trials section of the NCI website. Check NCI's list of cancer clinical trials for liver cancer prevention trials that are now accepting patients. </s>


Input: What is (are) Gastrointestinal Carcinoid Tumors ?

Output:
Key Points
                    - A gastrointestinal carcinoid tumor is cancer that forms in the lining of the gastrointestinal tract.     -  Health history can affect the risk of gastrointestinal carcinoid tumors.     - Some gastrointestinal carcinoid tumors have no signs or symptoms in the early stages.     -  Carcinoid syndrome may occur if the tumor spreads to the liver or other parts of the body.     - Imaging studies and tests that examine the blood and urine are used to detect (find) and diagnose gastrointestinal carcinoid tumors.    - Certain factors affect prognosis (chance of recovery) and treatment options.

                    A gastrointestinal carcinoid tumor is cancer that forms in the lining of the gastrointestinal tract.
                    The gastrointestinal (GI) tract is part of the body's digestive system. It helps to digest food, takes nutrients (vitamins, minerals, carbohydrates, fats, proteins, and water) from food to be used by the body and helps pass waste material out of the body. The GI tract is made up of these and other organs:         -  Stomach.    -  Small intestine (duodenum, jejunum, and ileum).    -  Colon.    -  Rectum.          Gastrointestinal carcinoid tumors form from a certain type of neuroendocrine cell (a type of cell that is like a nerve cell and a hormone -making cell). These cells are scattered throughout the chest and abdomen but most are found in the GI tract. Neuroendocrine cells make hormones that help control digestive juices and the muscles used in moving food through the stomach and intestines. A GI carcinoid tumor may also make hormones and release them into the body.   GI carcinoid tumors are rare and most grow very slowly. Most of them occur in the small intestine, rectum, and appendix. Sometimes more than one tumor will form.    See the following PDQ summaries for more information related to GI and other types of carcinoid tumors:         -  Non-Small Cell Lung Cancer Treatment.    -  Pancreatic Neuroendocrine Tumors (Islet Cell Tumors) Treatment.     -  Rectal Cancer Treatment.    -  Small Intestine Cancer Treatment.    -  Unusual Cancers of Childhood Treatment

                    Carcinoid syndrome may occur if the tumor spreads to the liver or other parts of the body.
                    The hormones made by gastrointestinal carcinoid tumors are usually destroyed by liver enzymes in the blood. If the tumor has spread to the liver and the liver enzymes cannot destroy the extra hormones made by the tumor, high amounts of these hormones may remain in the body and cause carcinoid syndrome. This can also happen if tumor cells enter the blood. Signs and symptoms of carcinoid syndrome include the following:         - Redness or a feeling of warmth in the face and neck.     - Abdominal pain.    - Feeling bloated.    - Diarrhea.    - Wheezing or other trouble breathing.    - Fast heartbeat.        These signs and symptoms may be caused by gastrointestinal carcinoid tumors or by other conditions. Talk to your doctor if you have any of these signs or symptoms. </s>


Input: Who is at risk for Gastrointestinal Carcinoid Tumors? ?

Output: Health history can affect the risk of gastrointestinal carcinoid tumors. Anything that increases a person's chance of developing a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesnt mean that you will not get cancer. Talk to your doctor if you think you may be at risk.    Risk factors for GI carcinoid tumors include the following:         - Having a family history of multiple endocrine neoplasia type 1 (MEN1) syndrome or neurofibromatosis type 1 (NF1) syndrome.     - Having certain conditions that affect the stomach's ability to make stomach acid, such as atrophic gastritis, pernicious anemia, or Zollinger-Ellison syndrome. </s>


Input: What are the symptoms of Gastrointestinal Carcinoid Tumors ?

Output: Some gastrointestinal carcinoid tumors have no signs or symptoms in the early stages.Signs and symptoms may be caused by the growth of the tumor and/or the hormones the tumor makes. Some tumors, especially tumors of the stomach or appendix, may not cause signs or symptoms. Carcinoid tumors are often found during tests or treatments for other conditions.    Carcinoid tumors in the small intestine (duodenum, jejunum, and ileum), colon, and rectum sometimes cause signs or symptoms as they grow or because of the hormones they make. Other conditions may cause the same signs or symptoms. Check with your doctor if you have any of the following:         -  Duodenum  Signs and symptoms of GI carcinoid tumors in the duodenum (first part of the small intestine, that connects to the stomach) may include the following:                  -  Abdominal pain.       -  Constipation.       -  Diarrhea.       - Change in stool color.       -  Nausea.       -  Vomiting.       -  Jaundice (yellowing of the skin and whites of the eyes).       - Heartburn.                -  Jejunum and ileum  Signs and symptoms of GI carcinoid tumors in the jejunum (middle part of the small intestine) and ileum (last part of the small intestine, that connects to the colon) may include the following:                  -  Abdominal pain.       - Weight loss for no known reason.       - Feeling very tired.       - Feeling bloated       -  Diarrhea.       -  Nausea.       - Vomiting.                -  Colon  Signs and symptoms of GI carcinoid tumors in the colon may include the following:                  - Abdominal pain.       - Weight loss for no known reason.                -  Rectum  Signs and symptoms of GI carcinoid tumors in the rectum may include the following:                  -  Blood in the stool.       - Pain in the rectum.       -  Constipation. </s>


Input: How to diagnose Gastrointestinal Carcinoid Tumors ?

Output: Imaging studies and tests that examine the blood and urine are used to detect (find) and diagnose gastrointestinal carcinoid 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.     -   Blood chemistry studies : A procedure in which a blood sample is checked to measure the amounts of certain substances, such as hormones, 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. The blood sample is checked to see if it contains a hormone produced by carcinoid tumors. This test is used to help diagnose carcinoid syndrome.     -   Tumor marker test : A procedure in which a sample of blood, urine, or tissue is checked to measure the amounts of certain substances, such as chromogranin A, made by organs, tissues, or tumor cells in the body. Chromogranin A is a tumor marker. It has been linked to neuroendocrine tumors when found in increased levels in the body.     -  Twenty-four-hour urine test: A test in which urine is collected for 24 hours to measure the amounts of certain substances, such as 5-HIAA or serotonin (hormone). An unusual (higher or lower than normal) amount of a substance can be a sign of disease in the organ or tissue that makes it. This test is used to help diagnose carcinoid syndrome.    -  MIBG scan : A procedure used to find neuroendocrine tumors, such as carcinoid tumors. A very small amount of radioactive material called MIBG (metaiodobenzylguanidine) is injected into a vein and travels through the bloodstream. Carcinoid tumors take up the radioactive material and are detected by a device that measures radiation.    -   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): 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     -   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.    -   Endoscopic ultrasound (EUS): A procedure in which an endoscope is inserted into the body, usually through the mouth or rectum. 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, such as the stomach, small intestine, colon, or rectum, and make echoes. The echoes form a picture of body tissues called a sonogram. This procedure is also called endosonography.     -   Upper endoscopy : A procedure to look at organs and tissues inside the body to check for abnormal areas. An endoscope is inserted through the mouth and passed through the esophagus into the stomach. Sometimes the endoscope also is passed from the stomach into the small intestine. An endoscope 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 disease.     -   Colonoscopy : A procedure to look inside the rectum and colon for polyps, abnormal areas, or cancer. A colonoscope is inserted through the rectum into the colon. A colonoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove polyps or tissue samples, which are checked under a microscope for signs of cancer.    -   Capsule endoscopy : A procedure used to see all of the small intestine. The patient swallows a capsule that contains a tiny camera. As the capsule moves through the gastrointestinal tract, the camera takes pictures and sends them to a receiver worn on the outside of the body.     -   Biopsy : The removal of cells or tissues so they can be viewed under a microscope to check for signs of cancer. Tissue samples may be taken during endoscopy and colonoscopy. </s>


Input: What is the outlook for Gastrointestinal Carcinoid Tumors ?

Output: Certain factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery) and treatment options depend on the following:         - Where the tumor is in the gastrointestinal tract.    - The size of the tumor.     - Whether the cancer has spread from the stomach and intestines to other parts of the body, such as the liver or lymph nodes.    - Whether the patient has carcinoid syndrome or has carcinoid heart syndrome.    - Whether the cancer can be completely removed by surgery.     - Whether the cancer is newly diagnosed or has recurred. </s>


Input: What are the stages of Gastrointestinal Carcinoid Tumors ?

Output:
Key Points
                    - After a gastrointestinal carcinoid tumor has been diagnosed, tests are done to find out if cancer cells have spread within the stomach and intestines 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 plan for cancer treatment depends on where the carcinoid tumor is found and whether it can be removed by surgery.

                    After a gastrointestinal carcinoid tumor has been diagnosed, tests are done to find out if cancer cells have spread within the stomach and intestines or to other parts of the body.
                    Staging is the process used to find out how far the cancer has spread. The information gathered from the staging process determines the stage of the disease. The results of tests and procedures used to diagnose gastrointestinal (GI) carcinoid tumors may also be used for staging. See the General Information section for a description of these tests and procedures. A bone scan may be done 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.

                    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 tumor as the primary tumor. For example, if a gastrointestinal (GI) carcinoid tumor spreads to the liver, the tumor cells in the liver are actually GI carcinoid tumor cells. The disease is metastatic GI carcinoid tumor, not liver cancer.

                    The plan for cancer treatment depends on where the carcinoid tumor is found and whether it can be removed by surgery.
                    For many cancers it is important to know the stage of the cancer in order to plan treatment. However, the treatment of gastrointestinal carcinoid tumors is not based on the stage of the cancer. Treatment depends mainly on whether the tumor can be removed by surgery and if the tumor has spread.   Treatment is based on whether the tumor:         - Can be completely removed by surgery.    - Has spread to other parts of the body.    - Has come back after treatment. The tumor may come back in the stomach or intestines or in other parts of the body.    - Has not gotten better with treatment. </s>


Input: What are the treatments for Gastrointestinal Carcinoid Tumors ?

Output:
Key Points
                    - There are different types of treatment for patients with gastrointestinal carcinoid tumors.     - Four types of standard treatment are used:         - Surgery      - Radiation therapy      - Chemotherapy      - Hormone therapy         - Treatment for carcinoid syndrome may also be needed.    - New types of treatment are being tested in clinical trials.          - Targeted therapy         - Patients may want to think about taking part in a clinical trial.    - Patients can enter clinical trials before, during, or after starting their cancer treatment.    - Follow-up tests may be needed.

                    There are different types of treatment for patients with gastrointestinal carcinoid tumors.
                    Different types of treatment are available for patients with gastrointestinal carcinoid tumor. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.

                    Four types of standard treatment are used:
                    Surgery     Treatment of GI carcinoid tumors usually includes surgery. One of the following surgical procedures may be used:             -  Endoscopic resection: Surgery to remove a small tumor that is on the inside lining of the GI tract. An endoscope is inserted through the mouth and passed through the esophagus to the stomach and sometimes, the duodenum. An endoscope is a thin, tube-like instrument with a light, a lens for viewing, and a tool for removing tumor tissue.     -  Local excision: Surgery to remove the tumor and a small amount of normal tissue around it.      -  Resection: Surgery to remove part or all of the organ that contains cancer. Nearby lymph nodes may also be removed.     -  Cryosurgery: A treatment that uses an instrument to freeze and destroy carcinoid tumor tissue. This type of treatment is also called cryotherapy. The doctor may use ultrasound to guide the instrument.      -  Radiofrequency ablation: The use of a special probe with tiny electrodes that release high-energy radio waves (similar to microwaves) that kill cancer cells. The probe may be inserted through the skin or through an incision (cut) in the abdomen.     -  Liver transplant: Surgery to remove the whole liver and replace it with a healthy donated liver.     -  Hepatic artery embolization: A procedure to embolize (block) the hepatic artery, which is the main blood vessel that brings blood into the liver. Blocking the flow of blood to the liver helps kill cancer cells growing there.               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.            Radiopharmaceutical therapy is a type of internal radiation therapy. Radiation is given to the tumor using a drug that has a radioactive substance, such as iodine I 131, attached to it. The radioactive substance kills the tumor cells.     External and internal radiation therapy are used to treat gastrointestinal carcinoid tumors that have spread to other parts of the body.        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).      Chemoembolization of the hepatic artery is a type of regional chemotherapy that may be used to treat a gastrointestinal carcinoid tumor that has spread to the liver. The anticancer drug is injected into the hepatic artery through a catheter (thin tube). The drug is mixed with a substance that embolizes (blocks) the artery, and cuts off blood flow to the tumor. Most of the anticancer drug is trapped near the tumor and only a small amount of the drug reaches other parts of the body. The blockage may be temporary or permanent, depending on the substance used to block the artery. The tumor is prevented from getting the oxygen and nutrients it needs to grow. The liver continues to receive blood from the hepatic portal vein, which carries blood from the stomach and intestine.     The way the chemotherapy is given depends on the type and stage of the cancer being treated.       Hormone therapy      Hormone therapy with a somatostatin analogue is a treatment that stops extra hormones from being made. GI carcinoid tumors are treated with octreotide or lanreotide which are injected under the skin or into the muscle. Octreotide and lanreotide may also have a small effect on stopping tumor growth.

                    Treatment for carcinoid syndrome may also be needed.
                    Treatment of carcinoid syndrome may include the following:          - Hormone therapy with a somatostatin analogue stops extra hormones from being made. Carcinoid syndrome is treated with octreotide or lanreotide to lessen flushing and diarrhea. Octreotide and lanreotide may also help slow tumor growth.     -  Interferon therapy stimulates the bodys immune system to work better and lessens flushing and diarrhea. Interferon may also help slow tumor growth.    - Taking medicine for diarrhea.    - Taking medicine for skin rashes.    - Taking medicine to breathe easier.    - Taking medicine before having anesthesia for a medical procedure.        Other ways to help treat carcinoid syndrome include avoiding things that cause flushing or difficulty breathing such as alcohol, nuts, certain cheeses and foods with capsaicin, such as chili peppers. Avoiding stressful situations and certain types of physical activity can also help treat carcinoid syndrome.   For some patients with carcinoid heart syndrome, a heart valve replacement may be done.

                    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.     Targeted therapy      Targeted therapy is a type of treatment that uses drugs or other substances to identify and attack specific cancer cells without harming normal cells. Several types of targeted therapy are being studied in the treatment of GI carcinoid tumors.

                    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 Gastrointestinal Carcinoid Tumors

		                    Carcinoid Tumors in the Stomach
		                    Treatment of gastrointestinal (GI) carcinoid tumors in the stomach may include the following:         -  Endoscopic surgery (resection) for small tumors.    - Surgery (resection) to remove part or all of the stomach. Nearby lymph nodes for larger tumors, tumors that grow deep into the stomach wall, or tumors that are growing and spreading quickly may also be removed.        For patients with GI carcinoid tumors in the stomach and MEN1 syndrome, treatment may also include:         - Surgery (resection) to remove tumors in the duodenum (first part of the small intestine, that connects to the stomach).    -  Hormone therapy.        Check the list of NCI-supported cancer clinical trials that are now accepting patients with localized gastrointestinal carcinoid tumor and regional gastrointestinal carcinoid tumor. 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.

		                    Carcinoid Tumors in the Small Intestine
		                    It is not clear what the best treatment is for GI carcinoid tumors in the duodenum (first part of the small intestine, that connects to the stomach). Treatment may include the following:         -  Endoscopic surgery (resection) for small tumors.    - Surgery (local excision) to remove slightly larger tumors.    - Surgery (resection) to remove the tumor and nearby lymph nodes.        Treatment of GI carcinoid tumors in the jejunum (middle part of the small intestine) and ileum (last part of the small intestine, that connects to the colon) may include the following:         -  Surgery (resection) to remove the tumor and the membrane that connects the intestines to the back of the abdominal wall. Nearby lymph nodes are also removed.    - A second surgery to remove the membrane that connects the intestines to the back of the abdominal wall, if any tumor remains or the tumor continues to grow.    -  Hormone therapy.         Check the list of NCI-supported cancer clinical trials that are now accepting patients with localized gastrointestinal carcinoid tumor and regional gastrointestinal carcinoid tumor. 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.

		                    Carcinoid Tumors in the Appendix
		                    Treatment of GI carcinoid tumors in the appendix may include the following:         -  Surgery (resection) to remove the appendix.    - Surgery (resection) to remove the right side of the colon including the appendix. Nearby lymph nodes are also removed.        Check the list of NCI-supported cancer clinical trials that are now accepting patients with localized gastrointestinal carcinoid tumor and regional gastrointestinal carcinoid tumor. 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.

		                    Carcinoid Tumors in the Colon
		                    Treatment of GI carcinoid tumors in the colon may include the following:         -  Surgery (resection) to remove part of the colon and nearby  lymph nodes, in order to remove as much of the cancer as possible.        Check the list of NCI-supported cancer clinical trials that are now accepting patients with localized gastrointestinal carcinoid tumor and regional gastrointestinal carcinoid tumor. 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.

		                    Carcinoid Tumors in the Rectum
		                    Treatment of GI carcinoid tumors in the rectum may include the following:         -  Endoscopic surgery (resection) for tumors that are smaller than 1 centimeter.    - Surgery (resection) for tumors that are larger than 2 centimeters or that have spread to the muscle layer of the rectal wall. This may be either:               - surgery to remove part of the rectum; or      -  surgery to remove the anus, the rectum, and part of the colon through an incision made in the abdomen.                 It is not clear what the best treatment is for tumors that are 1 to 2 centimeters. Treatment may include the following:         - Endoscopic surgery (resection).    - Surgery (resection) to remove part of the rectum.    - Surgery (resection) to remove the anus, the rectum, and part of the colon through an incision made in the abdomen.        Check the list of NCI-supported cancer clinical trials that are now accepting patients with localized gastrointestinal carcinoid tumor and regional gastrointestinal carcinoid tumor. 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.

		                    Metastatic Gastrointestinal Carcinoid Tumors
		                    Distant metastases    Treatment of distant metastases of GI carcinoid tumors is usually palliative therapy to relieve symptoms and improve quality of life. Treatment may include the following:          -  Surgery (resection) to remove as much of the tumor as possible.    -  Hormone therapy.    -  Radiopharmaceutical therapy.    -  External radiation therapy for cancer that has spread to the bone, brain, or spinal cord.    - A clinical trial of a new treatment.         Liver metastases    Treatment of cancer that has spread to the liver may include the following:          - Surgery (local excision) to remove the tumor from the liver.    -  Hepatic artery embolization.    -  Cryosurgery.    -  Radiofrequency ablation.    - Liver transplant.        Check the list of NCI-supported cancer clinical trials that are now accepting patients with metastatic gastrointestinal carcinoid tumor. 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 Gastrointestinal Carcinoid Tumors
		                    Treatment of recurrent GI carcinoid tumors may include the following:          -  Surgery (local excision) to remove part or all of the tumor.    - A clinical trial of a new treatment.        Check the list of NCI-supported cancer clinical trials that are now accepting patients with recurrent gastrointestinal carcinoid tumor. 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 Gastrointestinal Carcinoid Tumors ?

Output:
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.     Targeted therapy      Targeted therapy is a type of treatment that uses drugs or other substances to identify and attack specific cancer cells without harming normal cells. Several types of targeted therapy are being studied in the treatment of GI carcinoid tumors.

                    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) Chronic Myelogenous Leukemia ?

Output: Chronic myelogenous leukemia is a disease in which too many white blood cells are made in the bone marrow. See the PDQ summary on Chronic Myelogenous Leukemia Treatment for information on diagnosis, staging, and treatment. </s>


Input: What are the treatments for Chronic Myelogenous Leukemia ?

Output: See the PDQ summary about Chronic Myelogenous Leukemia Treatment for information. </s>


Input: What is (are) Neuroblastoma ?

Output:
Key Points
                    - Neuroblastoma is a disease in which malignant (cancer) cells form in neuroblasts (immature nerve tissue) in the adrenal gland, neck, chest, or spinal cord.    - Neuroblastoma is sometimes caused by a gene mutation (change) passed from the parent to the child.    - Signs and symptoms of neuroblastoma include bone pain and a lump in the abdomen, neck, or chest.     - Tests that examine many different body tissues and fluids are used to detect (find) and diagnose neuroblastoma.    - A biopsy is done to diagnose neuroblastoma.    - Certain factors affect prognosis (chance of recovery) and treatment options.

                    Neuroblastoma is a disease in which malignant (cancer) cells form in neuroblasts (immature nerve tissue) in the adrenal gland, neck, chest, or spinal cord.
                    Neuroblastoma often begins in the nerve tissue of the adrenal glands. There are two adrenal glands, one on top of each kidney in the back of the upper abdomen. The adrenal glands make important hormones that help control heart rate, blood pressure, blood sugar, and the way the body reacts to stress. Neuroblastoma may also begin in nerve tissue in the neck, chest, abdomen or pelvis.      Neuroblastoma most often begins in infancy and may be diagnosed in the first month of life. It is found when the tumor begins to grow and cause signs or symptoms. Sometimes it forms before birth and is found during a fetal ultrasound.   By the time neuroblastoma is diagnosed, the cancer has usually metastasized (spread). Neuroblastoma spreads most often to the lymph nodes, bones, bone marrow, and liver. In infants, it also spreads to the skin. </s>


Input: Is Neuroblastoma inherited ?

Output: Neuroblastoma is sometimes caused by a gene mutation (change) passed from the parent to the child. Gene mutations that increase the risk of neuroblastoma are sometimes inherited (passed from the parent to the child). In children with a gene mutation, neuroblastoma usually occurs at a younger age and more than one tumor may form in the adrenal glands. </s>