Input: What are the treatments for Rectal Cancer ?

Output:
Key Points
                    - There are different types of treatment for patients with rectal cancer.    - Five types of standard treatment are used:         - Surgery     - Radiation therapy     - Chemotherapy     - Active surveillance     - Targeted therapy        - Other types of treatment are being tested in clinical trials.    - Patients may want to think about taking part in a clinical trial.    - Patients can enter clinical trials before, during, or after starting their cancer treatment.    - Follow-up tests may be needed.

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

                    Five types of standard treatment are used:
                    Surgery     Surgery is the most common treatment for all stages of rectal cancer. The cancer is removed using one of the following types of surgery:            -  Polypectomy: If the cancer is found in a polyp (a small piece of bulging tissue), the polyp is often removed during a colonoscopy.     -  Local excision: If the cancer is found on the inside surface of the rectum and has not spread into the wall of the rectum, the cancer and a small amount of surrounding healthy tissue is removed.     -  Resection: If the cancer has spread into the wall of the rectum, the section of the rectum with cancer and nearby healthy tissue is removed. Sometimes the tissue between the rectum and the abdominal wall is also removed. The lymph nodes near the rectum are removed and checked under a microscope for signs of cancer.      -  Radiofrequency ablation: The use of a special probe with tiny electrodes that kill cancer cells. Sometimes the probe is inserted directly through the skin and only local anesthesia is needed. In other cases, the probe is inserted through an incision in the abdomen. This is done in the hospital with general anesthesia.     -  Cryosurgery: A treatment that uses an instrument to freeze and destroy abnormal tissue. This type of treatment is also called cryotherapy.     -  Pelvic exenteration: If the cancer has spread to other organs near the rectum, the lower colon, rectum, and bladder are removed. In women, the cervix, vagina, ovaries, and nearby lymph nodes may be removed. In men, the prostate may be removed. Artificial openings (stoma) are made for urine and stool to flow from the body to a collection bag.           After the cancer is removed, the surgeon will either:            - do an anastomosis (sew the healthy parts of the rectum together, sew the remaining rectum to the colon, or sew the colon to the anus); or     - make a stoma (an opening) from the rectum to the outside of the body for waste to pass through. This procedure is done if the cancer is too close to the anus and is called a colostomy. A bag is placed around the stoma to collect the waste. Sometimes the colostomy is needed only until the rectum has healed, and then it can be reversed. If the entire rectum is removed, however, the colostomy may be permanent.            Radiation therapy and/or chemotherapy may be given before surgery to shrink the tumor, make it easier to remove the cancer, and help with bowel control after surgery. Treatment given before surgery is called neoadjuvant therapy. Even if all the cancer that can be seen at the time of the operation is removed, some patients may be given radiation therapy and/or chemotherapy after surgery to kill any cancer cells that are left. Treatment given after the surgery, to lower the risk that the cancer will come back, is called adjuvant therapy.       Radiation therapy    Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. There are two types of radiation therapy:            -  External radiation therapy uses a machine outside the body to send radiation toward the cancer.     -  Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer.           The way the radiation therapy is given depends on the type and stage of the cancer being treated. External radiation therapy is used to treat rectal cancer.     Short-course preoperative radiation therapy is used in some types of rectal cancer. This treatment uses fewer and lower doses of radiation than standard treatment, followed by surgery several days after the last dose.       Chemotherapy    Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping the cells from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly in the cerebrospinal fluid, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy).      Chemoembolization of the hepatic artery is a type of regional chemotherapy that may be used to treat cancer that has spread to the liver. This is done by blocking the hepatic artery (the main artery that supplies blood to the liver) and injecting anticancer drugs between the blockage and the liver. The livers arteries then carry the drugs into the liver. Only a small amount of the drug reaches other parts of the body. The blockage may be temporary or permanent, depending on what is used to block the artery. The liver continues to receive some blood from the hepatic portal vein, which carries blood from the stomach and intestine.    The way the chemotherapy is given depends on the type and stage of the cancer being treated.    See Drugs Approved for Rectal Cancer for more information.       Active surveillance     Active surveillance is closely following a patient's condition without giving any treatment unless there are changes in test results. It is used to find early signs that the condition is getting worse. In active surveillance, patients are given certain exams and tests to check if the cancer is growing. When the cancer begins to grow, treatment is given to cure the cancer. Tests include the following:            -  Digital rectal exam.     -  MRI.     -  Endoscopy.     -  Sigmoidoscopy.     -  CT scan.     -  Carcinoembryonic antigen (CEA) assay.              Targeted therapy     Targeted therapy is a type of treatment that uses drugs or other substances to identify and attack specific cancer cells without harming normal cells.    Types of targeted therapies used in the treatment of rectal cancer include the following:            -  Monoclonal antibodies: Monoclonal antibody therapy is a type of targeted therapy being used for the treatment of rectal cancer. Monoclonal antibody therapy uses antibodies made in the laboratory from a single type of immune system cell. These antibodies can identify substances on cancer cells or normal substances that may help cancer cells grow. The antibodies attach to the substances and kill the cancer cells, block their growth, or keep them from spreading. Monoclonal antibodies are given by infusion. They may be used alone or to carry drugs, toxins, or radioactive material directly to cancer cells.                   -  Bevacizumab and ramucirumab are types of monoclonal antibodies that bind to a protein called vascular endothelial growth factor (VEGF). This may prevent the growth of new blood vessels that tumors need to grow.        -  Cetuximab and panitumumab are types of monoclonal antibodies that bind to a protein called epidermal growth factor receptor (EGFR) on the surface of some types of cancer cells. This may stop cancer cells from growing and dividing.                -  Angiogenesis inhibitors: Angiogenesis inhibitors stop the growth of new blood vessels that tumors need to grow.                   -  Ziv-aflibercept is a vascular endothelial growth factor trap that blocks an enzyme needed for the growth of new blood vessels in tumors.       -  Regorafenib is used to treat colorectal cancer that has spread to other parts of the body and has not gotten better with other treatment. It blocks the action of certain proteins, including vascular endothelial growth factor. This may help keep cancer cells from growing and may kill them. It may also prevent the growth of new blood vessels that tumors need to grow.                      See Drugs Approved for Rectal Cancer for more information.

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

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

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

                    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.   After treatment for rectal cancer, a blood test to measure amounts of carcinoembryonic antigen (a substance in the blood that may be increased when cancer is present) may be done to see if the cancer has come back.

            		Treatment Options by Stage

                    		Stage 0 (Carcinoma in Situ)
                    		Treatment of stage 0 may include the following:          - Simple polypectomy.    -  Local excision.     -  Resection (when the tumor is too large to remove by local excision).         Check the list of NCI-supported cancer clinical trials that are now accepting patients with stage 0 rectal cancer. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the NCI website.

                    		Stage I Rectal Cancer
                    		Treatment of stage I rectal cancer may include the following:         -  Local excision.    -  Resection.    -  Resection with radiation therapy and chemotherapy after surgery.        Check the list of NCI-supported cancer clinical trials that are now accepting patients with stage I rectal cancer. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the NCI website.

                    		Stages II and III Rectal Cancer
                    		Treatment of stage II and stage III rectal cancer may include the following:         -  Surgery.    -  Chemotherapy combined with radiation therapy, followed by surgery.    - Short-course radiation therapy followed by surgery and chemotherapy.    -  Resection followed by chemotherapy combined with radiation therapy.    - Chemotherapy combined with radiation therapy, followed by active surveillance. Surgery may be done if the cancer recurs (comes back).    - A clinical trial of a new treatment.         Check the list of NCI-supported cancer clinical trials that are now accepting patients with stage II rectal cancer. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the NCI website.

                    		Stage IV and Recurrent Rectal Cancer
                    		Treatment of stage IV and recurrent rectal cancer may include the following:         -  Surgery with or without chemotherapy or radiation therapy.    -  Systemic chemotherapy with or without targeted therapy (a monoclonal antibody or angiogenesis inhibitor).    - Chemotherapy to control the growth of the tumor.    - Radiation therapy, chemotherapy, or a combination of both, as palliative therapy to relieve symptoms and improve the quality of life.    - Placement of a stent to help keep the rectum open if it is partly blocked by the tumor, as palliative therapy to relieve symptoms and improve the quality of life.    - A clinical trial of a new anticancer drug.        Treatment of rectal cancer that has spread to other organs depends on where the cancer has spread.         - Treatment for areas of cancer that have spread to the liver includes the following:               - Surgery to remove the tumor. Chemotherapy may be given before surgery, to shrink the tumor.      -  Cryosurgery or radiofrequency ablation.      -  Chemoembolization and/or systemic chemotherapy.      - A clinical trial of chemoembolization combined with radiation therapy to the tumors in the liver.                  Check the list of NCI-supported cancer clinical trials that are now accepting patients with stage IV rectal cancer and recurrent rectal cancer. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the NCI website. </s>


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

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

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

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


Input: What is (are) Prostate Cancer ?

Output:
Key Points
                    - Prostate cancer is a disease in which malignant (cancer) cells form in the tissues of the prostate.    - Prostate cancer is the second most common cancer among men in the United States.

                    Prostate cancer is a disease in which malignant (cancer) cells form in the tissues of the prostate.
                    The prostate is a gland in the male reproductive system. The prostate is just below the bladder (the organ that collects and empties urine) and in front of the rectum (the lower part of the intestine). It is about the size of a walnut and surrounds part of the urethra (the tube that empties urine from the bladder). The prostate gland produces fluid that makes up part of the semen.       As men age, the prostate may get bigger. A bigger prostate may block the flow of urine from the bladder and cause problems with sexual function. This condition is called benign prostatic hyperplasia (BPH). BPH is not cancer, but surgery may be needed to correct it. The symptoms of BPH or of other problems in the prostate may be like symptoms of prostate cancer. </s>


Input: Who is at risk for Prostate Cancer? ?

Output: Prostate cancer is most common in older men. In the U.S., about one out of five men will be diagnosed with prostate cancer. Most men diagnosed with prostate cancer do not die of it.    See the following PDQ summaries for more information about prostate cancer:         -  Prostate Cancer Screening     -  Prostate Cancer Treatment </s>


Input: How to prevent Prostate Cancer ?

Output:
Key Points
                    - Avoiding risk factors and increasing protective factors may help prevent cancer.    - The following risk factors may increase the risk of prostate cancer:         - Age      - Family history of prostate cancer      - Race      - Hormones     - Vitamin E     - Folic acid     - Dairy and calcium        - The following protective factors may decrease the risk of prostate cancer:         - Folate     - Finasteride and Dutasteride        - The following have been proven not to affect the risk of prostate cancer, or their effects on prostate cancer risk are not known:         -  Selenium and vitamin E     - Diet     - Multivitamins     - Lycopene        - Cancer prevention clinical trials are used to study ways to prevent cancer.    -  New ways to prevent prostate 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 prostate cancer:
                    Age      Prostate cancer is rare in men younger than 50 years of age. The chance of developing prostate cancer increases as men get older.       Family history of prostate cancer     A man whose father, brother, or son has had prostate cancer has a higher-than-average risk of prostate cancer.       Race     Prostate cancer occurs more often in African-American men than in white men. African-American men with prostate cancer are more likely to die from the disease than white men with prostate cancer.       Hormones    The prostate needs male hormones to work the way it should. The main male sex hormone is testosterone. Testosterone helps the body develop and maintain male sex characteristics.    Testosterone is changed into dihydrotestosterone (DHT) by an enzyme in the body. DHT is important for normal prostate growth but can also cause the prostate to get bigger and may play a part in the development of prostate cancer.       Vitamin E    The Selenium and Vitamin E Cancer Prevention Trial (SELECT) found that vitamin E taken alone increased the risk of prostate cancer. The risk continued even after the men stopped taking vitamin E.       Folic acid    Folate is a kind of vitamin B that occurs naturally in some foods, such as green vegetables, beans and orange juice. Folic acid is a man-made form of folate that is found in vitamin supplements and fortified foods, such as whole-grain breads and cereals. A 10-year study showed that the risk of prostate cancer was increased in men who took 1 milligram (mg) supplements of folic acid. However, the risk of prostate cancer was lower in men who had enough folate in their diets.       Dairy and calcium    A diet high in dairy foods and calcium may cause a small increase in the risk of prostate cancer.

                    The following protective factors may decrease the risk of prostate cancer:
                    Folate    Folate is a kind of vitamin B that occurs naturally in some foods, such as green vegetables, beans and orange juice. Folic acid is a man-made form of folate that is found in vitamin supplements and fortified foods, such as whole-grain breads and cereals. A 10-year study showed that the risk of prostate cancer was lower in men who had enough folate in their diets. However, the risk of prostate cancer was increased in men who took 1 milligram (mg) supplements of folic acid.       Finasteride and Dutasteride     Finasteride and dutasteride are drugs used to lower the amount of male sex hormones made by the body. These drugs block the enzyme that changes testosterone into dihydrotestosterone (DHT). Higher than normal levels of DHT may play a part in developing prostate cancer. Taking finasteride or dutasteride has been shown to lower the risk for prostate cancer, but it is not known if these drugs lower the risk of death from prostate cancer.    The Prostate Cancer Prevention Trial (PCPT) studied whether the drug finasteride can prevent prostate cancer in healthy men 55 years of age and older. This prevention study showed there were fewer prostate cancers in the group of men that took finasteride compared with the group of men that did not. Also, the men who took finasteride who did have prostate cancer had more aggressive tumors. The number of deaths from prostate cancer was the same in both groups. Men who took finasteride reported more side effects compared with the group of men that did not, including erectile dysfunction, loss of desire for sex, and enlarged breasts.    The Reduction by Dutasteride of Prostate Cancer Events Trial (REDUCE) studied whether the drug dutasteride can prevent prostate cancer in men aged 50 to 75 years at higher risk for the disease. This prevention study showed there were fewer prostate cancers in the group of men who took dutasteride compared with the group of men that did not. The number of less aggressive prostate cancers was lower, but the number of more aggressive prostate cancers was not. Men who took dutasteride reported more side effects than men who did not, including erectile dysfunction, loss of desire for sex, less semen, and gynecomastia (enlarged breasts).

                    The following have been proven not to affect the risk of prostate cancer, or their effects on prostate cancer risk are not known:
                    Selenium and vitamin E    The Selenium and Vitamin E Cancer Prevention Trial (SELECT) studied whether taking vitamin E and selenium (a mineral) will prevent prostate cancer. The selenium and vitamin E were taken separately or together by healthy men 55 years of age and older (50 years of age and older for African-American men). The study showed that taking selenium alone or selenium and vitamin E together did not decrease the risk of prostate cancer.       Diet    It is not known if decreasing fat or increasing fruits and vegetables in the diet helps decrease the risk of prostate cancer or death from prostate cancer. In the PCPT trial, certain fatty acids increased the risk of high-grade prostate cancer while others decreased the risk of high-grade prostate cancer.       Multivitamins    Regular use of multivitamins has not been proven to increase the risk of early or localized prostate cancer. However, a large study showed an increased risk of advanced prostate cancer among men who took multivitamins more than seven times a week.       Lycopene    Some studies have shown that a diet high in lycopene may be linked to a decreased risk of prostate cancer, but other studies have not. It has not been proven that taking lycopene supplements decreases the risk of prostate cancer.

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

                    New ways to prevent prostate 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 prostate cancer prevention trials that are accepting patients. </s>


Input: Who is at risk for Prostate Cancer? ?

Output:
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 prostate cancer:
                    Age      Prostate cancer is rare in men younger than 50 years of age. The chance of developing prostate cancer increases as men get older.       Family history of prostate cancer     A man whose father, brother, or son has had prostate cancer has a higher-than-average risk of prostate cancer.       Race     Prostate cancer occurs more often in African-American men than in white men. African-American men with prostate cancer are more likely to die from the disease than white men with prostate cancer.       Hormones    The prostate needs male hormones to work the way it should. The main male sex hormone is testosterone. Testosterone helps the body develop and maintain male sex characteristics.    Testosterone is changed into dihydrotestosterone (DHT) by an enzyme in the body. DHT is important for normal prostate growth but can also cause the prostate to get bigger and may play a part in the development of prostate cancer.       Vitamin E    The Selenium and Vitamin E Cancer Prevention Trial (SELECT) found that vitamin E taken alone increased the risk of prostate cancer. The risk continued even after the men stopped taking vitamin E.       Folic acid    Folate is a kind of vitamin B that occurs naturally in some foods, such as green vegetables, beans and orange juice. Folic acid is a man-made form of folate that is found in vitamin supplements and fortified foods, such as whole-grain breads and cereals. A 10-year study showed that the risk of prostate cancer was increased in men who took 1 milligram (mg) supplements of folic acid. However, the risk of prostate cancer was lower in men who had enough folate in their diets.       Dairy and calcium    A diet high in dairy foods and calcium may cause a small increase in the risk of prostate cancer.

                    The following protective factors may decrease the risk of prostate cancer:
                    Folate    Folate is a kind of vitamin B that occurs naturally in some foods, such as green vegetables, beans and orange juice. Folic acid is a man-made form of folate that is found in vitamin supplements and fortified foods, such as whole-grain breads and cereals. A 10-year study showed that the risk of prostate cancer was lower in men who had enough folate in their diets. However, the risk of prostate cancer was increased in men who took 1 milligram (mg) supplements of folic acid.       Finasteride and Dutasteride     Finasteride and dutasteride are drugs used to lower the amount of male sex hormones made by the body. These drugs block the enzyme that changes testosterone into dihydrotestosterone (DHT). Higher than normal levels of DHT may play a part in developing prostate cancer. Taking finasteride or dutasteride has been shown to lower the risk for prostate cancer, but it is not known if these drugs lower the risk of death from prostate cancer.    The Prostate Cancer Prevention Trial (PCPT) studied whether the drug finasteride can prevent prostate cancer in healthy men 55 years of age and older. This prevention study showed there were fewer prostate cancers in the group of men that took finasteride compared with the group of men that did not. Also, the men who took finasteride who did have prostate cancer had more aggressive tumors. The number of deaths from prostate cancer was the same in both groups. Men who took finasteride reported more side effects compared with the group of men that did not, including erectile dysfunction, loss of desire for sex, and enlarged breasts.    The Reduction by Dutasteride of Prostate Cancer Events Trial (REDUCE) studied whether the drug dutasteride can prevent prostate cancer in men aged 50 to 75 years at higher risk for the disease. This prevention study showed there were fewer prostate cancers in the group of men who took dutasteride compared with the group of men that did not. The number of less aggressive prostate cancers was lower, but the number of more aggressive prostate cancers was not. Men who took dutasteride reported more side effects than men who did not, including erectile dysfunction, loss of desire for sex, less semen, and gynecomastia (enlarged breasts).

                    The following have been proven not to affect the risk of prostate cancer, or their effects on prostate cancer risk are not known:
                    Selenium and vitamin E    The Selenium and Vitamin E Cancer Prevention Trial (SELECT) studied whether taking vitamin E and selenium (a mineral) will prevent prostate cancer. The selenium and vitamin E were taken separately or together by healthy men 55 years of age and older (50 years of age and older for African-American men). The study showed that taking selenium alone or selenium and vitamin E together did not decrease the risk of prostate cancer.       Diet    It is not known if decreasing fat or increasing fruits and vegetables in the diet helps decrease the risk of prostate cancer or death from prostate cancer. In the PCPT trial, certain fatty acids increased the risk of high-grade prostate cancer while others decreased the risk of high-grade prostate cancer.       Multivitamins    Regular use of multivitamins has not been proven to increase the risk of early or localized prostate cancer. However, a large study showed an increased risk of advanced prostate cancer among men who took multivitamins more than seven times a week.       Lycopene    Some studies have shown that a diet high in lycopene may be linked to a decreased risk of prostate cancer, but other studies have not. It has not been proven that taking lycopene supplements decreases the risk of prostate cancer. </s>


Input: what research (or clinical trials) is being done for Prostate 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 prostate 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 prostate cancer prevention trials that are accepting patients. </s>


Input: What is (are) Extragonadal Germ Cell Tumors ?

Output:
Key Points
                    - Extragonadal germ cell tumors form from developing sperm or egg cells that travel from the gonads to other parts of the body.    - Age and gender can affect the risk of extragonadal germ cell tumors.     - Signs and symptoms of extragonadal germ cell tumors include breathing problems and chest pain.     - Imaging and blood tests are used to detect (find) and diagnose extragonadal germ cell tumors.    - Certain factors affect prognosis (chance of recovery) and treatment options.

                    Extragonadal germ cell tumors form from developing sperm or egg cells that travel from the gonads to other parts of the body.
                    " Extragonadal" means outside of the gonads (sex organs). When cells that are meant to form sperm in the testicles or eggs in the ovaries travel to other parts of the body, they may grow into extragonadal germ cell tumors. These tumors may begin to grow anywhere in the body but usually begin in organs such as the pineal gland in the brain, in the mediastinum (area between the lungs), or in the retroperitoneum (the back wall of the abdomen).     Extragonadal germ cell tumors can be benign (noncancer) or malignant (cancer). Benign extragonadal germ cell tumors are called benign teratomas. These are more common than malignant extragonadal germ cell tumors and often are very large.   Malignant extragonadal germ cell tumors are divided into two types, nonseminoma and seminoma. Nonseminomas tend to grow and spread more quickly than seminomas. They usually are large and cause signs and symptoms. If untreated, malignant extragonadal germ cell tumors may spread to the lungs, lymph nodes, bones, liver, or other parts of the body.   For information about germ cell tumors in the ovaries and testicles, see the following PDQ summaries:         -  Ovarian Germ Cell Tumors Treatment     -  Testicular Cancer Treatment </s>


Input: Who is at risk for Extragonadal Germ Cell Tumors? ?

Output: Age and gender can affect the risk of extragonadal germ cell tumors. Anything that increases your chance of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesnt mean that you will not get cancer. Talk with your doctor if you think you may be at risk. Risk factors for malignant extragonadal germ cell tumors include the following:         - Being male.    - Being age 20 or older.    - Having Klinefelter syndrome. </s>


Input: What are the symptoms of Extragonadal Germ Cell Tumors ?

Output: Signs and symptoms of extragonadal germ cell tumors include breathing problems and chest pain. Malignant extragonadal germ cell tumors may cause signs and symptoms as they grow into nearby areas. Other conditions may cause the same signs and symptoms. Check with your doctor if you have any of the following:         - Chest pain.    - Breathing problems.    - Cough.    -  Fever.    - Headache.    - Change in bowel habits.    - Feeling very tired.    - Trouble walking.    - Trouble in seeing or moving the eyes. </s>


Input: How to diagnose Extragonadal Germ Cell Tumors ?

Output: Imaging and blood tests are used to detect (find) and diagnose extragonadal germ cell 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. The testicles may be checked for lumps, swelling, or pain. A history of the patient's health habits and past illnesses and treatments will also be taken.    -   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.    -   Serum tumor marker test : A procedure in which a sample of blood is examined to measure the amounts of certain substances released into the blood by organs, tissues, or tumor cells in the body. Certain substances are linked to specific types of cancer when found in increased levels in the blood. These are called tumor markers. The following three tumor markers are used to detect extragonadal germ cell tumor:                -  Alpha-fetoprotein (AFP).      -  Beta-human chorionic gonadotropin (-hCG).       -  Lactate dehydrogenase (LDH).         Blood levels of the tumor markers help determine if the tumor is a seminoma or nonseminoma.    -   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. Sometimes a CT scan and a PET scan are done at the same time. A PET scan is a procedure to find malignant tumor cells in the body. A small amount of radioactive glucose (sugar) is injected into a vein. The PET scanner rotates around the body and makes a picture of where glucose is being used in the body. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do. When a PET scan and CT scan are done at the same time, it is called a PET-CT.    -   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 type of biopsy used depends on where the extragonadal germ cell tumor is found.                -  Excisional biopsy : The removal of an entire lump of tissue.      -  Incisional biopsy : The removal of part of a lump or sample of tissue.      -  Core biopsy : The removal of tissue using a wide needle.      -  Fine-needle aspiration (FNA) biopsy : The removal of tissue or fluid using a thin needle. </s>


Input: What is the outlook for Extragonadal Germ Cell Tumors ?

Output: Certain factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery) and treatment options depend on the following:         - Whether the tumor is nonseminoma or seminoma.    - The size of the tumor and where it is in the body.     - The blood levels of AFP, -hCG, and LDH.    - Whether the tumor has spread to other parts of the body.    - The way the tumor responds to initial treatment.    - Whether the tumor has just been diagnosed or has recurred (come back). </s>


Input: What are the stages of Extragonadal Germ Cell Tumors ?

Output:
Key Points
                    - After an extragonadal germ cell tumor has been diagnosed, tests are done to find out if cancer cells have spread to other parts of the body.     - There are three ways that cancer spreads in the body.    - Cancer may spread from where it began to other parts of the body.    -  The following prognostic groups are used for extragonadal germ cell tumors:         - Good prognosis     - Intermediate prognosis     - Poor prognosis

                    After an extragonadal germ cell tumor has been diagnosed, tests are done to find out if cancer cells have spread to other parts of the body.
                    The extent or spread of cancer is usually described as stages. For extragonadal germ cell tumors, prognostic groups are used instead of stages. The tumors are grouped according to how well the cancer is expected to respond to treatment. It is important to know the prognostic group in order to plan treatment.

                    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 an extragonadal germ cell tumor spreads to the lung, the tumor cells in the lung are actually cancerous germ cells. The disease is metastatic extragonadal germ cell tumor, not lung cancer.

                    The following prognostic groups are used for extragonadal germ cell tumors:
                    Good prognosis    A nonseminoma extragonadal germ cell tumor is in the good prognosis group if:             - the tumor is in the back of the abdomen; and     - the tumor has not spread to organs other than the lungs; and     - the levels of tumor markers AFP and -hCG are normal and LDH is slightly above normal.           A seminoma extragonadal germ cell tumor is in the good prognosis group if:            - the tumor has not spread to organs other than the lungs; and     - the level of AFP is normal; -hCG and LDH may be at any level.              Intermediate prognosis    A nonseminoma extragonadal germ cell tumor is in the intermediate prognosis group if:             - the tumor is in the back of the abdomen; and     - the tumor has not spread to organs other than the lungs; and     - the level of any one of the tumor markers (AFP, -hCG, or LDH) is more than slightly above normal.           A seminoma extragonadal germ cell tumor is in the intermediate prognosis group if:            - the tumor has spread to organs other than the lungs; and     - the level of AFP is normal; -hCG and LDH may be at any level.              Poor prognosis    A nonseminoma extragonadal germ cell tumor is in the poor prognosis group if:            - the tumor is in the chest; or     -  the tumor has spread to organs other than the lungs; or     - the level of any one of the tumor markers (AFP, -hCG, or LDH) is high.            Seminoma extragonadal germ cell tumor does not have a poor prognosis group. </s>


Input: What are the treatments for Extragonadal Germ Cell Tumors ?

Output:
Key Points
                    - There are different types of treatment for patients with extragonadal germ cell tumors.    - Three types of standard treatment are used:         - Radiation therapy     - Chemotherapy     - Surgery        - New types of treatment are being tested in clinical trials.          - High-dose chemotherapy with stem cell transplant        - Patients may want to think about taking part in a clinical trial.    - Patients can enter clinical trials before, during, or after starting their cancer treatment.    - Follow-up tests may be needed.

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

                    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 or keep them from growing. There are two types of radiation therapy:            -  External radiation therapy uses a machine outside the body to send radiation toward the cancer.     -  Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer.           The way the radiation therapy is given depends on the type and stage of the cancer being treated. External radiation therapy is used to treat seminoma.       Chemotherapy     Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly in the cerebrospinal fluid, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). The way the chemotherapy is given depends on the type and stage of the cancer being treated.       Surgery    Patients who have benign tumors or tumor remaining after chemotherapy or radiation therapy may need to have surgery.

                    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.     High-dose chemotherapy with stem cell transplant     High-dose chemotherapy with stem cell transplant is a method of giving high doses of chemotherapy and replacing blood -forming cells destroyed by the cancer treatment. Stem cells (immature blood cells) are removed from the blood or bone marrow of the patient or a donor and are frozen and stored. After the chemotherapy is completed, the stored stem cells are thawed and given back to the patient through an infusion. These reinfused stem cells grow into (and restore) the body's blood cells.

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

                    Patients can enter clinical trials before, during, or after starting their cancer treatment.
                    Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring (coming back) or reduce the side effects of cancer treatment.   Clinical trials are taking place in many parts of the country. 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.   After initial treatment for extragonadal germ cell tumors, blood levels of AFP and other tumor markers continue to be checked to find out how well the treatment is working.

		            Treatment Options for Extragonadal Germ Cell Tumors

		                    Benign Teratoma
		                    Treatment of benign teratomas is surgery.    Check the list of NCI-supported cancer clinical trials that are now accepting patients with benign teratoma. 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.

		                    Seminoma
		                    Treatment of seminoma extragonadal germ cell tumors may include the following:         -  Radiation therapy for small tumors in one area, followed by watchful waiting if there is tumor remaining after treatment.     -  Chemotherapy for larger tumors or tumors that have spread. If a tumor smaller than 3 centimeters remains after chemotherapy, watchful waiting follows. If a larger tumor remains after treatment, surgery or watchful waiting follow.        Check the list of NCI-supported cancer clinical trials that are now accepting patients with extragonadal seminoma. 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.

		                    Nonseminoma
		                    Treatment of nonseminoma extragonadal germ cell tumors may include the following:         -  Combination chemotherapy followed by surgery to remove any remaining tumor.     - A clinical trial of a new treatment.        Check the list of NCI-supported cancer clinical trials that are now accepting patients with malignant extragonadal non-seminomatous germ 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 Refractory Extragonadal Germ Cell Tumors
		                    Treatment of extragonadal germ cell tumors that are recurrent (come back after being treated) or refractory (do not get better during treatment) may include the following:         -  Chemotherapy.    - A clinical trial of high-dose chemotherapy with stem cell transplant.     - A clinical trial of a new treatment.        Check the list of NCI-supported cancer clinical trials that are now accepting patients with recurrent extragonadal germ 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. </s>


Input: what research (or clinical trials) is being done for Extragonadal Germ Cell 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.     High-dose chemotherapy with stem cell transplant     High-dose chemotherapy with stem cell transplant is a method of giving high doses of chemotherapy and replacing blood -forming cells destroyed by the cancer treatment. Stem cells (immature blood cells) are removed from the blood or bone marrow of the patient or a donor and are frozen and stored. After the chemotherapy is completed, the stored stem cells are thawed and given back to the patient through an infusion. These reinfused stem cells grow into (and restore) the body's blood cells.

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

                    Patients can enter clinical trials before, during, or after starting their cancer treatment.
                    Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring (coming back) or reduce the side effects of cancer treatment.   Clinical trials are taking place in many parts of the country. 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) Childhood Acute Myeloid Leukemia and Other Myeloid Malignancies ?

Output:
Key Points
                    - Childhood acute myeloid leukemia (AML) is a type of cancer in which the bone marrow makes a large number of abnormal blood cells.    - Leukemia and other diseases of the blood and bone marrow may affect red blood cells, white blood cells, and platelets.    - Other myeloid diseases can affect the blood and bone marrow.         - Chronic myelogenous leukemia     - Juvenile myelomonocytic leukemia     - Myelodysplastic syndromes        - AML or MDS may occur after treatment with certain anticancer drugs and/or radiation therapy.     - The risk factors for childhood AML, childhood CML, JMML, and MDS are similar.    - Signs and symptoms of childhood AML, childhood CML, JMML, or MDS include fever, feeling tired, and easy bleeding or bruising.    - Tests that examine the blood and bone marrow are used to detect (find) and diagnose childhood AML, childhood CML, JMML, and MDS.    - Certain factors affect prognosis (chance of recovery) and treatment options.

                    Childhood acute myeloid leukemia (AML) is a type of cancer in which the bone marrow makes a large number of abnormal blood cells.
                    Childhood acute myeloid leukemia (AML) is a cancer of the blood and bone marrow. AML is also called acute myelogenous leukemia, acute myeloblastic leukemia, acute granulocytic leukemia, and acute nonlymphocytic leukemia. Cancers that are acute usually get worse quickly if they are not treated. Cancers that are chronic usually get worse slowly.

                    Leukemia and other diseases of the blood and bone marrow may affect red blood cells, white blood cells, and platelets.
                    Normally, the bone marrow makes blood stem cells (immature cells) that become mature blood cells over time. A blood stem cell may become a myeloid stem cell or a lymphoid stem cell. A lymphoid stem cell becomes a white blood cell.    A myeloid stem cell becomes one of three types of mature blood cells:          -  Red blood cells that carry oxygen and other substances to all tissues of the body.    - White blood cells that fight infection and disease.    -  Platelets that form blood clots to stop bleeding.         In AML, the myeloid stem cells usually become a type of immature white blood cell called myeloblasts (or myeloid blasts). The myeloblasts, or leukemia cells, in AML are abnormal and do not become healthy white blood cells. The leukemia cells can build up in the blood and bone marrow so there is less room for healthy white blood cells, red blood cells, and platelets. When this happens, infection, anemia, or easy bleeding may occur. The leukemia cells can spread outside the blood to other parts of the body, including the central nervous system (brain and spinal cord), skin, and gums. Sometimes leukemia cells form a solid tumor called a granulocytic sarcoma or chloroma.   There are subtypes of AML based on the type of blood cell that is affected. The treatment of AML is different when it is a subtype called acute promyelocytic leukemia (APL) or when the child has Down syndrome.

                    Other myeloid diseases can affect the blood and bone marrow.
                    Chronic myelogenous leukemia    In chronic myelogenous leukemia (CML), too many bone marrow stem cells become a type of white blood cell called granulocytes. Some of these bone marrow stem cells never become mature white blood cells. These are called blasts. Over time, the granulocytes and blasts crowd out the red blood cells and platelets in the bone marrow. CML is rare in children.        Juvenile myelomonocytic leukemia     Juvenile myelomonocytic leukemia (JMML) is a rare childhood cancer that occurs more often in children around the age of 2 years and is more common in boys. In JMML, too many bone marrow stem cells become 2 types of white blood cells called myelocytes and monocytes. Some of these bone marrow stem cells never become mature white blood cells. These immature cells, called blasts, are unable to do their usual work. Over time, the myelocytes, monocytes, and blasts crowd out the red blood cells and platelets in the bone marrow. When this happens, infection, anemia, or easy bleeding may occur.       Myelodysplastic syndromes     Myelodysplastic syndromes (MDS) occur less often in children than in adults. In MDS, the bone marrow makes too few red blood cells, white blood cells, and platelets. These blood cells may not mature and enter the blood. The treatment for MDS depends on how low the numbers of red blood cells, white blood cells, or platelets are. Over time, MDS may become AML.    Transient myeloproliferative disorder (TMD) is a type of MDS. This disorder of the bone marrow can develop in newborns who have Down syndrome. It usually goes away on its own within the first 3 weeks of life. Infants who have Down syndrome and TMD have an increased chance of developing AML before the age of 3 years.     This summary is about childhood AML, childhood CML, JMML, and MDS. See the following PDQ summaries for more information about other types of leukemia and diseases of the blood and bone marrow in children and adults:         -  Childhood Acute Lymphoblastic Leukemia Treatment     -  Adult Acute Myeloid Leukemia Treatment     -  Adult Acute Lymphoblastic Leukemia Treatment     -  Chronic Myelogenous Leukemia Treatment     -  Chronic Lymphocytic Leukemia Treatment     -  Hairy Cell Leukemia Treatment     -  Myelodysplastic Syndromes Treatment     -  Myelodysplastic/Myeloproliferative Neoplasms Treatment

                    AML or MDS may occur after treatment with certain anticancer drugs and/or radiation therapy.
                    Cancer treatment with certain anticancer drugs and/or radiation therapy may cause therapy -related AML (t-AML) or therapy-related MDS (t-MDS). The risk of these therapy-related myeloid diseases depends on the total dose of the anticancer drugs used and the radiation dose and treatment field. Some patients also have an inherited risk for t-AML and t-MDS. These therapy-related diseases usually occur within 7 years after treatment, but are rare in children. </s>


Input: Who is at risk for Childhood Acute Myeloid Leukemia and Other Myeloid Malignancies? ?

Output: The risk factors for childhood AML, childhood CML, JMML, and MDS are similar. Anything that increases your risk of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesnt mean that you will not get cancer. Talk with your childs doctor if you think your child may be at risk. These and other factors may increase the risk of childhood AML, childhood CML, JMML, and MDS:         - Having a brother or sister, especially a twin, with leukemia.    - Being Hispanic.    - Being exposed to cigarette smoke or alcohol before birth.     - Having a personal history of aplastic anemia.    - Having a personal or family history of MDS.    - Having a family history of AML.    - Past treatment with chemotherapy or radiation therapy.    - Being exposed to ionizing radiation or chemicals such as benzene.    - Having certain genetic disorders, such as:               - Down syndrome.      -  Fanconi anemia.      -  Neurofibromatosis type 1.      -  Noonan syndrome.      -  Shwachman-Diamond syndrome. </s>


Input: What are the symptoms of Childhood Acute Myeloid Leukemia and Other Myeloid Malignancies ?

Output: Signs and symptoms of childhood AML, childhood CML, JMML, or MDS include fever, feeling tired, and easy bleeding or bruising. These and other signs and symptoms may be caused by childhood AML, childhood CML, JMML, or MDS or by other conditions. Check with a doctor if your child has any of the following:         -  Fever with or without an infection.    - Night sweats.    - Shortness of breath.    - Weakness or feeling tired.    - Easy bruising or bleeding.    -  Petechiae (flat, pinpoint spots under the skin caused by bleeding).    - Pain in the bones or joints.    - Pain or feeling of fullness below the ribs.    - Painless lumps in the neck, underarm, stomach, groin, or other parts of the body. In childhood AML, these lumps, called leukemia cutis, may be blue or purple.    - Painless lumps that are sometimes around the eyes. These lumps, called chloromas, are sometimes seen in childhood AML and may be blue-green.    - An eczema -like skin rash.        The signs and symptoms of TMD may include the following:         - Swelling all over the body.    - Shortness of breath.    - Trouble breathing.    - Weakness or feeling tired.    - Pain below the ribs. </s>


Input: How to diagnose Childhood Acute Myeloid Leukemia and Other Myeloid Malignancies ?

Output: Tests that examine the blood and bone marrow are used to detect (find) and diagnose childhood AML, childhood CML, JMML, and MDS. The following tests and procedures may be used:         -   Physical exam and history : An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patients health habits and past illnesses and treatments will also be taken.     -   Complete blood count (CBC) with differential: A procedure in which a sample of blood is drawn and checked for the following:                -  The number of red blood cells and platelets.      - The number and type of white blood cells.      - The amount of hemoglobin (the protein that carries oxygen) in the red blood cells.      - The portion of the blood sample made up of red blood cells.              -   Peripheral blood smear : A procedure in which a sample of blood is checked for blast cells, the number and kinds of white blood cells, number of platelets, and changes in the shape of the blood cells.    -   Blood chemistry studies : A procedure in which a blood sample is checked to measure the amounts of certain substances released into the blood by organs and tissues in the body. An unusual (higher or lower than normal) amount of a substance can be a sign of disease.    -   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.    -   Biopsy : The removal of cells or tissues so they can be viewed under a microscope by a pathologist to check for signs of cancer. Biopsies that may be done include the following:               -  Bone marrow aspiration and biopsy : The removal of bone marrow, blood, and a small piece of bone by inserting a hollow needle into the hipbone or breastbone.      -  Tumor biopsy: A biopsy of a chloroma may be done.      -  Lymph node biopsy: The removal of all or part of a lymph node.               -   Cytogenetic analysis : A laboratory test in which cells in a sample of blood or bone marrow are viewed under a microscope to look for certain changes in the chromosomes. Changes in the chromosomes may include when part of one chromosome is switched with part of another chromosome, part of one chromosome is missing or repeated, or part of one chromosome is turned upside down. The following test is a type of cytogenetic analysis:               -  FISH (fluorescence in situ hybridization): A laboratory technique used to look at genes or chromosomes in cells and tissues. Pieces of DNA that contain a fluorescent dye are made in the laboratory and added to cells or tissues on a glass slide. When these pieces of DNA bind to specific genes or areas of chromosomes on the slide, they light up when viewed under a microscope with a special light.             -   Reverse transcriptionpolymerase chain reaction (RTPCR) test: A laboratory test in which cells in a sample of tissue are studied using chemicals to look for certain changes in the structure or function of genes.    -   Immunophenotyping : A process used to identify cells, based on the types of antigens or markers on the surface of the cell, that may include special staining of the blood and bone marrow cells. This process is used to diagnose the subtype of AML by comparing the cancer cells to normal cells of the immune system.    -   Molecular testing : A laboratory test to check for certain genes, proteins, or other molecules in a sample of blood or bone marrow. Molecular tests also check for certain changes in a gene or chromosome that may cause or affect the chance of developing AML. A molecular test may be used to help plan treatment, find out how well treatment is working, or make a prognosis.    -   Lumbar puncture : A procedure used to collect a sample of cerebrospinal fluid (CSF) from the spinal column. This is done by placing a needle between two bones in the spine and into the CSF around the spinal cord and removing a sample of the fluid. The sample of CSF is checked under a microscope for signs that leukemia cells have spread to the brain and spinal cord. This procedure is also called an LP or spinal tap. </s>


Input: What is the outlook for Childhood Acute Myeloid Leukemia and Other Myeloid Malignancies ?

Output: Certain factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery) and treatment options for childhood AML depend on the following:         - The age of the child when the cancer is diagnosed.    - The race or ethnic group of the child.    - Whether the child is greatly overweight.    -  Number of white blood cells in the blood at diagnosis.    - Whether the AML occurred after previous cancer treatment.    - The subtype of AML.    - Whether there are certain chromosome or gene changes in the leukemia cells.    - Whether the child has Down syndrome. Most children with AML and Down syndrome can be cured of their leukemia.    - Whether the leukemia is in the central nervous system (brain and spinal cord).    - How quickly the leukemia responds to treatment.    - Whether the AML is newly diagnosed (untreated) or has recurred (come back) after being treated.    - The length of time since treatment ended, for AML that has recurred.        The prognosis and treatment options for childhood CML depend on how long it has been since the patient was diagnosed and how many blast cells are in the blood.   The prognosis (chance of recovery) and treatment options for JMML depend on the following:         - The age of the child when the cancer is diagnosed.    - The type of gene affected and the number of genes that have changes.    - How many red blood cells, white blood cells, or platelets are in the blood.    - Whether the JMML is newly diagnosed (untreated) or has recurred after treatment.        The prognosis (chance of recovery) and treatment options for MDS depend on the following:         - Whether the MDS was caused by previous cancer treatment.    - How low the numbers of red blood cells, white blood cells, or platelets are.    - Whether the MDS is newly diagnosed (untreated) or has recurred after treatment. </s>


Input: What are the stages of Childhood Acute Myeloid Leukemia and Other Myeloid Malignancies ?

Output:
Key Points
                    - Once childhood acute myeloid leukemia (AML) has been diagnosed, tests are done to find out if the cancer has spread to other parts of the body.    -  There is no standard staging system for childhood AML, childhood chronic myelogenous leukemia (CML), juvenile myelomonocytic leukemia (JMML), or myelodysplastic syndromes (MDS).

                    Once childhood acute myeloid leukemia (AML) has been diagnosed, tests are done to find out if the cancer has spread to other parts of the body.
                    The following tests and procedures may be used to determine if the leukemia has spread:         -   Lumbar puncture : A procedure used to collect a sample of cerebrospinal fluid (CSF) from the spinal column. This is done by placing a needle between two bones in the spine and into the CSF around the spinal cord and removing a sample of the fluid. The sample of CSF is checked under a microscope for signs that leukemia cells have spread to the brain and spinal cord. This procedure is also called an LP or spinal tap.    -   Biopsy of the testicles, ovaries, or skin: The removal of cells or tissues from the testicles, ovaries, or skin so they can be viewed under a microscope to check for signs of cancer. This is done only if something unusual about the testicles, ovaries, or skin is found during the physical exam.

                    There is no standard staging system for childhood AML, childhood chronic myelogenous leukemia (CML), juvenile myelomonocytic leukemia (JMML), or myelodysplastic syndromes (MDS).
                    The extent or spread of cancer is usually described as stages. Instead of stages, treatment of childhood AML, childhood CML, JMML, and MDS is based on one or more of the following:          - The type of disease or the subtype of AML.    - Whether leukemia has spread outside the blood and bone marrow.    - Whether the disease is newly diagnosed, in remission, or recurrent.         Newly diagnosed childhood AML    Newly diagnosed childhood AML has not been treated except to relieve signs and symptoms such as fever, bleeding, or pain, and one of the following is true:         - More than 20% of the cells in the bone marrow are blasts (leukemia cells). or    - Less than 20% of the cells in the bone marrow are blasts and there is a specific change in the chromosome.         Childhood AML in remission    In childhood AML in remission, the disease has been treated and the following are true:         - The complete blood count is almost normal.    - Less than 5% of the cells in the bone marrow are blasts (leukemia cells).    - There are no signs or symptoms of leukemia in the brain, spinal cord, or other parts of the body. </s>


Input: what research (or clinical trials) is being done for Childhood Acute Myeloid Leukemia and Other Myeloid Malignancies ?

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.     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.     Natural killer (NK) cells are a type of biologic therapy. NK cells are white blood cells that can kill tumor cells. These may be taken from a donor and given to the patient by infusion to help kill leukemia 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>