Consider the following medical report that includes the patient's historical health records. Use it to predict the disease that the patient is high likely exposed to. 

 Medical Report: allergies: patient recorded as having no known allergies to drugs attending: chief complaint: weakness major surgical or invasive procedure: c4 to t10 fusion with t6 corpectomy history of present illness: this is a 66 y/o m with hx of metastatic melanoma who presents from clinic today with lower extremity weakness, numbness and tingling. patient reports waking up this morning and feeling weak in his legs, finding himself unstable as he walks. at baseline, patient ambulates well, without use of walker or cane. he also endorses waking up and feeling numbness and tingling in both lower extremities. he denies any changes in urinary, does not endorse any incontinence, and feels like the strength in his upper extremities are unchanged. he is also chronically constipated, and has some abdominal pain secondary to constipation. his last bm was sunday. he denies any f/c, ha. he reports chronic nausea with recent poor po intake. he also endorses chronic back pain, which he feels has worsened last week since he lifted his dog. . patient was seen in clinic to be screened for clinical trial 09-021 (modar +/- parp inhibitor). his vitals were bp: 167/106; hr: 66; t: 96.6; rr 16; o2 96 ra. on exam he was felt to have assym reflexes and unsteady gait. recieved diluadid 1mg iv and decadron 10mg iv at 4pm. . currently, patient does not have any complaints. . ros: he occasionally is sob, in particular when lying on his back, and has some chronic . he denies any new rashes, dysuria, hematuria, bloody stools. otherwise ros is negative. past medical history: the patient is a 66 yo man who was diagnosed with cutaneous melanoma 35 years ago. a lesion on the left upper back was removed, and an axillary lymph node dissection was performed. approximately six months ago, he developed progressive fatigue. he also had the insidious onset of back pain. within the past month, he began losing weight (about 20 lbs) and had a diminished appetite. he underwent diagnostic imaging which disclosed a lung mass and bony tumors concerning for lung cancer. both of these areas were biopsied and were, in fact, melanoma. immunohistochemical stains performed on cell block preparation reveal the tumor cells are immunoreactive for mart-1 and s-100. no reactivity is seen in ae1/ae3, kappa or lambda light chains. . pmh: hypertension childhood seizures, none recently social history: his married with one son. is retired; formerly he worked at the naval base, designing submarines. he had some radiation exposure in . he drinks alcohol on occasion, and smoked 1ppd for 20 years, quitting 25 years ago. family history: his paternal grandmother and 1st cousin on that side both had melanoma. his father died of lung cancer. physical exam: vitals - 110/78 18 52 96% 1l gen: nad heent: anicteric, op clear, nonerythematous lymph: no cervical or supraclavicular lad; no axilliary lad card: rr, no m/r/g lung: ctab no w/r/r abd: soft nt, nd no hsm ext: no c/c/e rectal: normal tone neuro: a&o x3, perrl, eomi, tongue midline, facial sensation intact scm/trap; no pronator drift, sensation to light touch in ue intact bl; sensation to light touch in le intact bl; reduced sensation in pinprick on rle up to knee compared to lle. 4+/5 strength in knee extension bl, knee flexion bl, hip flexion/extension bl, 5/5 strength in ue bl. gait imbalanced, romberg sign and heel-shin deferred. normal finger to nose. on discharge; full strength in all extremities pertinent results: 03:26pm gran ct-5600 03:26pm plt count-250 03:26pm wbc-8.7 rbc-5.40 hgb-15.3 hct-47.0 mcv-87 mch-28.4 mchc-32.6 rdw-13.1 03:26pm albumin-4.1 calcium-9.7 phosphate-4.4 magnesium-2.8* 03:26pm alt(sgpt)-22 ast(sgot)-27 ld(ldh)-583* alk phos-218* tot bili-0.6 dir bili-0.3 indir bil-0.3 03:26pm estgfr-using this 03:26pm urea n-22* creat-1.2 sodium-140 potassium-4.4 chloride-100 total co2-32 anion gap-12 cbc on discharge: complete blood count wbc rbc hgb hct mcv mch mchc rdw plt ct 12:25pm 13.3* 3.01* 8.6* 25.7* 86 28.5 33.4 14.3 274 brief hospital course: 66 y/o m with recurrent metastatic melanoma to lungs and c+l spine who presents from clinic with le weakness, numbness and tingling. was admitted to rule out cord compression. he was found to have t6 compression fracture and taken to the or on . he was brought to the icu where he was closely monitored and later extubated. his hct was monitored and received 2 units rbcs was neurologically intact post-op and transferred to the floor where he worked well with pt and tolerated a po diet. his follow-up appoinments were arranged and was sent to on . medications on admission: amlodipine 10 mg daily atenolol 100 mg qam cyclobenzaprine 5 mg tid gabapentin 100 mg tid reglan 10 mg q4-6hr prn omeprazole ? dose oxcarbazepine 150 mg oxycontin 30 mg oxycodone 5 mg 1-2 tabs q4hr prn prochlorperazine 10 mg prn simvastatin 20 mg qhs tamsulosin 0.4 mg qhs bisacodyl prn docusate prn milk of mag prn discharge medications: 1. cyclobenzaprine 10 mg tablet sig: 0.5 tablet po tid (3 times a day). 2. metoclopramide 10 mg tablet sig: one (1) tablet po qid (4 times a day) as needed for nausea. 3. omeprazole 20 mg capsule, delayed release(e.c.) sig: two (2) capsule, delayed release(e.c.) po daily (daily). 4. oxcarbazepine 150 mg tablet sig: one (1) tablet po bid (2 times a day). 5. gabapentin 100 mg capsule sig: one (1) capsule po tid (3 times a day). 6. simvastatin 10 mg tablet sig: two (2) tablet po daily (daily). 7. tamsulosin 0.4 mg capsule, sust. release 24 hr sig: one (1) capsule, sust. release 24 hr po hs (at bedtime). 8. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 9. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. 10. dronabinol 2.5 mg capsule sig: four (4) capsule po tid (3 times a day) as needed for nausea. 11. heparin (porcine) 5,000 unit/ml solution sig: one (1) ml injection tid (3 times a day). 12. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed for constipation. 13. atenolol 50 mg tablet sig: two (2) tablet po daily (daily). 14. lorazepam 0.5 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed for anxiety. 15. hydromorphone 2 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed for pain. 16. ondansetron hcl (pf) 4 mg/2 ml solution sig: one (1) injection q8h (every 8 hours) as needed for nausea. 17. hydromorphone (pf) 1 mg/ml syringe sig: 0.5 ml injection q3h (every 3 hours) as needed for brt pain. 18. insulin sliding scale discharge disposition: extended care facility: discharge diagnosis: primary: metastatic melanoma, cord compression discharge condition: stable. discharge instructions: you were seen in the hospital because of your weakness. an mri of the spine showed that you have metastatic disease to your cevical and thoracic spine. some of these metastasis have caused compression of your spinal cord. you were treated with steroids, and received a brace for your back. ?????? do not smoke. ?????? keep your wound(s) clean and dry / no tub baths or pool swimming for two weeks from your date of surgery. ?????? no pulling up, lifting more than 10 lbs., or excessive bending or twisting. ?????? limit your use of stairs to 2-3 times per day. ?????? you are required to wear your back brace at all times. ?????? you may only shower with back brace on. ?????? take your pain medication as instructed; you may find it best if taken in the morning when you wake-up for morning stiffness, and before bed for sleeping discomfort. ?????? do not take any anti-inflammatory medications such as motrin, advil, aspirin, and ibuprofen etc. unless directed by your doctor. ?????? increase your intake of fluids and fiber, as pain medicine (narcotics) can cause constipation. we recommend taking an over the counter stool softener, such as docusate (colace) while taking narcotic pain medication. ?????? clearance to drive and return to work will be addressed at your post-operative office visit. call your surgeon immediately if you experience any of the following: ?????? pain that is continually increasing or not relieved by pain medicine. ?????? any weakness, numbness, tingling in your extremities. ?????? any signs of infection at the wound site: redness, swelling, tenderness, and drainage. ?????? fever greater than or equal to 101?????? f. ?????? any change in your bowel or bladder habits (such as loss of bowl or urine control). if you experience numbness, tingling, or weakness to any or your arms or legs, please call your pcp or come to the emergency room. please support the neck at all times when patient is being lifted from bed!! followup instructions: ??????please return to the office in 5 days for removal of your staples and a wound check please return to see dr. in 1 month. you will need a ct scan of your cervical and thoracic spine prior to your appointment. please call ( you will need to follow up with the clinic. you have been scheduled for at 2:30pm in the clinic with dr. . please call ( with any questions. a consultation has been arranged by the caritas radiation oncology team on 8:30am, with dr. . he should be transported directly to the radiation oncology department in the basement, they will help with registration there. the contact information for the radiation oncology team at caritas is: , phone: ( fax: md procedure: dorsal and dorsolumbar fusion of the anterior column, anterior technique other endovascular procedures on other vessels dorsal and dorsolumbar fusion of the posterior column, posterior technique repair of vertebral fracture other cervical fusion of the posterior column, posterior technique insertion of interbody spinal fusion device fusion or refusion of 9 or more vertebrae insertion of recombinant bone morphogenetic protein intra-operative neurophysiologic monitoring diagnoses: unspecified essential hypertension secondary malignant neoplasm of lung personal history of malignant melanoma of skin secondary malignant neoplasm of bone and bone marrow neoplasm related pain (acute) (chronic) myelopathy in other diseases classified elsewhere pathologic fracture of vertebrae 

Answer: The patient is high likely exposed to