Input: How to prevent Skin Cancer ?

Output:
Key Points
                    - Avoiding risk factors and increasing protective factors may help prevent cancer.    - Being exposed to ultraviolet radiation is a risk factor for skin cancer.    - It is not known if the following lower the risk of nonmelanoma skin cancer:         - Sunscreen use and avoiding sun exposure     - Chemopreventive agents        - It is not known if the following lower the risk of melanoma:         - Sunscreen     - Counseling and protecting the skin from the sun        - Cancer prevention clinical trials are used to study ways to prevent cancer.    -  New ways to prevent skin cancer are being studied in clinical trials.

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

                    Being exposed to ultraviolet radiation is a risk factor for skin cancer.
                    Some studies suggest that being exposed to ultraviolet (UV) radiation and the sensitivity of a persons skin to UV radiation are risk factors for skin cancer. UV radiation is the name for the invisible rays that are part of the energy that comes from the sun. Sunlamps and tanning beds also give off UV radiation.   Risk factors for nonmelanoma and melanoma cancers are not the same.         -  Risk factors for nonmelanoma skin cancer:                  - Being exposed to natural sunlight or artificial sunlight (such as from tanning beds) over long periods of time.       - Having a fair complexion, which includes the following:                         - Fair skin that freckles and burns easily, does not tan, or tans poorly.         - Blue or green or other light-colored eyes.          - Red or blond hair.                       - Having actinic keratosis.        - Past treatment with radiation.       - Having a weakened immune system.       - Being exposed to arsenic.                -  Risk factors for melanoma skin cancer:                  - Having a fair complexion, which includes the following:                         - Fair skin that freckles and burns easily, does not tan, or tans poorly.          - Blue or green or other light-colored eyes.         - Red or blond hair.                      - Being exposed to natural sunlight or artificial sunlight (such as from tanning beds) over long periods of time.       - Having a history of many blistering sunburns, especially as a child or teenager.       - Having several large or many small moles.       - Having a family history of unusual moles (atypical nevus syndrome).       - Having a family or personal history of melanoma.        - Being white.

                    It is not known if the following lower the risk of nonmelanoma skin cancer:
                    Sunscreen use and avoiding sun exposure    It is not known if nonmelanoma skin cancer risk is decreased by staying out of the sun, using sunscreens, or wearing protective clothing when outdoors. This is because not enough studies have been done to prove this.    Sunscreen may help decrease the amount of UV radiation to the skin. One study found that wearing sunscreen can help prevent actinic keratoses, scaly patches of skin that sometimes become squamous cell carcinoma.     The harms of using sunscreen are likely to be small and include allergic reactions to skin creams and lower levels of vitamin D made in the skin because of less sun exposure.     It is also possible that when a person uses sunscreen to avoid sunburn they may spend too much time in the sun and be exposed to harmful UV radiation.    Although protecting the skin and eyes from the sun has not been proven to lower the chance of getting skin cancer, skin experts suggest the following:            -  Use sunscreen that protects against UV radiation.     -  Do not stay out in the sun for long periods of time, especially when the sun is at its strongest.     -  Wear long sleeve shirts, long pants, sun hats, and sunglasses, when outdoors.              Chemopreventive agents     Chemoprevention is the use of drugs, vitamins, or other agents to try to reduce the risk of cancer. The following chemopreventive agents have been studied to find whether they lower the risk of nonmelanoma skin cancer:         Beta carotene      Studies of beta carotene (taken as a supplement in pills) have not shown that it prevents nonmelanoma skin cancer from forming or coming back.            Isotretinoin      High doses of isotretinoin have been shown to prevent new skin cancers in patients with xeroderma pigmentosum. However, isotretinoin has not been shown to prevent nonmelanoma skin cancers from coming back in patients previously treated for nonmelanoma skin cancers. Treatment with isotretinoin can cause serious side effects.            Selenium      Studies have shown that selenium (taken in brewer's yeast tablets) does not lower the risk of basal cell carcinoma, and may increase the risk of squamous cell carcinoma.            Celecoxib      A study of celecoxib in patients with actinic keratosis and a history of nonmelanoma skin cancer found those who took celecoxib had slightly lower rates of recurrent nonmelanoma skin cancers. Celecoxib may have serious side effects on the heart and blood vessels.             Alpha-difluoromethylornithine (DFMO)      A study of alpha-difluoromethylornithine (DFMO) in patients with a history of nonmelanoma skin cancer showed that those who took DFMO had lower rates of nonmelanoma skin cancers coming back than those who took a placebo. DFMO may cause hearing loss which is usually temporary.            Nicotinamide (vitamin B3)      Studies have shown that nicotinamide (vitamin B3) helps prevent new actinic keratoses lesions from forming in people who had four or fewer actinic lesions before taking nicotinamide. More studies are needed to find out if nicotinamide prevents nonmelanoma skin cancer from forming or coming back.

                    It is not known if the following lower the risk of melanoma:
                    Sunscreen    It has not been proven that using sunscreen to prevent sunburn can protect against melanoma caused by UV radiation. Other risk factors such as having skin that burns easily, having a large number of benign moles, or having atypical nevi may also play a role in whether melanoma forms.       Counseling and protecting the skin from the sun    It is not known if people who receive counseling or information about avoiding sun exposure make changes in their behavior to protect their skin from the sun.

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

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


Input: Who is at risk for Skin Cancer? ?

Output:
Key Points
                    - Avoiding risk factors and increasing protective factors may help prevent cancer.    - Being exposed to ultraviolet radiation is a risk factor for skin cancer.    - It is not known if the following lower the risk of nonmelanoma skin cancer:         - Sunscreen use and avoiding sun exposure     - Chemopreventive agents        - It is not known if the following lower the risk of melanoma:         - Sunscreen     - Counseling and protecting the skin from the sun        - Cancer prevention clinical trials are used to study ways to prevent cancer.    -  New ways to prevent skin cancer are being studied in clinical trials.

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

                    Being exposed to ultraviolet radiation is a risk factor for skin cancer.
                    Some studies suggest that being exposed to ultraviolet (UV) radiation and the sensitivity of a persons skin to UV radiation are risk factors for skin cancer. UV radiation is the name for the invisible rays that are part of the energy that comes from the sun. Sunlamps and tanning beds also give off UV radiation.   Risk factors for nonmelanoma and melanoma cancers are not the same.         -  Risk factors for nonmelanoma skin cancer:                  - Being exposed to natural sunlight or artificial sunlight (such as from tanning beds) over long periods of time.       - Having a fair complexion, which includes the following:                         - Fair skin that freckles and burns easily, does not tan, or tans poorly.         - Blue or green or other light-colored eyes.          - Red or blond hair.                       - Having actinic keratosis.        - Past treatment with radiation.       - Having a weakened immune system.       - Being exposed to arsenic.                -  Risk factors for melanoma skin cancer:                  - Having a fair complexion, which includes the following:                         - Fair skin that freckles and burns easily, does not tan, or tans poorly.          - Blue or green or other light-colored eyes.         - Red or blond hair.                      - Being exposed to natural sunlight or artificial sunlight (such as from tanning beds) over long periods of time.       - Having a history of many blistering sunburns, especially as a child or teenager.       - Having several large or many small moles.       - Having a family history of unusual moles (atypical nevus syndrome).       - Having a family or personal history of melanoma.        - Being white.

                    It is not known if the following lower the risk of nonmelanoma skin cancer:
                    Sunscreen use and avoiding sun exposure    It is not known if nonmelanoma skin cancer risk is decreased by staying out of the sun, using sunscreens, or wearing protective clothing when outdoors. This is because not enough studies have been done to prove this.    Sunscreen may help decrease the amount of UV radiation to the skin. One study found that wearing sunscreen can help prevent actinic keratoses, scaly patches of skin that sometimes become squamous cell carcinoma.     The harms of using sunscreen are likely to be small and include allergic reactions to skin creams and lower levels of vitamin D made in the skin because of less sun exposure.     It is also possible that when a person uses sunscreen to avoid sunburn they may spend too much time in the sun and be exposed to harmful UV radiation.    Although protecting the skin and eyes from the sun has not been proven to lower the chance of getting skin cancer, skin experts suggest the following:            -  Use sunscreen that protects against UV radiation.     -  Do not stay out in the sun for long periods of time, especially when the sun is at its strongest.     -  Wear long sleeve shirts, long pants, sun hats, and sunglasses, when outdoors.              Chemopreventive agents     Chemoprevention is the use of drugs, vitamins, or other agents to try to reduce the risk of cancer. The following chemopreventive agents have been studied to find whether they lower the risk of nonmelanoma skin cancer:         Beta carotene      Studies of beta carotene (taken as a supplement in pills) have not shown that it prevents nonmelanoma skin cancer from forming or coming back.            Isotretinoin      High doses of isotretinoin have been shown to prevent new skin cancers in patients with xeroderma pigmentosum. However, isotretinoin has not been shown to prevent nonmelanoma skin cancers from coming back in patients previously treated for nonmelanoma skin cancers. Treatment with isotretinoin can cause serious side effects.            Selenium      Studies have shown that selenium (taken in brewer's yeast tablets) does not lower the risk of basal cell carcinoma, and may increase the risk of squamous cell carcinoma.            Celecoxib      A study of celecoxib in patients with actinic keratosis and a history of nonmelanoma skin cancer found those who took celecoxib had slightly lower rates of recurrent nonmelanoma skin cancers. Celecoxib may have serious side effects on the heart and blood vessels.             Alpha-difluoromethylornithine (DFMO)      A study of alpha-difluoromethylornithine (DFMO) in patients with a history of nonmelanoma skin cancer showed that those who took DFMO had lower rates of nonmelanoma skin cancers coming back than those who took a placebo. DFMO may cause hearing loss which is usually temporary.            Nicotinamide (vitamin B3)      Studies have shown that nicotinamide (vitamin B3) helps prevent new actinic keratoses lesions from forming in people who had four or fewer actinic lesions before taking nicotinamide. More studies are needed to find out if nicotinamide prevents nonmelanoma skin cancer from forming or coming back.

                    It is not known if the following lower the risk of melanoma:
                    Sunscreen    It has not been proven that using sunscreen to prevent sunburn can protect against melanoma caused by UV radiation. Other risk factors such as having skin that burns easily, having a large number of benign moles, or having atypical nevi may also play a role in whether melanoma forms.       Counseling and protecting the skin from the sun    It is not known if people who receive counseling or information about avoiding sun exposure make changes in their behavior to protect their skin from the sun. </s>


Input: what research (or clinical trials) is being done for Skin 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 skin cancer are being studied in clinical trials.
                    Clinical trials are taking place in many parts of the country. Information about clinical trials can be found in the Clinical Trials section of the NCI Web site. Check NCI's list of cancer clinical trials for nonmelanoma skin cancer prevention trials and melanoma prevention trials that are now accepting patients. </s>


Input: What is (are) Ovarian, Fallopian Tube, and Primary Peritoneal Cancer ?

Output:
Key Points
                    - Ovarian, fallopian tube, and primary peritoneal cancers are diseases in which malignant (cancer) cells form in the ovaries, fallopian tubes, or peritoneum.    - Ovarian cancer is the leading cause of death from cancer of the female reproductive system.

                    Ovarian, fallopian tube, and primary peritoneal cancers are diseases in which malignant (cancer) cells form in the ovaries, fallopian tubes, or peritoneum.
                    The ovaries are a pair of organs in the female reproductive system. They are in the pelvis, one on each side of the uterus (the hollow, pear-shaped organ where a fetus grows). Each ovary is about the size and shape of an almond. The ovaries make eggs and female hormones (chemicals that control the way certain cells or organs work in the body).   The fallopian tubes are a pair of long, slender tubes, one on each side of the uterus. Eggs pass from the ovaries, through the fallopian tubes, to the uterus. Cancer sometimes begins at the end of the fallopian tube near the ovary and spreads to the ovary.   The peritoneum is the tissue that lines the abdominal wall and covers organs in the abdomen. Primary peritoneal cancer is cancer that forms in the peritoneum and has not spread there from another part of the body. Cancer sometimes begins in the peritoneum and spreads to the ovary.

                    Ovarian cancer is the leading cause of death from cancer of the female reproductive system.
                    In recent years, there has been a small decrease in the number of new cases of ovarian cancer and the number of deaths from ovarian cancer. New cases of ovarian cancer and deaths from ovarian cancer are higher among white women than black women, but have decreased in both groups.   Women who have a family history of ovarian cancer and/or certain inherited gene changes, such as BRCA1 or BRCA2 gene changes, have a higher risk than women who do not have a family history or who have not inherited these gene changes. For women with inherited risk, genetic counseling and genetic testing can be used to find out more about how likely they are to develop ovarian cancer.   It is hard to find ovarian cancer early. Early ovarian cancer may not cause any symptoms. When symptoms do appear, ovarian cancer is often advanced.   See the following PDQ summaries for more information about ovarian, fallopian tube, and primary peritoneal cancers:         -  Genetics of Breast and Gynecologic Cancers (written for health professionals)    -  Ovarian, Fallopian Tube, and Primary Peritoneal Cancer Screening     -  Ovarian Epithelial, Fallopian Tube, and Primary Peritoneal Cancer Treatment </s>


Input: How to prevent Ovarian, Fallopian Tube, and Primary Peritoneal Cancer ?

Output:
Key Points
                    - Avoiding risk factors and increasing protective factors may help prevent cancer.    - The following are risk factors for ovarian, fallopian tube, and primary peritoneal cancer:         - Family history of ovarian, fallopian tube, and primary peritoneal cancer     - Inherited risk     - Hormone replacement therapy     -  Weight and height        - The following are protective factors for ovarian, fallopian tube, and primary peritoneal cancer:         - Oral contraceptives     - Tubal ligation     - Breastfeeding     - Risk-reducing salpingo-oophorectomy        - It is not clear whether the following affect the risk of ovarian, fallopian tube, and primary peritoneal cancer:         - Diet     - Alcohol     - Aspirin and non-steroidal anti-inflammatory drugs     - Smoking     - Talc     - Infertility treatment        - Cancer prevention clinical trials are used to study ways to prevent cancer.    -  New ways to prevent ovarian, fallopian tube, and primary peritoneal cancer are being studied in clinical trials.

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

                    The following are risk factors for ovarian, fallopian tube, and primary peritoneal cancer:
                    Family history of ovarian, fallopian tube, and primary peritoneal cancer    A woman whose mother or sister had ovarian cancer has an increased risk of ovarian cancer. A woman with two or more relatives with ovarian cancer also has an increased risk of ovarian cancer.        Inherited risk    The risk of ovarian cancer is increased in women who have inherited certain changes in the BRCA1, BRCA2, or other genes.     The risk of ovarian cancer is also increased in women who have certain inherited syndromes that include:            -  Familial site-specific ovarian cancer syndrome.     -  Familial breast/ovarian cancer syndrome.     -  Hereditary nonpolyposis colorectal cancer (HNPCC; Lynch syndrome).              Hormone replacement therapy     The use of estrogen -only hormone replacement therapy (HRT) after menopause is linked to a slightly increased risk of ovarian cancer in women who are taking HRT or have taken HRT within the past 3 years. The risk of ovarian cancer increases the longer a woman uses estrogen-only HRT. When hormone therapy is stopped, the risk of ovarian cancer decreases over time.     It is not clear whether there is an increased risk of ovarian cancer with the use of HRT that has both estrogen and progestin.        Weight and height    Being overweight or obese during the teenage years is linked to an increased risk of ovarian cancer. Being obese is linked to an increased risk of death from ovarian cancer. Being tall (5'8" or taller) may also be linked to a slight increase in the risk of ovarian cancer.

                    The following are protective factors for ovarian, fallopian tube, and primary peritoneal cancer:
                    Oral contraceptives     Taking oral contraceptives (the pill) lowers the risk of ovarian cancer. The longer oral contraceptives are used, the lower the risk may be. The decrease in risk may last up to 30 years after a woman has stopped taking oral contraceptives.     Taking oral contraceptives increases the risk of blood clots. This risk is higher in women who also smoke.        Tubal ligation     The risk of ovarian cancer is decreased in women who have a tubal ligation (surgery to close both fallopian tubes).        Breastfeeding    Breastfeeding is linked to a decreased risk of ovarian cancer. The longer a woman breastfeeds, the lower her risk of ovarian cancer.       Risk-reducing salpingo-oophorectomy    Some women who have a high risk of ovarian cancer may choose to have a risk-reducing salpingo-oophorectomy (surgery to remove the fallopian tubes and ovaries when there are no signs of cancer). This includes women who have inherited certain changes in the BRCA1 and BRCA2 genes or have an inherited syndrome. (See the Risk-reducing salpingo-oophorectomy section in the PDQ health professional summary on Genetics of Breast and Gynecologic Cancers for more information.)    It is very important to have a cancer risk assessment and counseling before making this decision. These and other factors may be discussed:            -  Infertility.     -  Early menopause: The drop in estrogen levels caused by removing the ovaries can cause early menopause. Symptoms of menopause include the following:                   -  Hot flashes.       - Night sweats.       - Trouble sleeping.       - Mood changes.       - Decreased sex drive.       - Heart disease.       -  Vaginal dryness.       - Frequent urination.       -  Osteoporosis (decreased bone density).           These symptoms may not be the same in all women. Hormone replacement therapy (HRT) may be used to lessen these symptoms.     - Risk of ovarian cancer in the peritoneum: Women who have had a risk-reducing salpingo-oophorectomy continue to have a small risk of ovarian cancer in the peritoneum (thin layer of tissue that lines the inside of the abdomen). This may occur if ovarian cancer cells had already spread to the peritoneum before the surgery or if some ovarian tissue remains after surgery.

                    It is not clear whether the following affect the risk of ovarian, fallopian tube, and primary peritoneal cancer:
                    Diet    Studies of dietary factors including various foods, teas, and nutrients have not found a strong link to ovarian cancer.       Alcohol    Studies have not shown a link between drinking alcohol and the risk of ovarian cancer.       Aspirin and non-steroidal anti-inflammatory drugs    Some studies of aspirin and non-steroidal anti-inflammatory drugs (NSAIDs) have found a decreased risk of ovarian cancer and others have not.        Smoking    Some studies found a very small increased risk of one rare type of ovarian cancer in women who were current smokers compared with women who never smoked.       Talc    Studies of women who used talcum powder (talc) dusted on the perineum (the area between the vagina and the anus) have not found clear evidence of an increased risk of ovarian cancer.        Infertility treatment    Overall, studies in women using fertility drugs have not found clear evidence of an increased risk of ovarian cancer. Risk of ovarian borderline malignant tumors may be higher in women who take fertility drugs. The risk of invasive ovarian cancer may be higher in women who do not get pregnant after taking fertility drugs.

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

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


Input: Who is at risk for Ovarian, Fallopian Tube, and Primary Peritoneal Cancer? ?

Output:
Key Points
                    - Avoiding risk factors and increasing protective factors may help prevent cancer.    - The following are risk factors for ovarian, fallopian tube, and primary peritoneal cancer:         - Family history of ovarian, fallopian tube, and primary peritoneal cancer     - Inherited risk     - Hormone replacement therapy     -  Weight and height        - The following are protective factors for ovarian, fallopian tube, and primary peritoneal cancer:         - Oral contraceptives     - Tubal ligation     - Breastfeeding     - Risk-reducing salpingo-oophorectomy        - It is not clear whether the following affect the risk of ovarian, fallopian tube, and primary peritoneal cancer:         - Diet     - Alcohol     - Aspirin and non-steroidal anti-inflammatory drugs     - Smoking     - Talc     - Infertility treatment        - Cancer prevention clinical trials are used to study ways to prevent cancer.    -  New ways to prevent ovarian, fallopian tube, and primary peritoneal cancer are being studied in clinical trials.

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

                    The following are risk factors for ovarian, fallopian tube, and primary peritoneal cancer:
                    Family history of ovarian, fallopian tube, and primary peritoneal cancer    A woman whose mother or sister had ovarian cancer has an increased risk of ovarian cancer. A woman with two or more relatives with ovarian cancer also has an increased risk of ovarian cancer.        Inherited risk    The risk of ovarian cancer is increased in women who have inherited certain changes in the BRCA1, BRCA2, or other genes.     The risk of ovarian cancer is also increased in women who have certain inherited syndromes that include:            -  Familial site-specific ovarian cancer syndrome.     -  Familial breast/ovarian cancer syndrome.     -  Hereditary nonpolyposis colorectal cancer (HNPCC; Lynch syndrome).              Hormone replacement therapy     The use of estrogen -only hormone replacement therapy (HRT) after menopause is linked to a slightly increased risk of ovarian cancer in women who are taking HRT or have taken HRT within the past 3 years. The risk of ovarian cancer increases the longer a woman uses estrogen-only HRT. When hormone therapy is stopped, the risk of ovarian cancer decreases over time.     It is not clear whether there is an increased risk of ovarian cancer with the use of HRT that has both estrogen and progestin.        Weight and height    Being overweight or obese during the teenage years is linked to an increased risk of ovarian cancer. Being obese is linked to an increased risk of death from ovarian cancer. Being tall (5'8" or taller) may also be linked to a slight increase in the risk of ovarian cancer.

                    It is not clear whether the following affect the risk of ovarian, fallopian tube, and primary peritoneal cancer:
                    Diet    Studies of dietary factors including various foods, teas, and nutrients have not found a strong link to ovarian cancer.       Alcohol    Studies have not shown a link between drinking alcohol and the risk of ovarian cancer.       Aspirin and non-steroidal anti-inflammatory drugs    Some studies of aspirin and non-steroidal anti-inflammatory drugs (NSAIDs) have found a decreased risk of ovarian cancer and others have not.        Smoking    Some studies found a very small increased risk of one rare type of ovarian cancer in women who were current smokers compared with women who never smoked.       Talc    Studies of women who used talcum powder (talc) dusted on the perineum (the area between the vagina and the anus) have not found clear evidence of an increased risk of ovarian cancer.        Infertility treatment    Overall, studies in women using fertility drugs have not found clear evidence of an increased risk of ovarian cancer. Risk of ovarian borderline malignant tumors may be higher in women who take fertility drugs. The risk of invasive ovarian cancer may be higher in women who do not get pregnant after taking fertility drugs. </s>


Input: what research (or clinical trials) is being done for Ovarian, Fallopian Tube, and Primary Peritoneal 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 ovarian, fallopian tube, and primary peritoneal cancer are being studied in clinical trials.
                    Clinical trials are taking place in many parts of the country. Information about clinical trials can be found in the Clinical Trials section of the NCI website. Check NCI's list of cancer clinical trials for ovarian cancer prevention trials that are now accepting patients. </s>


Input: What is (are) Pancreatic Neuroendocrine Tumors (Islet Cell Tumors) ?

Output:
Key Points
                    - Pancreatic neuroendocrine tumors form in hormone-making cells (islet cells) of the pancreas.    - Pancreatic NETs may or may not cause signs or symptoms.    - There are different kinds of functional pancreatic NETs.     - Having certain syndromes can increase the risk of pancreatic NETs.     - Different types of pancreatic NETs have different signs and symptoms.     - Lab tests and imaging tests are used to detect (find) and diagnose pancreatic NETs.     - Other kinds of lab tests are used to check for the specific type of pancreatic NETs.    - Certain factors affect prognosis (chance of recovery) and treatment options.

                    Pancreatic neuroendocrine tumors form in hormone-making cells (islet cells) of the pancreas.
                    The pancreas is a gland about 6 inches long that is shaped like a thin pear lying on its side. The wider end of the pancreas is called the head, the middle section is called the body, and the narrow end is called the tail. The pancreas lies behind the stomach and in front of the spine.      There are two kinds of cells in the pancreas:         -   Endocrine pancreas cells  make several kinds of hormones (chemicals that control the actions of certain cells or organs in the body), such as insulin to control blood sugar. They cluster together in many small groups (islets) throughout the pancreas. Endocrine pancreas cells are also called islet cells or islets of Langerhans. Tumors that form in islet cells are called islet cell tumors, pancreatic endocrine tumors, or pancreatic neuroendocrine tumors (pancreatic NETs).     -   Exocrine pancreas cells  make enzymes that are released into the small intestine to help the body digest food. Most of the pancreas is made of ducts with small sacs at the end of the ducts, which are lined with exocrine cells.         This summary discusses islet cell tumors of the endocrine pancreas. See the PDQ summary on Pancreatic Cancer Treatment for information on exocrine pancreatic cancer.    Pancreatic neuroendocrine tumors (NETs) may be benign (not cancer) or malignant (cancer). When pancreatic NETs are malignant, they are called pancreatic endocrine cancer or islet cell carcinoma.   Pancreatic NETs are much less common than pancreatic exocrine tumors and have a better prognosis.

                    There are different kinds of functional pancreatic NETs.
                    Pancreatic NETs make different kinds of hormones such as gastrin, insulin, and glucagon. Functional pancreatic NETs include the following:         -   Gastrinoma: A tumor that forms in cells that make gastrin. Gastrin is a hormone that causes the stomach to release an acid that helps digest food. Both gastrin and stomach acid are increased by gastrinomas. When increased stomach acid, stomach ulcers, and diarrhea are caused by a tumor that makes gastrin, it is called Zollinger-Ellison syndrome. A gastrinoma usually forms in the head of the pancreas and sometimes forms in the small intestine. Most gastrinomas are malignant (cancer).    -   Insulinoma: A tumor that forms in cells that make insulin. Insulin is a hormone that controls the amount of glucose (sugar) in the blood. It moves glucose into the cells, where it can be used by the body for energy. Insulinomas are usually slow-growing tumors that rarely spread. An insulinoma forms in the head, body, or tail of the pancreas. Insulinomas are usually benign (not cancer).    -   Glucagonoma: A tumor that forms in cells that make glucagon. Glucagon is a hormone that increases the amount of glucose in the blood. It causes the liver to break down glycogen. Too much glucagon causes hyperglycemia (high blood sugar). A glucagonoma usually forms in the tail of the pancreas. Most glucagonomas are malignant (cancer).    -  Other types of tumors: There are other rare types of functional pancreatic NETs that make hormones, including hormones that control the balance of sugar, salt, and water in the body. These tumors include:                - VIPomas, which make vasoactive intestinal peptide. VIPoma may also be called Verner-Morrison syndrome.      - Somatostatinomas, which make somatostatin.         These other types of tumors are grouped together because they are treated in much the same way. </s>


Input: Who is at risk for Pancreatic Neuroendocrine Tumors (Islet Cell Tumors)? ?

Output: Having certain syndromes can increase the risk of pancreatic NETs. 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.     Multiple endocrine neoplasia type 1 (MEN1) syndrome is a risk factor for pancreatic NETs. </s>


Input: How to diagnose Pancreatic Neuroendocrine Tumors (Islet Cell Tumors) ?

Output:
Lab tests and imaging tests are used to detect (find) and diagnose pancreatic NETs.
                    	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 glucose (sugar), 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.     -   Chromogranin A test: A test in which a blood sample is checked to measure the amount of chromogranin A in the blood. A higher than normal amount of chromogranin A and normal amounts of hormones such as gastrin, insulin, and glucagon can be a sign of a non-functional pancreatic NET.     -   Abdominal CT scan (CAT scan): A procedure that makes a series of detailed pictures of the abdomen, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.    -   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).    -   Somatostatin receptor scintigraphy : A type of radionuclide scan that may be used to find small pancreatic NETs. A small amount of radioactive octreotide (a hormone that attaches to tumors) is injected into a vein and travels through the blood. The radioactive octreotide attaches to the tumor and a special camera that detects radioactivity is used to show where the tumors are in the body. This procedure is also called octreotide scan and SRS.     -   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 and make echoes. The echoes form a picture of body tissues called a sonogram. This procedure is also called endosonography.     -   Endoscopic retrograde cholangiopancreatography (ERCP): A procedure used to x-ray the ducts (tubes) that carry bile from the liver to the gallbladder and from the gallbladder to the small intestine. Sometimes pancreatic cancer causes these ducts to narrow and block or slow the flow of bile, causing jaundice. An endoscope is passed through the mouth, esophagus, and stomach into the first part of the small intestine. An endoscope is a thin, tube-like instrument with a light and a lens for viewing. A catheter (a smaller tube) is then inserted through the endoscope into the pancreatic ducts. A dye is injected through the catheter into the ducts and an x-ray is taken. If the ducts are blocked by a tumor, a fine tube may be inserted into the duct to unblock it. This tube (or stent) may be left in place to keep the duct open. Tissue samples may also be taken and checked under a microscope for signs of cancer.    -   Angiogram : A procedure to look at blood vessels and the flow of blood. A contrast dye is injected into the blood vessel. As the contrast dye moves through the blood vessel, x-rays are taken to see if there are any blockages.     -   Laparotomy : A surgical procedure in which an incision (cut) is made in the wall of the abdomen to check the inside of the abdomen for signs of disease. The size of the incision depends on the reason the laparotomy is being done. Sometimes organs are removed or tissue samples are taken and checked under a microscope for signs of disease.    -   Intraoperative ultrasound : A procedure that uses high-energy sound waves (ultrasound) to create images of internal organs or tissues during surgery. A transducer placed directly on the organ or tissue is used to make the sound waves, which create echoes. The transducer receives the echoes and sends them to a computer, which uses the echoes to make pictures called sonograms.    -   Biopsy : The removal of cells or tissues so they can be viewed under a microscope by a pathologist to check for signs of cancer. There are several ways to do a biopsy for pancreatic NETs. Cells may be removed using a fine or wide needle inserted into the pancreas during an x-ray or ultrasound. Tissue may also be removed during a laparoscopy (a surgical incision made in the wall of the abdomen).    -   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 blood. The radioactive material collects in bones where cancer cells have spread and is detected by a scanner.

                    	Other kinds of lab tests are used to check for the specific type of pancreatic NETs.
                    	The following tests and procedures may be used:    Gastrinoma          -  Fasting serum gastrin test: A test in which a blood sample is checked to measure the amount of gastrin in the blood. This test is done after the patient has had nothing to eat or drink for at least 8 hours. Conditions other than gastrinoma can cause an increase in the amount of gastrin in the blood.    -  Basal acid output test: A test to measure the amount of acid made by the stomach. The test is done after the patient has had nothing to eat or drink for at least 8 hours. A tube is inserted through the nose or throat, into the stomach. The stomach contents are removed and four samples of gastric acid are removed through the tube. These samples are used to find out the amount of gastric acid made during the test and the pH level of the gastric secretions.    -   Secretin stimulation test : If the basal acid output test result is not normal, a secretin stimulation test may be done. The tube is moved into the small intestine and samples are taken from the small intestine after a drug called secretin is injected. Secretin causes the small intestine to make acid. When there is a gastrinoma, the secretin causes an increase in how much gastric acid is made and the level of gastrin in the blood.    -  Somatostatin receptor scintigraphy: A type of radionuclide scan that may be used to find small pancreatic NETs. A small amount of radioactive octreotide (a hormone that attaches to tumors) is injected into a vein and travels through the blood. The radioactive octreotide attaches to the tumor and a special camera that detects radioactivity is used to show where the tumors are in the body. This procedure is also called octreotide scan and SRS.         Insulinoma          -  Fasting serum glucose and insulin test: A test in which a blood sample is checked to measure the amounts of glucose (sugar) and insulin in the blood. The test is done after the patient has had nothing to eat or drink for at least 24 hours.          Glucagonoma          -  Fasting serum glucagon test: A test in which a blood sample is checked to measure the amount of glucagon in the blood. The test is done after the patient has had nothing to eat or drink for at least 8 hours.          Other tumor types          - VIPoma               - Serum VIP (vasoactive intestinal peptide) test: A test in which a blood sample is checked to measure the amount of VIP.       - Blood chemistry studies: A procedure in which a blood sample is checked to measure the amounts of certain substances released into the blood by organs and tissues in the body. An unusual (higher or lower than normal) amount of a substance can be a sign of disease. In VIPoma, there is a lower than normal amount of potassium.      - Stool analysis : A stool sample is checked for a higher than normal sodium (salt) and potassium levels.             - Somatostatinoma               - Fasting serum somatostatin test: A test in which a blood sample is checked to measure the amount of somatostatin in the blood. The test is done after the patient has had nothing to eat or drink for at least 8 hours.      - Somatostatin receptor scintigraphy: A type of radionuclide scan that may be used to find small pancreatic NETs. A small amount of radioactive octreotide (a hormone that attaches to tumors) is injected into a vein and travels through the blood. The radioactive octreotide attaches to the tumor and a special camera that detects radioactivity is used to show where the tumors are in the body. This procedure is also called octreotide scan and SRS. </s>


Input: What is the outlook for Pancreatic Neuroendocrine Tumors (Islet Cell Tumors) ?

Output: Certain factors affect prognosis (chance of recovery) and treatment options. Pancreatic NETs can often be cured. The prognosis (chance of recovery) and treatment options depend on the following:         - The type of cancer cell.    - Where the tumor is found in the pancreas.     - Whether the tumor has spread to more than one place in the pancreas or to other parts of the body.    - Whether the patient has MEN1 syndrome.    - The patient's age and general health.    - Whether the cancer has just been diagnosed or has recurred (come back). </s>


Input: What are the stages of Pancreatic Neuroendocrine Tumors (Islet Cell Tumors) ?

Output:
Key Points
                    - The plan for cancer treatment depends on where the NET is found in the pancreas and whether it has spread.     - 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 NET is found in the pancreas and whether it has spread.
                    The process used to find out if cancer has spread within the pancreas or to other parts of the body is called staging. The results of the tests and procedures used to diagnose pancreatic neuroendocrine tumors (NETs) are also used to find out whether the cancer has spread. See the General Information section for a description of these tests and procedures.    Although there is a standard staging system for pancreatic NETs, it is not used to plan treatment. Treatment of pancreatic NETs is based on the following:          - Whether the cancer is found in one place in the pancreas.    - Whether the cancer is found in several places in the pancreas.    - Whether the cancer has spread to lymph nodes near the pancreas or to other parts of the body such as the liver, lung, peritoneum, or bone.

                    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 pancreatic neuroendocrine tumor spreads to the liver, the tumor cells in the liver are actually neuroendocrine tumor cells. The disease is metastatic pancreatic neuroendocrine tumor, not liver cancer. </s>


Input: What are the treatments for Pancreatic Neuroendocrine Tumors (Islet Cell Tumors) ?

Output:
Key Points
                    - There are different types of treatment for patients with pancreatic NETs.     - Six types of standard treatment are used:         - Surgery     - Chemotherapy     - Hormone therapy     - Hepatic arterial occlusion or chemoembolization     - Targeted therapy     - Supportive care        - New types of treatment are being tested in clinical trials.    - Patients may want to think about taking part in a clinical trial.    - Patients can enter clinical trials before, during, or after starting their cancer treatment.    - Follow-up tests may be needed.

                    There are different types of treatment for patients with pancreatic NETs.
                    Different types of treatments are available for patients with pancreatic neuroendocrine tumors (NETs). 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.

                    Six types of standard treatment are used:
                    Surgery     An operation may be done to remove the tumor. One of the following types of surgery may be used:            -  Enucleation: Surgery to remove the tumor only. This may be done when cancer occurs in one place in the pancreas.     -  Pancreatoduodenectomy: A surgical procedure in which the head of the pancreas, the gallbladder, nearby lymph nodes and part of the stomach, small intestine, and bile duct are removed. Enough of the pancreas is left to make digestive juices and insulin. The organs removed during this procedure depend on the patient's condition. This is also called the Whipple procedure.     -  Distal pancreatectomy: Surgery to remove the body and tail of the pancreas. The spleen may also be removed.     - Total gastrectomy: Surgery to remove the whole stomach.     -  Parietal cell vagotomy: Surgery to cut the nerve that causes stomach cells to make acid.     -  Liver resection: Surgery to remove part or all of the liver.     -  Radiofrequency ablation: The use of a special probe with tiny electrodes that kill cancer cells. Sometimes the probe is inserted directly through the skin and only local anesthesia is needed. In other cases, the probe is inserted through an incision in the abdomen. This is done in the hospital with general anesthesia.      -  Cryosurgical ablation: A procedure in which tissue is frozen to destroy abnormal cells. This is usually done with a special instrument that contains liquid nitrogen or liquid carbon dioxide. The instrument may be used during surgery or laparoscopy or inserted through the skin. This procedure is also called cryoablation.               Chemotherapy     Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the cerebrospinal fluid, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). Combination chemotherapy is the use of more than one anticancer drug. The way the chemotherapy is given depends on the type of the cancer being treated.       Hormone therapy     Hormone therapy is a cancer treatment that removes hormones or blocks their action and stops cancer cells from growing. Hormones are substances made by glands in the body and circulated in the bloodstream. Some hormones can cause certain cancers to grow. If tests show that the cancer cells have places where hormones can attach (receptors), drugs, surgery, or radiation therapy is used to reduce the production of hormones or block them from working.       Hepatic arterial occlusion or chemoembolization     Hepatic arterial occlusion uses drugs, small particles, or other agents to block or reduce the flow of blood to the liver through the hepatic artery (the major blood vessel that carries blood to the liver). This is done to kill cancer cells growing in the liver. 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.    Chemotherapy delivered during hepatic arterial occlusion is called chemoembolization. The anticancer drug is injected into the hepatic artery through a catheter (thin tube). The drug is mixed with the substance that 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.        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. Certain types of targeted therapies are being studied in the treatment of pancreatic NETs.       Supportive care     Supportive care is given to lessen the problems caused by the disease or its treatment. Supportive care for pancreatic NETs may include treatment for the following:            - Stomach ulcers may be treated with drug therapy such as:                  -  Proton pump inhibitor drugs such as omeprazole, lansoprazole, or pantoprazole.       - Histamine blocking drugs such as cimetidine, ranitidine, or famotidine.       - Somatostatin-type drugs such as octreotide.                -  Diarrhea may be treated with:                   -  Intravenous (IV) fluids with electrolytes such as potassium or chloride.        - Somatostatin-type drugs such as octreotide.                - Low blood sugar may be treated by having small, frequent meals or with drug therapy to maintain a normal blood sugar level.     -  High blood sugar may be treated with drugs taken by mouth or insulin by injection.

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

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

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

                    Follow-up tests may be needed.
                    Some of the tests that were done to diagnose the cancer or to find out the stage of the cancer may be repeated. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests.   Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your condition has changed or if the cancer has recurred (come back). These tests are sometimes called follow-up tests or check-ups.

		            Treatment Options for Pancreatic Neuroendocrine Tumors

		                    Gastrinoma
		                    Treatment of gastrinoma may include supportive care and the following:         - For symptoms caused by too much stomach acid, treatment may be a drug that decreases the amount of acid made by the stomach.    - For a single tumor in the head of the pancreas:               -  Surgery to remove the tumor.      - Surgery to cut the nerve that causes stomach cells to make acid and treatment with a drug that decreases stomach acid.      - Surgery to remove the whole stomach (rare).             - For a single tumor in the body or tail of the pancreas, treatment is usually surgery to remove the body or tail of the pancreas.     - For several tumors in the pancreas, treatment is usually surgery to remove the body or tail of the pancreas. If tumor remains after surgery, treatment may include either:               - Surgery to cut the nerve that causes stomach cells to make acid and treatment with a drug that decreases stomach acid; or      - Surgery to remove the whole stomach (rare).             - For one or more tumors in the duodenum (the part of the small intestine that connects to the stomach), treatment is usually pancreatoduodenectomy (surgery to remove the head of the pancreas, the gallbladder, nearby lymph nodes and part of the stomach, small intestine, and bile duct).    - If no tumor is found, treatment may include the following:               - Surgery to cut the nerve that causes stomach cells to make acid and treatment with a drug that decreases stomach acid.      - Surgery to remove the whole stomach (rare).             - If the cancer has spread to the liver, treatment may include:               - Surgery to remove part or all of the liver.      -  Radiofrequency ablation or cryosurgical ablation.      -  Chemoembolization.             - If cancer has spread to other parts of the body or does not get better with surgery or drugs to decrease stomach acid, treatment may include:               -  Chemotherapy.      -  Hormone therapy.             - If the cancer mostly affects the liver and the patient has severe symptoms from hormones or from the size of tumor, treatment may include:               -  Hepatic arterial occlusion, with or without systemic chemotherapy.      - Chemoembolization, with or without systemic chemotherapy.                 Check the list of NCI-supported cancer clinical trials that are now accepting patients with gastrinoma. 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.

		                    Insulinoma
		                    Treatment of insulinoma may include the following:         - For one small tumor in the head or tail of the pancreas, treatment is usually surgery to remove the tumor.    - For one large tumor in the head of the pancreas that cannot be removed by surgery, treatment is usually pancreatoduodenectomy (surgery to remove the head of the pancreas, the gallbladder, nearby lymph nodes and part of the stomach, small intestine, and bile duct).     - For one large tumor in the body or tail of the pancreas, treatment is usually a distal pancreatectomy (surgery to remove the body and tail of the pancreas).    - For more than one tumor in the pancreas, treatment is usually surgery to remove any tumors in the head of the pancreas and the body and tail of the pancreas.    - For tumors that cannot be removed by surgery, treatment may include the following:               -  Combination chemotherapy.      -  Palliative drug therapy to decrease the amount of insulin made by the pancreas.      -  Hormone therapy.      - Radiofrequency ablation or cryosurgical ablation.             - For cancer that has spread to lymph nodes or other parts of the body, treatment may include the following:               - Surgery to remove the cancer.       -  Radiofrequency ablation or cryosurgical ablation, if the cancer cannot be removed by surgery.             - If the cancer mostly affects the liver and the patient has severe symptoms from hormones or from the size of tumor, treatment may include:               -  Hepatic arterial occlusion, with or without systemic chemotherapy.      -  Chemoembolization, with or without systemic chemotherapy.                 Check the list of NCI-supported cancer clinical trials that are now accepting patients with insulinoma. 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.

		                    Glucagonoma
		                    Treatment may include the following:          - For one small tumor in the head or tail of the pancreas, treatment is usually surgery to remove the tumor.    - For one large tumor in the head of the pancreas that cannot be removed by surgery, treatment is usually pancreatoduodenectomy (surgery to remove the head of the pancreas, the gallbladder, nearby lymph nodes and part of the stomach, small intestine, and bile duct).    - For more than one tumor in the pancreas, treatment is usually surgery to remove the tumor or surgery to remove the body and tail of the pancreas.    - For tumors that cannot be removed by surgery, treatment may include the following:               -  Combination chemotherapy.      -  Hormone therapy.      -  Radiofrequency ablation or cryosurgical ablation.             - For cancer that has spread to lymph nodes or other parts of the body, treatment may include the following:               - Surgery to remove the cancer.       - Radiofrequency ablation or cryosurgical ablation, if the cancer cannot be removed by surgery.             - If the cancer mostly affects the liver and the patient has severe symptoms from hormones or from the size of tumor, treatment may include:               -  Hepatic arterial occlusion, with or without systemic chemotherapy.      -  Chemoembolization, with or without systemic chemotherapy.                 Check the list of NCI-supported cancer clinical trials that are now accepting patients with glucagonoma. 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.

		                    Other Pancreatic Neuroendocrine Tumors (Islet Cell Tumors)
		                    For VIPoma, treatment may include the following:         -  Fluids and hormone therapy to replace fluids and electrolytes that have been lost from the body.    -  Surgery to remove the tumor and nearby lymph nodes.    - Surgery to remove as much of the tumor as possible when the tumor cannot be completely removed or has spread to distant parts of the body. This is palliative therapy to relieve symptoms and improve the quality of life.     - For tumors that have spread to lymph nodes or other parts of the body, treatment may include the following:               - Surgery to remove the tumor.       -  Radiofrequency ablation or cryosurgical ablation, if the tumor cannot be removed by surgery.             - For tumors that continue to grow during treatment or have spread to other parts of the body, treatment may include the following:               -  Chemotherapy.      -  Targeted therapy.                  For somatostatinoma, treatment may include the following:         - Surgery to remove the tumor.    - For cancer that has spread to distant parts of the body, surgery to remove as much of the cancer as possible to relieve symptoms and improve quality of life.    - For tumors that continue to grow during treatment or have spread to other parts of the body, treatment may include the following:               - Chemotherapy.      - Targeted therapy.                  Treatment of other types of pancreatic neuroendocrine tumors (NETs) may include the following:         - Surgery to remove the tumor.    - For cancer that has spread to distant parts of the body, surgery to remove as much of the cancer as possible or hormone therapy to relieve symptoms and improve quality of life.    - For tumors that continue to grow during treatment or have spread to other parts of the body, treatment may include the following:               - Chemotherapy.      - Targeted therapy.                 Check the list of NCI-supported cancer clinical trials that are now accepting patients with islet cell 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 or Progressive Pancreatic Neuroendocrine Tumors (Islet Cell Tumors)
		                    Treatment of pancreatic neuroendocrine tumors (NETs) that continue to grow during treatment or recur (come back) may include the following:         -  Surgery to remove the tumor.    -  Chemotherapy.    -  Hormone therapy.    -  Targeted therapy.    - For liver metastases:               -  Regional chemotherapy.      -  Hepatic arterial occlusion or chemoembolization, with or without systemic chemotherapy.             - A clinical trial of a new therapy.        Check the list of NCI-supported cancer clinical trials that are now accepting patients with recurrent islet cell carcinoma. 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 Pancreatic Neuroendocrine Tumors (Islet Cell Tumors) ?

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

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

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


Input: What is (are) Langerhans Cell Histiocytosis ?

Output:
Key Points
                    - Langerhans cell histiocytosis is a type of cancer that can damage tissue or cause lesions to form in one or more places in the body.    - Family history or having a parent who was exposed to certain chemicals may increase the risk of LCH.    - The signs and symptoms of LCH depend on where it is in the body.         - Skin and nails     - Mouth     - Bone     - Lymph nodes and thymus     - Endocrine system      - Central nervous system (CNS)     - Liver and spleen     - Lung     - Bone marrow        - Tests that examine the organs and body systems where LCH may occur are used to detect (find) and diagnose LCH.    - Certain factors affect prognosis (chance of recovery) and treatment options.

                    Langerhans cell histiocytosis is a type of cancer that can damage tissue or cause lesions to form in one or more places in the body.
                    Langerhans cell histiocytosis (LCH) is a rare cancer that begins in LCH cells (a type of dendritic cell which fights infection). Sometimes there are mutations (changes) in LCH cells as they form. These include mutations of the  BRAF  gene. These changes may make the LCH cells grow and multiply quickly. This causes LCH cells to build up in certain parts of the body, where they can damage tissue or form lesions.    LCH is not a disease of the Langerhans cells that normally occur in the skin.   LCH may occur at any age, but is most common in young children. Treatment of LCH in children is different from treatment of LCH in adults. The treatments for LCH in children and adults are described in separate sections of this summary.   Check the list of NCI-supported cancer clinical trials that are now accepting patients with childhood Langerhans cell histiocytosis. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your child's doctor about clinical trials that may be right for your child. General information about clinical trials is available from the NCI website. </s>


Input: Who is at risk for Langerhans Cell Histiocytosis? ?

Output: Anything that increases your risk of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesn't mean that you will not get cancer. Talk with your doctor if you think you may be at risk. Risk factors for LCH include the following:         - Having a parent who was exposed to certain chemicals such as benzene.    - Having a parent who was exposed to metal, granite, or wood dust in the workplace.    - A family history of cancer, including LCH.    -  Having infections as a newborn.    - Having a personal history or family history of thyroid disease.    - Smoking, especially in young adults.    - Being Hispanic. </s>


Input: What are the symptoms of Langerhans Cell Histiocytosis ?

Output: These and other signs and symptoms may be caused by LCH or by other conditions. Check with your doctor if you or your child have any of the following:     Skin and nails    LCH in infants may affect the skin only. In some cases, skin-only LCH may get worse over weeks or months and become a form called high-risk multisystem LCH.     In infants, signs or symptoms of LCH that affects the skin may include:            -  Flaking of the scalp that may look like cradle cap.     - Raised, brown or purple skin rash anywhere on the body.            In children and adults, signs or symptoms of LCH that affects the skin and nails may include:            -  Flaking of the scalp that may look like dandruff.     -  Raised, red or brown, crusted rash in the groin area, abdomen, back, or chest, that may be itchy.     - Bumps or ulcers on the scalp.     - Ulcers behind the ears, under the breasts, or in the groin area.     - Fingernails that fall off or have discolored grooves that run the length of the nail.              Mouth    Signs or symptoms of LCH that affects the mouth may include:            - Swollen gums.     - Sores on the roof of the mouth, inside the cheeks, or on the tongue or lips.     - Teeth that become uneven.     - Tooth loss.              Bone    Signs or symptoms of LCH that affects the bone may include:            - Swelling or a lump over a bone, such as the skull, ribs, spine, thigh bone, upper arm bone, elbow, eye socket, or bones around the ear.     - Pain where there is swelling or a lump over a bone.           Children with LCH lesions in bones around the ears or eyes have a high risk for diabetes insipidus and other central nervous system disease.       Lymph nodes and thymus    Signs or symptoms of LCH that affects the lymph nodes or thymus may include:            - Swollen lymph nodes.     - Trouble breathing.     -  Superior vena cava syndrome. This can cause coughing, trouble breathing, and swelling of the face, neck, and upper arms.              Endocrine system     Signs or symptoms of LCH that affects the pituitary gland may include:            - Diabetes insipidus. This can cause a strong thirst and frequent urination.     - Slow growth.     - Early or late puberty.     - Being very overweight.           Signs or symptoms of LCH that affects the thyroid may include:            - Swollen thyroid gland.     -  Hypothyroidism. This can cause tiredness, lack of energy, being sensitive to cold, constipation, dry skin, thinning hair, memory problems, trouble concentrating, and depression. In infants, this can also cause a loss of appetite and choking on food. In children and adolescents, this can also cause behavior problems, weight gain, slow growth, and late puberty.     - Trouble breathing.              Central nervous system (CNS)    Signs or symptoms of LCH that affects the CNS (brain and spinal cord) may include:            - Loss of balance, uncoordinated body movements, and trouble walking.     - Trouble speaking.     - Trouble seeing.     - Headaches.     - Changes in behavior or personality.     - Memory problems.           These signs and symptoms may be caused by lesions in the CNS or by CNS neurodegenerative syndrome.       Liver and spleen    Signs or symptoms of LCH that affects the liver or spleen may include:            - Swelling in the abdomen caused by a buildup of extra fluid.     - Trouble breathing.     - Yellowing of the skin and whites of the eyes.     - Itching.     - Easy bruising or bleeding.     - Feeling very tired.              Lung    Signs or symptoms of LCH that affects the lung may include:            - Collapsed lung. This condition can cause chest pain or tightness, trouble breathing, feeling tired, and a bluish color to the skin.     - Trouble breathing, especially in adults who smoke.     - Dry cough.     - Chest pain.              Bone marrow    Signs or symptoms of LCH that affects the bone marrow may include:            - Easy bruising or bleeding.     -  Fever.     - Frequent infections. </s>


Input: How to diagnose Langerhans Cell Histiocytosis ?

Output: The following tests and procedures may be used to detect (find) and diagnose LCH or conditions caused by LCH:         -   Physical exam and history : An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient's health habits and past illnesses and treatments will also be taken.    -   Neurological exam : A series of questions and tests to check the brain, spinal cord, and nerve function. The exam checks a person's mental status, coordination, and ability to walk normally, and how well the muscles, senses, and reflexes work. This may also be called a neuro exam or a neurologic exam.     -   Complete blood count (CBC) with differential : A procedure in which a sample of blood is drawn and checked for the following:               - The amount of hemoglobin (the protein that carries oxygen) in the red blood cells.      -  The portion of the blood sample made up of red blood cells.       - The number and type of white blood cells.      - The number of red blood cells and platelets.             -   Blood chemistry studies : A procedure in which a blood sample is checked to measure the amounts of certain substances released into the body by organs and tissues in the body. An unusual (higher or lower than normal) amount of a substance can be a sign of disease.    -   Liver function test : A blood test to measure the blood levels of certain substances released by the liver. A high or low level of these substances can be a sign of disease in the liver.    -   BRAF gene testing : A laboratory test in which a sample of blood or tissue is tested for mutations of the BRAF gene.    -   Urinalysis : A test to check the color of urine and its contents, such as sugar, protein, red blood cells, and white blood cells.     -   Water deprivation test : A test to check how much urine is made and whether it becomes concentrated when little or no water is given. This test is used to diagnose diabetes insipidus, which may be caused by LCH.    -   Bone marrow aspiration and biopsy : The removal of bone marrow and a small piece of bone by inserting a hollow needle into the hipbone. A pathologist views the bone marrow and bone under a microscope to look for signs of LCH.  The following tests may be done on the tissue that was removed:               -  Immunohistochemistry : A test that uses antibodies to check for certain antigens in a sample of tissue. The antibody is usually linked to a radioactive substance or a dye that causes the tissue to light up under a microscope. This type of test may be used to tell the difference between different types of cancer.       -  Flow cytometry : A laboratory test that measures the number of cells in a sample, how many cells are live, and the size of the cells. It also shows the shapes of the cells and whether there are tumor markers on the surface of the cells. The cells are stained with a light-sensitive dye, placed in a fluid, and passed in a stream before a laser or other type of light. The measurements are based on how the light-sensitive dye reacts to the light.              -   Bone scan : A procedure to check if there are rapidly dividing 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 with cancer and is detected by a scanner.     -   X-ray : An x-ray of the organs and bones inside the body. 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. Sometimes a skeletal survey is done. This is a procedure to x-ray all of the bones in the body.    -   CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.    -   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. A substance called gadolinium may be injected into a vein. The gadolinium collects around the LCH cells so that they show up brighter in the picture. This procedure is also called nuclear magnetic resonance imaging (NMRI).    -   PET scan (positron emission tomography scan): A procedure to find 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. Tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do.    -   Ultrasound exam: A procedure in which high-energy sound waves (ultrasound) are bounced off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram. The picture can be printed to be looked at later.    -   Bronchoscopy : A procedure to look inside the trachea and large airways in the lung for abnormal areas. A bronchoscope is inserted through the nose or mouth into the trachea and lungs. A bronchoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue samples, which are checked under a microscope for signs of cancer.    -   Endoscopy : A procedure to look at organs and tissues inside the body to check for abnormal areas in the gastrointestinal tract or lungs. An endoscope is inserted through an incision (cut) in the skin or opening in the body, such as the mouth. 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.    -   Biopsy : The removal of cells or tissues so they can be viewed under a microscope by a pathologist to check for LCH cells. To diagnose LCH, a biopsy of bone lesions, skin, lymph nodes, or the liver may be done. </s>


Input: What is the outlook for Langerhans Cell Histiocytosis ?

Output: LCH in organs such as the skin, bones, lymph nodes, or pituitary gland usually gets better with treatment and is called "low- risk". LCH in the spleen, liver, or bone marrow is harder to treat and is called "high-risk".    The prognosis (chance of recovery) and treatment options depend on the following:          - Whether there are mutations of the BRAF gene.    - How old the patient is when diagnosed with LCH.    - How many organs or body systems the cancer affects.    - Whether the cancer is found in the liver, spleen, bone marrow, or certain bones in the skull.    - How quickly the cancer responds to initial treatment.    - Whether the cancer has just been diagnosed or has come back (recurred).        In infants up to one year of age, LCH may go away without treatment. </s>


Input: What are the stages of Langerhans Cell Histiocytosis ?

Output:
Key Points
                    - There is no staging system for Langerhans cell histiocytosis (LCH).    - Treatment of LCH is based on where LCH cells are found in the body and how many body systems are affected.

                    There is no staging system for Langerhans cell histiocytosis (LCH).
                    The extent or spread of cancer is usually described as stages. There is no staging system for LCH.

                    Treatment of LCH is based on where LCH cells are found in the body and how many body systems are affected.
                    LCH is described as single-system disease or multisystem disease, depending on how many body systems are affected:          -  Single-system LCH: LCH is found in one part of an organ or body system (unifocal) or in more than one part of that organ or body system (multifocal). Bone is the most common single place for LCH to be found.    -  Multisystem LCH: LCH occurs in two or more organs or body systems or may be spread throughout the body. Multisystem LCH is less common than single-system LCH.        LCH may affect low-risk organs or high-risk organs:         -  Low-risk organs include the skin, bone, lungs, lymph nodes, gastrointestinal tract, pituitary gland, and central nervous system (CNS).    -  High-risk organs include the liver, spleen, and bone marrow. </s>