Input: what research (or clinical trials) is being done for Small Cell Lung Cancer ?

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

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

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


Input: What is (are) Retinoblastoma ?

Output:
Key Points
                    - Retinoblastoma is a disease in which malignant (cancer) cells form in the tissues of the retina.    - Retinoblastoma occurs in heritable and nonheritable forms.     -  Treatment for both forms of retinoblastoma should include genetic counseling.    - Children with a family history of retinoblastoma should have eye exams to check for retinoblastoma.     - A child who has heritable retinoblastoma has an increased risk of trilateral retinoblastoma and other cancers.    - Signs and symptoms of retinoblastoma include "white pupil" and eye pain or redness.     - Tests that examine the retina are used to detect (find) and diagnose retinoblastoma.    - Certain factors affect prognosis (chance of recovery) and treatment options.

                    Retinoblastoma is a disease in which malignant (cancer) cells form in the tissues of the retina.
                    The retina is the nerve tissue that lines the inside of the back of the eye. The retina senses light and sends images to the brain by way of the optic nerve.      Although retinoblastoma may occur at any age, it occurs most often in children younger than 2 years. The cancer may be in one eye (unilateral) or in both eyes (bilateral). Retinoblastoma rarely spreads from the eye to nearby tissue or other parts of the body.    Cavitary retinoblastoma is a rare type of retinoblastoma in which cavities (hollow spaces) form within the tumor.

                    Treatment for both forms of retinoblastoma should include genetic counseling.
                    Parents should receive genetic counseling (a discussion with a trained professional about the risk of genetic diseases) to discuss genetic testing to check for a mutation (change) in the RB1 gene. Genetic counseling also includes a discussion of the risk of retinoblastoma for the child and the child's brothers or sisters. </s>


Input: Is Retinoblastoma inherited ?

Output:
Retinoblastoma occurs in heritable and nonheritable forms.
                    A child is thought to have the heritable form of retinoblastoma when one of the following is true:         - There is a family history of retinoblastoma.    - There is a certain mutation (change) in the RB1 gene. The mutation in the RB1 gene may be passed from the parent to the child or it may occur in the egg or sperm before conception or soon after conception.    - There is more than one tumor in the eye or there is a tumor in both eyes.    - There is a tumor in one eye and the child is younger than 1 year.        After heritable retinoblastoma has been diagnosed and treated, new tumors may continue to form for a few years. Regular eye exams to check for new tumors are usually done every 2 to 4 months for at least 28 months.    Nonheritable retinoblastoma is retinoblastoma that is not the heritable form. Most cases of retinoblastoma are the nonheritable form.

                    Treatment for both forms of retinoblastoma should include genetic counseling.
                    Parents should receive genetic counseling (a discussion with a trained professional about the risk of genetic diseases) to discuss genetic testing to check for a mutation (change) in the RB1 gene. Genetic counseling also includes a discussion of the risk of retinoblastoma for the child and the child's brothers or sisters.

                    Children with a family history of retinoblastoma should have eye exams to check for retinoblastoma.
                    A child with a family history of retinoblastoma should have regular eye exams beginning early in life to check for retinoblastoma, unless it is known that the child does not have the RB1 gene change. Early diagnosis of retinoblastoma may mean the child will need less intense treatment.   Brothers or sisters of a child with retinoblastoma should have regular eye exams by an ophthalmologist until age 3 to 5 years, unless it is known that the brother or sister does not have the RB1 gene change.

                    A child who has heritable retinoblastoma has an increased risk of trilateral retinoblastoma and other cancers.
                    A child with heritable retinoblastoma has an increased risk of a pineal tumor in the brain. When retinoblastoma and a brain tumor occur at the same time, it is called trilateral retinoblastoma. The brain tumor is usually diagnosed between 20 and 36 months of age. Regular screening using MRI (magnetic resonance imaging) may be done for a child thought to have heritable retinoblastoma or for a child with retinoblastoma in one eye and a family history of the disease. CT (computerized tomography) scans are usually not used for routine screening in order to avoid exposing the child to ionizing radiation.    Heritable retinoblastoma also increases the child's risk of other types of cancer such as lung cancer, bladder cancer, or melanoma in later years. Regular follow-up exams are important. </s>


Input: Who is at risk for Retinoblastoma? ?

Output: A child who has heritable retinoblastoma has an increased risk of trilateral retinoblastoma and other cancers. A child with heritable retinoblastoma has an increased risk of a pineal tumor in the brain. When retinoblastoma and a brain tumor occur at the same time, it is called trilateral retinoblastoma. The brain tumor is usually diagnosed between 20 and 36 months of age. Regular screening using MRI (magnetic resonance imaging) may be done for a child thought to have heritable retinoblastoma or for a child with retinoblastoma in one eye and a family history of the disease. CT (computerized tomography) scans are usually not used for routine screening in order to avoid exposing the child to ionizing radiation.    Heritable retinoblastoma also increases the child's risk of other types of cancer such as lung cancer, bladder cancer, or melanoma in later years. Regular follow-up exams are important. </s>


Input: What are the symptoms of Retinoblastoma ?

Output: These and other signs and symptoms may be caused by retinoblastoma or by other conditions. Check with a doctor if your child has any of the following:         -  Pupil of the eye appears white instead of red when light shines into it. This may be seen in flash photographs of the child.    - Eyes appear to be looking in different directions (lazy eye).    - Pain or redness in the eye.    -  Infection around the eye.     - Eyeball is larger than normal.     - Colored part of the eye and pupil look cloudy. </s>


Input: How to diagnose Retinoblastoma ?

Output: 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. The doctor will ask if there is a family history of retinoblastoma.    -  Eye exam with dilated pupil: An exam of the eye in which the pupil is dilated (opened wider) with medicated eye drops to allow the doctor to look through the lens and pupil to the retina. The inside of the eye, including the retina and the optic nerve, is examined with a light. Depending on the age of the child, this exam may be done under anesthesia. There are several types of eye exams that are done with the pupil dilated:               -  Ophthalmoscopy : An exam of the inside of the back of the eye to check the retina and optic nerve using a small magnifying lens and a light.      -  Slit-lamp biomicroscopy : An exam of the inside of the eye to check the retina, optic nerve, and other parts of the eye using a strong beam of light and a microscope.      - Fluorescein angiography : A procedure to look at blood vessels and the flow of blood inside the eye. An orange fluorescent dye called fluorescein is injected into a blood vessel in the arm and goes into the bloodstream. As the dye travels through blood vessels of the eye, a special camera takes pictures of the retina and choroid to find any blood vessels that are blocked or leaking.              -   RB1 gene test: A laboratory test in which a sample of blood or tissue is tested for a change in the RB1 gene.    -   Ultrasound exam of the eye: A procedure in which high-energy sound waves (ultrasound) are bounced off the internal tissues of the eye to make echoes. Eye drops are used to numb the eye and a small probe that sends and receives sound waves is placed gently on the surface of the eye. The echoes make a picture of the inside of the eye and the distance from the cornea to the retina is measured. The picture, called a sonogram, shows on the screen of the ultrasound monitor. The picture can be printed to be looked at later.    -  MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body, such as the eye. This procedure is also called nuclear magnetic resonance imaging (NMRI).    -  CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, such as the eye, 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.        Retinoblastoma can usually be diagnosed without a biopsy.   When retinoblastoma is in one eye, it sometimes forms in the other eye. Exams of the unaffected eye are done until it is known if the retinoblastoma is the heritable form. </s>


Input: What is the outlook for Retinoblastoma ?

Output: The prognosis (chance of recovery) and treatment options depend on the following:         - Whether the cancer is in one or both eyes.    - The size and number of tumors.    - Whether the tumor has spread to the area around the eye, to the brain, or to other parts of the body.    - Whether there are symptoms at the time of diagnosis, for trilateral retinoblastoma.    - The age of the child.    - How likely it is that vision can be saved in one or both eyes.    - Whether a second type of cancer has formed. </s>


Input: What are the stages of Retinoblastoma ?

Output:
Key Points
                    - After retinoblastoma has been diagnosed, tests are done to find out if cancer cells have spread within the eye or to other parts of the body.     - The International Retinoblastoma Staging System (IRSS) may be used for staging retinoblastoma.          - Stage 0     - Stage I     - Stage II     - Stage III     - Stage IV        - There are three ways that cancer spreads in the body.    - Cancer may spread from where it began to other parts of the body.    - Treatment for retinoblastoma depends on whether it is intraocular (within the eye) or extraocular (outside the eye).          - Intraocular retinoblastoma      - Extraocular retinoblastoma (metastatic)

                    After retinoblastoma has been diagnosed, tests are done to find out if cancer cells have spread within the eye or to other parts of the body.
                    The process used to find out if cancer has spread within the eye or to other parts of the body is called staging. The information gathered from the staging process determines whether retinoblastoma is only in the eye (intraocular) or has spread outside the eye (extraocular). It is important to know the stage in order to plan treatment. The results of the tests used to diagnose cancer are often also used to stage the disease. (See the General Information section.)   The following tests and procedures may be used in the staging process:         -   Bone scan : A procedure to check if there are rapidly dividing cells, such as cancer cells, in the bone. A very small amount of radioactive material is injected into a vein and travels through the bloodstream. The radioactive material collects in the bones and is detected by a scanner that also takes a picture of the body. Areas of bone with cancer show up brighter in the picture because they take up more radioactive material than normal bone cells do.    -   Bone marrow aspiration and biopsy : The removal of bone marrow and a small piece of bone by inserting a hollow needle into the hipbone or breastbone. A pathologist views the bone marrow under a microscope to look for signs of cancer. A bone marrow aspiration and biopsy is done if the doctor thinks the cancer has spread outside of the eye.    -   Lumbar puncture : A procedure used to collect 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 the cancer has spread to the brain and spinal cord. This procedure is also called an LP or spinal tap.

                    The International Retinoblastoma Staging System (IRSS) may be used for staging retinoblastoma.
                    There are several staging systems for retinoblastoma. The IRSS stages are based on how much cancer remains after surgery to remove the tumor and whether the cancer has spread.      Stage 0     The tumor is in the eye only. The eye has not been removed and the tumor was treated without surgery.        Stage I    The tumor is in the eye only. The eye has been removed and no cancer cells remain.        Stage II     The tumor is in the eye only. The eye has been removed and there are cancer cells left that can be seen only with a microscope.        Stage III     Stage III is divided into stages IIIa and IIIb:            - In stage IIIa, cancer has spread from the eye to tissues around the eye socket.     - In stage IIIb, cancer has spread from the eye to lymph nodes near the ear or in the neck.               Stage IV     Stage IV is divided into stages IVa and IVb:            - In stage IVa, cancer has spread to the blood but not to the brain or spinal cord. One or more tumors may have spread to other parts of the body such as the bone or liver.     - In stage IVb, cancer has spread to the brain or spinal cord. It also may have spread to other parts of the body.

                    There are three ways that cancer spreads in the body.
                    Cancer can spread through tissue, the lymph system, and the blood:         - Tissue. The cancer spreads from where it began by growing into nearby areas.     - Lymph system. The cancer spreads from where it began by getting into the lymph system. The cancer travels through the lymph vessels to other parts of the body.     - Blood. The cancer spreads from where it began by getting into the blood. The cancer travels through the blood vessels to other parts of the body.

                    Cancer may spread from where it began to other parts of the body.
                    When cancer spreads to another part of the body, it is called metastasis. Cancer cells break away from where they began (the primary tumor) and travel through the lymph system or blood.         - Lymph system. The cancer gets into the lymph system, travels through the lymph vessels, and forms a tumor (metastatic tumor) in another part of the body.    - Blood. The cancer gets into the blood, travels through the blood vessels, and forms a tumor (metastatic tumor) in another part of the body.        The metastatic tumor is the same type of cancer as the primary tumor. For example, if retinoblastoma spreads to the bone, the cancer cells in the bone are actually retinoblastoma cells. The disease is metastatic retinoblastoma, not bone cancer.

                    Treatment for retinoblastoma depends on whether it is intraocular (within the eye) or extraocular (outside the eye).
                    Intraocular retinoblastoma     In intraocular retinoblastoma, cancer is found in one or both eyes and may be in the retina only or may also be in other parts of the eye such as the choroid, ciliary body, or part of the optic nerve. Cancer has not spread to tissues around the outside of the eye or to other parts of the body.        Extraocular retinoblastoma (metastatic)    In extraocular retinoblastoma, cancer has spread beyond the eye. It may be found in tissues around the eye (orbital retinoblastoma) or it may have spread to the central nervous system (brain and spinal cord) or to other parts of the body such as the liver, bones, bone marrow, or lymph nodes. </s>


Input: What are the treatments for Retinoblastoma ?

Output:
Key Points
                    - There are different types of treatment for patients with retinoblastoma.     - Children with retinoblastoma should have their treatment planned by a team of health care providers who are experts in treating cancer in children.    - Treatment for retinoblastoma may cause side effects.    - Six types of standard treatment are used:         - Cryotherapy     - Thermotherapy     - Chemotherapy      - Radiation therapy     - High-dose chemotherapy with stem cell rescue     - Surgery (enucleation)         - 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 retinoblastoma.
                    Different types of treatment are available for patients with retinoblastoma. 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.    Because cancer in children is rare, taking part in a clinical trial should be considered. Some clinical trials are open only to patients who have not started treatment.

                    Children with retinoblastoma should have their treatment planned by a team of health care providers who are experts in treating cancer in children.
                    The goals of treatment are to save the child's life, to save vision and the eye, and to prevent serious side effects. Treatment will be overseen by a pediatric oncologist, a doctor who specializes in treating children with cancer. The pediatric oncologist works with other health care providers who are experts in treating children with eye cancer and who specialize in certain areas of medicine. These may include a pediatric ophthalmologist (children's eye doctor) who has a lot of experience in treating retinoblastoma and the following specialists:         -  Pediatric surgeon.    -  Radiation oncologist.    -  Pediatrician.    -  Pediatric nurse specialist.    -  Rehabilitation specialist.    -  Social worker.    -  Geneticist or genetic counselor.

                    Treatment for retinoblastoma may cause side effects.
                    For information about side effects that begin during treatment for cancer, see our Side Effects page.   Side effects from cancer treatment that begin after treatment and continue for months or years are called late effects. Late effects of treatment for retinoblastoma may include the following:          - Physical problems such as seeing or hearing problems or, if the eye is removed, a change in the shape and size of the bone around the eye.     - Changes in mood, feelings, thinking, learning, or memory.     -  Second cancers (new types of cancer), such as lung and bladder cancers, osteosarcoma, soft tissue sarcoma, or melanoma.         The following risk factors may increase the risk of having another cancer:         - Having the heritable form of retinoblastoma.    - Past treatment with radiation therapy, especially before age 1 year.    - Having already had a previous second cancer.        It is important to talk with your child's doctors about the effects cancer treatment can have on your child. Regular follow-up by health professionals who are experts in diagnosing and treating late effects is important. See the PDQ summary on Late Effects of Treatment for Childhood Cancer for more information.

                    Six types of standard treatment are used:
                    Cryotherapy     Cryotherapy is a treatment that uses an instrument to freeze and destroy abnormal tissue. This type of treatment is also called cryosurgery.       Thermotherapy     Thermotherapy is the use of heat to destroy cancer cells. Thermotherapy may be given using a laser beam aimed through the dilated pupil or onto the outside of the eyeball. Thermotherapy may be used alone for small tumors or combined with chemotherapy for larger tumors. This treatment is a type of laser therapy.       Chemotherapy     Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. The way the chemotherapy is given depends on the stage of the cancer and where the cancer is in the body.    There are different types of chemotherapy:            -  Systemic chemotherapy: 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 is given to shrink the tumor (chemoreduction) and avoid surgery to remove the eye. After chemoreduction, other treatments may include radiation therapy, cryotherapy, laser therapy, or regional chemotherapy.  Systemic chemotherapy may also be given to kill any cancer cells that are left after the initial treatment or to patients with retinoblastoma that occurs outside the eye. Treatment given after the initial treatment, to lower the risk that the cancer will come back, is called adjuvant therapy.     - Regional chemotherapy: When chemotherapy is placed directly into the cerebrospinal fluid (intrathecal chemotherapy), an organ (such as the eye), or a body cavity, the drugs mainly affect cancer cells in those areas. Several types of regional chemotherapy are used to treat retinoblastoma.                  -  Ophthalmic artery infusion chemotherapy: Ophthalmic artery infusion chemotherapy carries anticancer drugs directly to the eye. A catheter is put into an artery that leads to the eye and the anticancer drug is given through the catheter. After the drug is given, a small balloon may be inserted into the artery to block it and keep most of the anticancer drug trapped near the tumor. This type of chemotherapy may be given as the initial treatment when the tumor is in the eye only or when the tumor has not responded to other types of treatment. Ophthalmic artery infusion chemotherapy is given at special retinoblastoma treatment centers.        -  Intravitreal chemotherapy: Intravitreal chemotherapy is the injection of anticancer drugs directly into the vitreous humor (jelly-like substance) inside in the eye. It is used to treat cancer that has spread to the vitreous humor and has not responded to treatment or has come back after treatment.                       See Drugs Approved for Retinoblastoma for more information.       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-beam radiation therapy uses a machine outside the body to send radiation toward the cancer. Certain ways of giving radiation therapy can help keep radiation from damaging nearby healthy tissue. These types of radiation therapy include the following:                  -  Intensity-modulated radiation therapy (IMRT): IMRT is a type of 3-dimensional (3-D) external radiation therapy that uses a computer to make pictures of the size and shape of the tumor. Thin beams of radiation of different intensities (strengths) are aimed at the tumor from many angles.       -  Proton-beam radiation therapy: Proton-beam therapy is a type of high-energy, external radiation therapy. A radiation therapy machine aims streams of protons (tiny, invisible, positively-charged particles) at the cancer cells to kill them.                -  Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. Certain ways of giving radiation therapy can help keep radiation from damaging nearby healthy tissue. This type of internal radiation therapy may include the following:                  -  Plaque radiotherapy: Radioactive seeds are attached to one side of a disk, called a plaque, and placed directly on the outside wall of the eye near the tumor. The side of the plaque with the seeds on it faces the eyeball, aiming radiation at the tumor. The plaque helps protect other nearby tissue from the radiation.                      The way the radiation therapy is given depends on the type and stage of the cancer being treated and how the cancer responded to other treatments. External and internal radiation therapy are used to treat retinoblastoma.       High-dose chemotherapy with stem cell rescue     High-dose chemotherapy with stem cell rescue is a way 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 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.    See Drugs Approved for Retinoblastoma for more information.       Surgery (enucleation)      Enucleation is surgery to remove the eye and part of the optic nerve. A sample of the eye tissue that is removed will be checked under a microscope to see if there are any signs that the cancer is likely to spread to other parts of the body. This should be done by an experienced pathologist, who is familiar with retinoblastoma and other diseases of the eye. Enucleation is done if there is little or no chance that vision can be saved and when the tumor is large, did not respond to treatment, or comes back after treatment. The patient will be fitted for an artificial eye.    Close follow-up is needed for 2 years or more to check for signs of recurrence in the area around the affected eye and to check the other eye.

                    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 child's 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 Retinoblastoma

		                    Treatment of Unilateral, Bilateral, and Cavitary Retinoblastoma
		                    If it is likely that the eye can be saved, treatment may include the following:         -  Systemic chemotherapy or ophthalmic artery infusion chemotherapy, with or without intravitreal chemotherapy, to shrink the tumor. This may be followed by one or more of the following:               -  Cryotherapy.       -  Thermotherapy.      -  Plaque radiotherapy.             -  External-beam radiation therapy for bilateral intraocular retinoblastoma that does not respond to other treatments.    - A clinical trial of ophthalmic artery infusion for unilateral retinoblastoma that has spread to the vitreous humor.        If the tumor is large and it is not likely that the eye can be saved, treatment may include the following:         -  Surgery (enucleation). After surgery, systemic chemotherapy may be given to lower the risk that the cancer will spread to other parts of the body.        When retinoblastoma is in both eyes, the treatment for each eye may be different, depending on the size of the tumor and whether it is likely that the eye can be saved. The dose of systemic chemotherapy is usually based on the eye that has more cancer.   Treatment for cavitary retinoblastoma, a type of intraocular retinoblastoma, may include the following:         - Systemic chemotherapy or ophthalmic artery infusion chemotherapy.        Check the list of NCI-supported cancer clinical trials that are now accepting patients with intraocular retinoblastoma. 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.

		                    Treatment of Extraocular Retinoblastoma
		                    Treatment for extraocular retinoblastoma that has spread to the area around the eye may include the following:         -  Systemic chemotherapy and external-beam radiation therapy.    - Systemic chemotherapy followed by surgery (enucleation). External-beam radiation therapy and more chemotherapy may be given after surgery.         Treatment for extraocular retinoblastoma that has spread to the brain may include the following:         - Systemic or intrathecal chemotherapy.    -  External-beam radiation therapy to the brain and spinal cord.     - Chemotherapy followed by high-dose chemotherapy with stem cell rescue.        It is not clear whether treatment with chemotherapy, radiation therapy, or high-dose chemotherapy with stem cell rescue helps patients with extraocular retinoblastoma live longer.   For trilateral retinoblastoma, treatment may include the following:         - Systemic chemotherapy followed by high-dose chemotherapy with stem cell rescue.    - Systemic chemotherapy followed by surgery and external-beam radiation therapy.        For retinoblastoma that has spread to other parts of the body, but not the brain, treatment may include the following:         - Chemotherapy followed by high-dose chemotherapy with stem cell rescue and external-beam radiation therapy.        Check the list of NCI-supported cancer clinical trials that are now accepting patients with extraocular retinoblastoma. 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.

		                    Treatment of Progressive or Recurrent Retinoblastoma
		                    Treatment of progressive or recurrent intraocular retinoblastoma may include the following:         -  External-beam radiation therapy or plaque radiotherapy.    -  Cryotherapy.    -  Thermotherapy.    -  Systemic chemotherapy or ophthalmic artery infusion chemotherapy.    -  Intravitreal chemotherapy.    -  Surgery (enucleation).        Treatment of progressive or recurrent extraocular retinoblastoma may include the following:         - Systemic chemotherapy and external-beam radiation therapy for retinoblastoma that comes back after surgery to remove the eye.    - Systemic chemotherapy followed by high-dose chemotherapy with stem cell rescue and external-beam radiation therapy.    - A clinical trial of a new treatment.        Check the list of NCI-supported cancer clinical trials that are now accepting patients with recurrent retinoblastoma. 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: what research (or clinical trials) is being done for Retinoblastoma ?

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) Skin Cancer ?

Output:
Key Points
                    - Skin cancer is a disease in which malignant (cancer) cells form in the tissues of the skin.    - There are different types of cancer that start in the skin.     - Skin color and being exposed to sunlight can increase the risk of nonmelanoma skin cancer and actinic keratosis.     - Nonmelanoma skin cancer and actinic keratosis often appear as a change in the skin.    - Tests or procedures that examine the skin are used to detect (find) and diagnose nonmelanoma skin cancer and actinic keratosis.    - Certain factors affect prognosis (chance of recovery) and treatment options.

                    Skin cancer is a disease in which malignant (cancer) cells form in the tissues of the skin.
                    The skin is the bodys largest organ. It protects against heat, sunlight, injury, and infection. Skin also helps control body temperature and stores water, fat, and vitamin D. The skin has several layers, but the two main layers are the epidermis (upper or outer layer) and the dermis (lower or inner layer). Skin cancer begins in the epidermis, which is made up of three kinds of cells:         -  Squamous cells: Thin, flat cells that form the top layer of the epidermis.    -  Basal cells: Round cells under the squamous cells.    -  Melanocytes: Cells that make melanin and are found in the lower part of the epidermis. Melanin is the pigment that gives skin its natural color. When skin is exposed to the sun, melanocytes make more pigment and cause the skin to darken.          Skin cancer can occur anywhere on the body, but it is most common in skin that is often exposed to sunlight, such as the face, neck, hands, and arms.

                    There are different types of cancer that start in the skin.
                    The most common types are basal cell carcinoma and squamous cell carcinoma, which are nonmelanoma skin cancers. Nonmelanoma skin cancers rarely spread to other parts of the body. Melanoma is a much rarer type of skin cancer. It is more likely to invade nearby tissues and spread to other parts of the body. Actinic keratosis is a skin condition that sometimes becomes squamous cell carcinoma.   This summary is about nonmelanoma skin cancer and actinic keratosis. See the following PDQ summaries for information on melanoma and other kinds of cancer that affect the skin:         -  Melanoma Treatment     -  Mycosis Fungoides and the Szary Syndrome Treatment     -   Kaposi Sarcoma Treatment     -  Merkel Cell Carcinoma Treatment     -  Unusual Cancers of Childhood Treatment     -  Genetics of Skin Cancer

                    Nonmelanoma skin cancer and actinic keratosis often appear as a change in the skin.
                    Not all changes in the skin are a sign of nonmelanoma skin cancer or actinic keratosis. Check with your doctor if you notice any changes in your skin.    Signs of nonmelanoma skin cancer include the following:         - A sore that does not heal.    - Areas of the skin that are:               - Raised, smooth, shiny, and look pearly.       - Firm and look like a scar, and may be white, yellow, or waxy.      - Raised, and red or reddish-brown.       - Scaly, bleeding or crusty. </s>


Input: Who is at risk for Skin Cancer? ?

Output: Skin color and being exposed to sunlight can increase the risk of nonmelanoma skin cancer and actinic keratosis. 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 basal cell carcinoma and squamous cell carcinoma include the following:         - 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.     - Having certain changes in the genes that are linked to skin cancer.    - Being exposed to arsenic. </s>


Input: How to diagnose Skin Cancer ?

Output: Tests or procedures that examine the skin are used to detect (find) and diagnose nonmelanoma skin cancer and actinic keratosis. The following procedures may be used:         -  Skin exam: A doctor or nurse checks the skin for bumps or spots that look abnormal in color, size, shape, or texture.    -  Skin biopsy : All or part of the abnormal-looking growth is cut from the skin and viewed under a microscope by a pathologist to check for signs of cancer. There are four main types of skin biopsies:               -  Shave biopsy : A sterile razor blade is used to shave-off the abnormal-looking growth.      -  Punch biopsy : A special instrument called a punch or a trephine is used to remove a circle of tissue from the abnormal-looking growth.      -  Incisional biopsy : A scalpel is used to remove part of a growth.      -  Excisional biopsy : A scalpel is used to remove the entire growth. </s>


Input: What is the outlook for Skin Cancer ?

Output: Certain factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery) depends mostly on the stage of the cancer and the type of treatment used to remove the cancer.   Treatment options depend on the following:         - The stage of the cancer (whether it has spread deeper into the skin or to other places in the body).    - The type of cancer.    - The size of the tumor and what part of the body it affects.    - The patients general health. </s>


Input: What are the stages of Skin Cancer ?

Output:
Key Points
                    - After nonmelanoma skin cancer has been diagnosed, tests are done to find out if cancer cells have spread within the skin or to other parts of the body.     - There are three ways that cancer spreads in the body.    - Cancer may spread from where it began to other parts of the body.    - Staging of nonmelanoma skin cancer depends on whether the tumor has certain "high-risk" features and if the tumor is on the eyelid.    - The following stages are used for nonmelanoma skin cancer that is not on the eyelid:         - Stage 0 (Carcinoma in Situ)     - Stage I Stage I nonmelanoma skin cancer. The tumor is no more than 2 centimeters.     - Stage II Stage II nonmelanoma skin cancer. The tumor is more than 2 centimeters wide.     - Stage III     - Stage IV        - The following stages are used for nonmelanoma skin cancer on the eyelid:         - Stage 0 (Carcinoma in Situ)     - Stage I      - Stage II     - Stage III     - Stage IV        - Treatment is based on the type of nonmelanoma skin cancer or other skin condition diagnosed:         - Basal cell carcinoma     - Squamous cell carcinoma     - Actinic keratosis

                    After nonmelanoma skin cancer has been diagnosed, tests are done to find out if cancer cells have spread within the skin or to other parts of the body.
                    The process used to find out if cancer has spread within the skin or to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment.    The following tests and procedures may be used in the staging process:         -   CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.    -   MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI).    -   Lymph node biopsy : For squamous cell carcinoma, the lymph nodes may be removed and checked to see if cancer has spread to them.

                    There are three ways that cancer spreads in the body.
                    Cancer can spread through tissue, the lymph system, and the blood:         - Tissue. The cancer spreads from where it began by growing into nearby areas.     - Lymph system. The cancer spreads from where it began by getting into the lymph system. The cancer travels through the lymph vessels to other parts of the body.     - Blood. The cancer spreads from where it began by getting into the blood. The cancer travels through the blood vessels to other parts of the body.

                    Cancer may spread from where it began to other parts of the body.
                    When cancer spreads to another part of the body, it is called metastasis. Cancer cells break away from where they began (the primary tumor) and travel through the lymph system or blood.         - Lymph system. The cancer gets into the lymph system, travels through the lymph vessels, and forms a tumor (metastatic tumor) in another part of the body.    - Blood. The cancer gets into the blood, travels through the blood vessels, and forms a tumor (metastatic tumor) in another part of the body.        The metastatic tumor is the same type of cancer as the primary tumor. For example, if skin cancer spreads to the lung, the cancer cells in the lung are actually skin cancer cells. The disease is metastatic skin cancer, not lung cancer.

                    Staging of nonmelanoma skin cancer depends on whether the tumor has certain "high-risk" features and if the tumor is on the eyelid.
                    Staging for nonmelanoma skin cancer that is on the eyelid is different from staging for nonmelanoma skin cancer that affects other parts of the body.     The following are high-risk features for nonmelanoma skin cancer that is not on the eyelid:         - The tumor is thicker than 2 millimeters.    - The tumor is described as Clark level IV (has spread into the lower layer of the dermis) or Clark level V (has spread into the layer of fat below the skin).    - The tumor has grown and spread along nerve pathways.    - The tumor began on an ear or on a lip that has hair on it.    - The tumor has cells that look very different from normal cells under a microscope.

                    The following stages are used for nonmelanoma skin cancer that is not on the eyelid:
                    Stage 0 (Carcinoma in Situ)     In stage 0, abnormal cells are found in the squamous cell or basal cell layer of the epidermis (topmost layer of the skin). These abnormal cells may become cancer and spread into nearby normal tissue. Stage 0 is also called carcinoma in situ.        Stage I     In stage I, cancer has formed. The tumor is not larger than 2 centimeters at its widest point and may have one high-risk feature.       Stage II     In stage II, the tumor is either:            - larger than 2 centimeters at its widest point; or     - any size and has two or more high-risk features.              Stage III    In stage III:            - The tumor has spread to the jaw, eye socket, or side of the skull. Cancer may have spread to one lymph node on the same side of the body as the tumor. The lymph node is not larger than 3 centimeters.              or              - Cancer has spread to one lymph node on the same side of the body as the tumor. The lymph node is not larger than 3 centimeters and one of the following is true:                  - the tumor is not larger than 2 centimeters at its widest point and may have one high-risk feature; or       - the tumor is larger than 2 centimeters at its widest point; or       - the tumor is any size and has two or more high-risk features.                          Stage IV    In stage IV, one of the following is true:            - The tumor is any size and may have spread to the jaw, eye socket, or side of the skull. Cancer has spread to one lymph node on the same side of the body as the tumor and the affected node is larger than 3 centimeters but not larger than 6 centimeters, or cancer has spread to more than one lymph node on one or both sides of the body and the affected nodes are not larger than 6 centimeters; or     - The tumor is any size and may have spread to the jaw, eye socket, skull, spine, or ribs. Cancer has spread to one lymph node that is larger than 6 centimeters; or      - The tumor is any size and has spread to the base of the skull, spine, or ribs. Cancer may have spread to the lymph nodes; or     - Cancer has spread to other parts of the body, such as the lung.

                    The following stages are used for nonmelanoma skin cancer on the eyelid:
                    Stage 0 (Carcinoma in Situ)    In stage 0, abnormal cells are found in the epidermis (topmost layer of the skin). These abnormal cells may become cancer and spread into nearby normal tissue. Stage 0 is also called carcinoma in situ.       Stage I      Stage I is divided into stages IA, IB, and IC.            -  Stage IA: The tumor is 5 millimeters or smaller and has not spread to the connective tissue of the eyelid or to the edge of the eyelid where the lashes are.      -  Stage IB: The tumor is larger than 5 millimeters but not larger than 10 millimeters or has spread to the connective tissue of the eyelid, or to the edge of the eyelid where the lashes are.     -  Stage IC: The tumor is larger than 10 millimeters but not larger than 20 millimeters or has spread through the full thickness of the eyelid.              Stage II    In stage II, one of the following is true:            - The tumor is larger than 20 millimeters.     - The tumor has spread to nearby parts of the eye or eye socket.     - The tumor has spread to spaces around the nerves in the eyelid.              Stage III     Stage III is divided into stages IIIA, IIIB, and IIIC.            -  Stage IIIA: To remove all of the tumor, the whole eye and part of the optic nerve must be removed. The bone, muscles, fat, and connective tissue around the eye may also be removed.     -  Stage IIIB: The tumor may be anywhere in or near the eye and has spread to nearby lymph nodes.     -  Stage IIIC: The tumor has spread to structures around the eye or in the face, or to the brain, and cannot be removed in surgery.              Stage IV    The tumor has spread to distant parts of the body.

                    Treatment is based on the type of nonmelanoma skin cancer or other skin condition diagnosed:
                    Basal cell carcinoma      Basal cell carcinoma is the most common type of skin cancer. It usually occurs on areas of the skin that have been in the sun, most often the nose. Often this cancer appears as a raised bump that looks smooth and pearly. Another type looks like a scar and is flat and firm and may be white, yellow, or waxy. Basal cell carcinoma may spread to tissues around the cancer, but it usually does not spread to other parts of the body.       Squamous cell carcinoma      Squamous cell carcinoma occurs on areas of the skin that have been in the sun, such as the ears, lower lip, and the back of the hands. Squamous cell carcinoma may also appear on areas of the skin that have been burned or exposed to chemicals or radiation. Often this cancer appears as a firm red bump. The tumor may feel scaly, bleed, or form a crust. Squamous cell tumors may spread to nearby lymph nodes. Squamous cell carcinoma that has not spread can usually be cured.       Actinic keratosis     Actinic keratosis is a skin condition that is not cancer, but sometimes changes into squamous cell carcinoma. It usually occurs in areas that have been exposed to the sun, such as the face, the back of the hands, and the lower lip. It looks like rough, red, pink, or brown scaly patches on the skin that may be flat or raised, or the lower lip cracks and peels and is not helped by lip balm or petroleum jelly. </s>


Input: What are the treatments for Skin Cancer ?

Output:
Key Points
                    - There are different types of treatment for patients with nonmelanoma skin cancer and actinic keratosis.     - Six types of standard treatment are used:         - Surgery      - Radiation therapy      - Chemotherapy      - Photodynamic therapy     - Biologic therapy     - Targeted therapy        - New types of treatment are being tested in clinical trials.    - Treatment for skin cancer may cause side effects.    - Patients may want to think about taking part in a clinical trial.    - Patients can enter clinical trials before, during, or after starting their cancer treatment.    - Follow-up tests may be needed.

                    There are different types of treatment for patients with nonmelanoma skin cancer and actinic keratosis.
                    Different types of treatment are available for patients with nonmelanoma skin cancer and actinic keratosis. 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     One or more of the following surgical procedures may be used to treat nonmelanoma skin cancer or actinic keratosis:            -  Mohs micrographic surgery: The tumor is cut from the skin in thin layers. During surgery, the edges of the tumor and each layer of tumor removed are viewed through a microscope to check for cancer cells. Layers continue to be removed until no more cancer cells are seen. This type of surgery removes as little normal tissue as possible and is often used to remove skin cancer on the face.      - Simple excision: The tumor is cut from the skin along with some of the normal skin around it.      - Shave excision: The abnormal area is shaved off the surface of the skin with a small blade.      -  Electrodesiccation and curettage: The tumor is cut from the skin with a curette (a sharp, spoon-shaped tool). A needle-shaped electrode is then used to treat the area with an electric current that stops the bleeding and destroys cancer cells that remain around the edge of the wound. The process may be repeated one to three times during the surgery to remove all of the cancer.     -  Cryosurgery: A treatment that uses an instrument to freeze and destroy abnormal tissue, such as carcinoma in situ. This type of treatment is also called cryotherapy.     -  Laser surgery: A surgical procedure that uses a laser beam (a narrow beam of intense light) as a knife to make bloodless cuts in tissue or to remove a surface lesion such as a tumor.     -  Dermabrasion: Removal of the top layer of skin using a rotating wheel or small particles to rub away skin cells.              Radiation therapy      Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. There are two types of radiation therapy:            -  External radiation therapy uses a machine outside the body to send radiation toward the cancer.     -  Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer.           The way the radiation therapy is given depends on the type of cancer being treated. External radiation therapy is used to treat skin cancer.       Chemotherapy      Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the cerebrospinal fluid, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). Chemotherapy for nonmelanoma skin cancer and actinic keratosis is usually topical (applied to the skin in a cream or lotion). The way the chemotherapy is given depends on the condition being treated.     Retinoids (drugs related to vitamin A) are sometimes used to treat squamous cell carcinoma of the skin.    See Drugs Approved for Basal Cell Carcinoma for more information.       Photodynamic therapy     Photodynamic therapy (PDT) is a cancer treatment that uses a drug and a certain type of laser light to kill cancer cells. A drug that is not active until it is exposed to light is injected into a vein. The drug collects more in cancer cells than in normal cells. For skin cancer, laser light is shined onto the skin and the drug becomes active and kills the cancer cells. Photodynamic therapy causes little damage to healthy tissue.       Biologic therapy     Biologic therapy is a treatment that uses the patients immune system to fight cancer. Substances made by the body or made in a laboratory are used to boost, direct, or restore the bodys natural defenses against cancer. This type of cancer treatment is also called biotherapy or immunotherapy.     Interferon and imiquimod are biologic agents used to treat skin cancer. Interferon (by injection) may be used to treat squamous cell carcinoma of the skin. Topical imiquimod therapy (a cream applied to the skin) may be used to treat some small basal cell carcinomas.    See Drugs Approved for Basal Cell Carcinoma for more information.       Targeted therapy     Targeted therapy is a type of treatment that uses drugs or other substances to attack cancer cells. Targeted therapies usually cause less harm to normal cells than chemotherapy or radiation therapy do.     Targeted therapy with a signal transduction inhibitor is used to treat basal cell carcinoma. Signal transduction inhibitors block signals that are passed from one molecule to another inside a cell. Blocking these signals may kill cancer cells. Vismodegib and sonidegib are signal transduction inhibitors used to treat basal cell carcinoma.     See Drugs Approved for Basal Cell Carcinoma for more information.

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

                    Treatment for skin cancer may cause side effects.
                    For information about side effects caused by treatment for cancer, see our Side Effects page.

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

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

                    Follow-up tests may be needed.
                    Some of the tests that were done to diagnose the cancer or to find out the stage of the cancer may be repeated. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests.   Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your condition has changed or if the cancer has recurred (come back). These tests are sometimes called follow-up tests or check-ups.   Basal cell carcinoma and squamous cell carcinoma are likely to recur (come back), usually within 5 years, or new tumors may form. Talk to your doctor about how often you should have your skin checked for signs of cancer.

		            Treatment Options for Nonmelanoma Skin Cancer

		                    Basal Cell Carcinoma
		                    Treatment of basal cell carcinoma may include the following:         - Simple excision.    -  Mohs micrographic surgery.    -  Radiation therapy.    -  Electrodesiccation and curettage.    -  Cryosurgery.    -  Photodynamic therapy.    -  Topical chemotherapy.    -  Topical biologic therapy with imiquimod.    -  Laser surgery.        Treatment of recurrent basal cell carcinoma is usually Mohs micrographic surgery.   Treatment of basal cell carcinoma that is metastatic or cannot be treated with local therapy may include the following:         -  Targeted therapy with a signal transduction inhibitor.    -  Chemotherapy.    - A clinical trial of a new treatment.        Check the list of NCI-supported cancer clinical trials that are now accepting patients with basal cell carcinoma of the skin. 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.

		                    Squamous Cell Carcinoma
		                    Treatment of squamous cell carcinoma may include the following:         - Simple excision.    -  Mohs micrographic surgery.    -  Radiation therapy.    -  Electrodesiccation and curettage.    -  Cryosurgery.        Treatment of recurrent squamous cell carcinoma may include the following:         - Simple excision.    - Mohs micrographic surgery.    - Radiation therapy.        Treatment of squamous cell carcinoma that is metastatic or cannot be treated with local therapy may include the following:         -  Chemotherapy.    -  Retinoid therapy and biologic therapy with interferon.    -  A clinical trial of a new treatment.        Check the list of NCI-supported cancer clinical trials that are now accepting patients with squamous cell carcinoma of the skin. 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 Skin Cancer ?

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

                    Treatment for skin cancer may cause side effects.
                    For information about side effects caused by treatment for cancer, see our Side Effects page.

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

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


Input: What is (are) Salivary Gland Cancer ?

Output:
Key Points
                    - Salivary gland cancer is a rare disease in which malignant (cancer) cells form in the tissues of the salivary glands.    - Being exposed to certain types of radiation may increase the risk of salivary cancer.     - Signs of salivary gland cancer include a lump or trouble swallowing.     - Tests that examine the head, neck, and the inside of the mouth are used to detect (find) and diagnose salivary gland cancer.    - Certain factors affect treatment options and prognosis (chance of recovery).

                    Salivary gland cancer is a rare disease in which malignant (cancer) cells form in the tissues of the salivary glands.
                    The salivary glands make saliva and release it into the mouth. Saliva has enzymes that help digest food and antibodies that help protect against infections of the mouth and throat. There are 3 pairs of major salivary glands:         - Parotid glands: These are the largest salivary glands and are found in front of and just below each ear. Most major salivary gland tumors begin in this gland.    - Sublingual glands: These glands are found under the tongue in the floor of the mouth.    - Submandibular glands: These glands are found below the jawbone.         There are also hundreds of small (minor) salivary glands lining parts of the mouth, nose, and larynx that can be seen only with a microscope. Most small salivary gland tumors begin in the palate (roof of the mouth).   More than half of all salivary gland tumors are benign (not cancerous) and do not spread to other tissues.     Salivary gland cancer is a type of head and neck cancer. </s>


Input: Who is at risk for Salivary Gland Cancer? ?

Output: Being exposed to certain types of radiation may increase the risk of salivary cancer. Anything that increases the chance of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesnt mean that you will not get cancer. Talk with your doctor if you think you may be at risk. Although the cause of most salivary gland cancers is not known, risk factors include the following:         - Older age.    - Treatment with radiation therapy to the head and neck.    - Being exposed to certain substances at work. </s>


Input: What are the symptoms of Salivary Gland Cancer ?

Output: Signs of salivary gland cancer include a lump or trouble swallowing. Salivary gland cancer may not cause any symptoms. It may be found during a regular dental check-up or physical exam. Signs and symptoms may be caused by salivary gland cancer or by other conditions. Check with your doctor if you have any of the following:         - A lump (usually painless) in the area of the ear, cheek, jaw, lip, or inside the mouth.    -  Fluid draining from the ear.    - Trouble swallowing or opening the mouth widely.    - Numbness or weakness in the face.    - Pain in the face that does not go away. </s>


Input: How to diagnose Salivary Gland Cancer ?

Output: Tests that examine the head, neck, and the inside of the mouth are used to detect (find) and diagnose salivary gland cancer. The following procedures may be used:         -  Physical exam and history : An exam of the body to check general signs of health. The head, neck, mouth, and throat will be checked 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.    -   MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI).    -   CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.     -   PET scan (positron emission tomography scan): A procedure to find malignant tumor cells in the body. A small amount of radioactive glucose (sugar) is injected into a vein. The PET scanner rotates around the body and makes a picture of where glucose is being used in the body. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do.    -   Endoscopy : A procedure to look at organs and tissues inside the body to check for abnormal areas. For salivary gland cancer, an endoscope is inserted into the mouth to look at the mouth, throat, and larynx. An endoscope is a thin, tube-like instrument with a light and a lens for viewing.     -   Biopsy : The removal of cells or tissues so they can be viewed under a microscope by a pathologist to check for signs of cancer.               -  Fine needle aspiration (FNA) biopsy : The removal of tissue or fluid using a thin needle. An FNA is the most common type of biopsy used for salivary gland cancer.      -  Incisional biopsy : The removal of part of a lump or a sample of tissue that doesnt look normal.      -  Surgery : If cancer cannot be diagnosed from the sample of tissue removed during an FNA biopsy or an incisional biopsy, the mass may be removed and checked for signs of cancer.                 Because salivary gland cancer can be hard to diagnose, patients should ask to have the tissue samples checked by a pathologist who has experience in diagnosing salivary gland cancer. </s>


Input: What is the outlook for Salivary Gland Cancer ?

Output: Certain factors affect treatment options and prognosis (chance of recovery). The treatment options and prognosis (chance of recovery) depend on the following:         - The stage of the cancer (especially the size of the tumor).    - The type of salivary gland the cancer is in.    - The type of cancer cells (how they look under a microscope).    - The patient's age and general health. </s>


Input: What are the stages of Salivary Gland Cancer ?

Output:
Key Points
                    - After salivary gland cancer has been diagnosed, tests are done to find out if cancer cells have spread within the salivary gland or to other parts of the body.     - There are three ways that cancer spreads in the body.    - Cancer may spread from where it began to other parts of the body.    - The following stages are used for major salivary gland cancers:         - Stage I     - Stage II     - Stage III     - Stage IV

                    After salivary gland cancer has been diagnosed, tests are done to find out if cancer cells have spread within the salivary gland or to other parts of the body.
                    The process used to find out if cancer has spread within the salivary glands or to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment. The following procedures may be used in the staging process:         -   MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI).    -   CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, 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.

                    There are three ways that cancer spreads in the body.
                    Cancer can spread through tissue, the lymph system, and the blood:         - Tissue. The cancer spreads from where it began by growing into nearby areas.     - Lymph system. The cancer spreads from where it began by getting into the lymph system. The cancer travels through the lymph vessels to other parts of the body.     - Blood. The cancer spreads from where it began by getting into the blood. The cancer travels through the blood vessels to other parts of the body.

                    Cancer may spread from where it began to other parts of the body.
                    When cancer spreads to another part of the body, it is called metastasis. Cancer cells break away from where they began (the primary tumor) and travel through the lymph system or blood.         - Lymph system. The cancer gets into the lymph system, travels through the lymph vessels, and forms a tumor (metastatic tumor) in another part of the body.    - Blood. The cancer gets into the blood, travels through the blood vessels, and forms a tumor (metastatic tumor) in another part of the body.        The metastatic tumor is the same type of cancer as the primary tumor. For example, if salivary gland cancer spreads to the lung, the cancer cells in the lung are actually salivary gland cancer cells. The disease is metastatic salivary gland cancer, not lung cancer.

                    The following stages are used for major salivary gland cancers:
                    Stage I    In stage I, the tumor is in the salivary gland only and is 2 centimeters or smaller.        Stage II    In stage II, the tumor is in the salivary gland only and is larger than 2 centimeters but not larger than 4 centimeters.       Stage III    In stage III, one of the following is true:            - The tumor is not larger than 4 centimeters and has spread to a single lymph node on the same side as the tumor and the lymph node is 3 centimeters or smaller.     - The tumor is larger than 4 centimeters and/or has spread to soft tissue around the affected gland. Cancer may have spread to a single lymph node on the same side as the tumor and the lymph node is 3 centimeters or smaller.              Stage IV     Stage IV is divided into stages IVA, IVB, and IVC as follows:            -  Stage IVA:                  - The tumor may be any size and may have spread to soft tissue around the affected gland. Cancer has spread to a single lymph node on the same side as the tumor and the lymph node is larger than 3 centimeters but not larger than 6 centimeters, or has spread to more than one lymph node on either or both sides of the body and the lymph nodes are not larger than 6 centimeters; or       - Cancer has spread to the skin, jawbone, ear canal, and/or facial nerve, and may have spread to one or more lymph nodes on either or both sides of the body. The lymph nodes are not larger than 6 centimeters.                -  Stage IVB:                  - The tumor may be any size and may have spread to soft tissue around the affected gland. Cancer has spread to a lymph node larger than 6 centimeters; or       - Cancer has spread to the base of the skull and/or the carotid artery, and may have spread to one or more lymph nodes of any size on either or both sides of the body.                -  Stage IVC:                  - The tumor may be any size and may have spread to soft tissue around the affected gland, to the skin, jawbone, ear canal, facial nerve, base of the skull, or carotid artery, or to one or more lymph nodes on either or both sides of the body. Cancer has spread to distant parts of the body.                       Salivary gland cancers are also grouped by grade. The grade of a tumor tells how fast the cancer cells are growing, based on how the cells look under a microscope. Low-grade cancers grow more slowly than high-grade cancers.     Minor salivary gland cancers are staged according to where they were first found in the body. </s>


Input: What are the treatments for Salivary Gland Cancer ?

Output:
Key Points
                    - There are different types of treatment for patients with salivary gland cancer.     - Patients with salivary gland cancer should have their treatment planned by a team of doctors who are experts in treating head and neck cancer.    - Three types of standard treatment are used:         - Surgery      - Radiation therapy      - Chemotherapy         - New types of treatment are being tested in clinical trials.         - Radiosensitizers        - Patients may want to think about taking part in a clinical trial.    - Patients can enter clinical trials before, during, or after starting their cancer treatment.    - Follow-up tests may be needed.

                    There are different types of treatment for patients with salivary gland cancer.
                    Different types of treatment are available for patients with salivary gland 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.

                    Patients with salivary gland cancer should have their treatment planned by a team of doctors who are experts in treating head and neck cancer.
                    Your treatment will be overseen by a medical oncologist, a doctor who specializes in treating people with cancer. Because the salivary glands help in eating and digesting food, patients may need special help adjusting to the side effects of the cancer and its treatment. The medical oncologist may refer you to other doctors who have experience and expertise in treating patients with head and neck cancer and who specialize in certain areas of medicine. These include the following:         - Head and neck surgeon.    -  Radiation oncologist.    -  Dentist.    -  Speech therapist.    -  Dietitian.    -  Psychologist.    -  Rehabilitation specialist.    -  Plastic surgeon.

                    Three types of standard treatment are used:
                    Surgery      Surgery (removing the cancer in an operation) is a common treatment for salivary gland cancer. A doctor may remove the cancer and some of the healthy tissue around the cancer. In some cases, a lymphadenectomy (surgery in which lymph nodes are removed) will also be done.    Even if the doctor removes all the cancer that can be seen at the time of the surgery, some patients may be given radiation therapy after surgery to kill any cancer cells that are left. Treatment given after 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. Special types of external radiation may be used to treat some salivary gland tumors. These include:                  -  Fast neutron radiation therapy: Fast neutron radiation therapy is a type of high-energy external radiation therapy. A radiation therapy machine aims neutrons (tiny, invisible particles) at the cancer cells to kill them. Fast neutron radiation therapy uses a higher-energy radiation than the x-ray type of radiation therapy. This allows the radiation therapy to be given in fewer treatments.       -  Photon-beam radiation therapy: Photon-beam radiation therapy is a type of external radiation therapy that reaches deep tumors with high-energy x-rays made by a machine called a linear accelerator. This can be delivered as hyperfractionated radiation therapy, in which the total dose of radiation is divided into small doses and the treatments are given more than once a day.                -  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 salivary gland cancer, and may also be used as palliative therapy to relieve symptoms and improve quality of life.       Chemotherapy      Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the cerebrospinal fluid, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). The way the chemotherapy is given depends on the type and stage of the cancer being treated.    See Drugs Approved for Head and Neck Cancer for more information. (Salivary gland cancer is a type of head and neck cancer.)

                    New types of treatment are being tested in clinical trials.
                    This summary section describes treatments that are being studied in clinical trials. It may not mention every new treatment being studied. Information about clinical trials is available from the NCI website.     Radiosensitizers     Radiosensitizers are drugs that make tumor cells more sensitive to radiation therapy. Combining radiation therapy with radiosensitizers may kill more tumor cells.

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

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

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

		            Treatment Options by Stage

		                    Stage I Salivary Gland Cancer
		                    Treatment for stage I salivary gland cancer depends on whether the cancer is low-grade (slow growing) or high-grade (fast growing).   If the cancer is low-grade, treatment may include the following:         -  Surgery with or without radiation therapy.    -  Fast neutron radiation therapy.        If the cancer is high-grade, treatment may include the following:         - Surgery with or without radiation therapy.    - A clinical trial of chemotherapy.    - A clinical trial of a new local therapy.        Check the list of NCI-supported cancer clinical trials that are now accepting patients with stage I salivary gland cancer. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the NCI website.

		                    Stage II Salivary Gland Cancer
		                    Treatment for stage II salivary gland cancer depends on whether the cancer is low-grade (slow growing) or high-grade (fast growing).   If the cancer is low-grade, treatment may include the following:         -  Surgery with or without radiation therapy.    - Radiation therapy.    -  Chemotherapy.        If the cancer is high-grade, treatment may include the following:         - Surgery with or without radiation therapy.    -  Fast neutron or photon-beam radiation therapy.    - A clinical trial of radiation therapy and/or radiosensitizers.    - A clinical trial of chemotherapy.        Check the list of NCI-supported cancer clinical trials that are now accepting patients with stage II salivary gland cancer. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the NCI website.

		                    Stage III Salivary Gland Cancer
		                    Treatment for stage III salivary gland cancer depends on whether the cancer is low-grade (slow growing) or high-grade (fast growing).   If the cancer is low-grade, treatment may include the following:         -  Surgery with or without lymphadenectomy. Radiation therapy may also be given after surgery.    - Radiation therapy.    -  Fast neutron radiation therapy to lymph nodes with cancer.    -  Chemotherapy.    - A clinical trial of fast neutron radiation therapy to the tumor.    - A clinical trial of chemotherapy.        If the cancer is high-grade, treatment may include the following:         - Surgery with or without lymphadenectomy. Radiation therapy may also be given after surgery.    - Fast neutron radiation therapy.    - Radiation therapy as palliative therapy to relieve symptoms and improve quality of life.    - A clinical trial of radiation therapy and/or radiosensitizers.    - A clinical trial of chemotherapy.        Check the list of NCI-supported cancer clinical trials that are now accepting patients with stage III salivary gland 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 Salivary Gland Cancer
		                    Treatment of stage IV salivary gland cancer may include the following:         -  Fast neutron or photon-beam radiation therapy.    - A clinical trial of chemotherapy with or without radiation therapy.        Check the list of NCI-supported cancer clinical trials that are now accepting patients with stage IV salivary gland 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 Salivary Gland Cancer ?

Output:
New types of treatment are being tested in clinical trials.
                    This summary section describes treatments that are being studied in clinical trials. It may not mention every new treatment being studied. Information about clinical trials is available from the NCI website.     Radiosensitizers     Radiosensitizers are drugs that make tumor cells more sensitive to radiation therapy. Combining radiation therapy with radiosensitizers may kill more tumor cells.

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

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


Input: What is (are) Urethral Cancer ?

Output:
Key Points
                    - Urethral cancer is a disease in which malignant (cancer) cells form in the tissues of the urethra.    - There are different types of urethral cancer that begin in cells that line the urethra.     - A history of bladder cancer can affect the risk of urethral cancer.    - Signs of urethral cancer include bleeding or trouble with urination.     - Tests that examine the urethra and bladder are used to detect (find) and diagnose urethral cancer.    - Certain factors affect prognosis (chance of recovery) and treatment options.

                    Urethral cancer is a disease in which malignant (cancer) cells form in the tissues of the urethra.
                    The urethra is the tube that carries urine from the bladder to outside the body. In women, the urethra is about 1 inches long and is just above the vagina. In men, the urethra is about 8 inches long, and goes through the prostate gland and the penis to the outside of the body. In men, the urethra also carries semen.     Urethral cancer is a rare cancer that occurs more often in men than in women.

                    There are different types of urethral cancer that begin in cells that line the urethra.
                    These cancers are named for the types of cells that become malignant (cancer):         -  Squamous cell carcinoma is the most common type of urethral cancer. It forms in cells in the part of the urethra near the bladder in women, and in the lining of the urethra in the penis in men.    -  Transitional cell carcinoma forms in the area near the urethral opening in women, and in the part of the urethra that goes through the prostate gland in men.    -  Adenocarcinoma forms in the glands that are around the urethra in both men and women.         Urethral cancer can metastasize (spread) quickly to tissues around the urethra and is often found in nearby lymph nodes by the time it is diagnosed.

                    A history of bladder cancer can affect the risk of urethral cancer.
                    Anything that increases your chance of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesnt mean that you will not get cancer. Talk with your doctor if you think you may be at risk. Risk factors for urethral cancer include the following:         - Having a history of bladder cancer.     - Having conditions that cause chronic inflammation in the urethra, including:               - Sexually transmitted diseases (STDs), including human papillomavirus (HPV), especially HPV type 16.      - Frequent urinary tract infections (UTIs). </s>


Input: What are the symptoms of Urethral Cancer ?

Output: Signs of urethral cancer include bleeding or trouble with urination. These and other signs and symptoms may be caused by urethral cancer or by other conditions. There may be no signs or symptoms in the early stages. Check with your doctor if you have any of the following:         - Trouble starting the flow of urine.    - Weak or interrupted ("stop-and-go") flow of urine.    - Frequent urination, especially at night.    -  Incontinence.    -  Discharge from the urethra.    - Bleeding from the urethra or blood in the urine.    - A lump or thickness in the perineum or penis.    - A painless lump or swelling in the groin. </s>