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: neck pain major surgical or invasive procedure: anterior c4-6 diskectomy with anterior fusion and posterior fusion intubation extubation history of present illness: mr. is a 78 year old cantonese speaking male with metastatic nsclc proven by biopsy on admitted from clinic p/w severe neck and intermittent r chest wall pain. per the famly, the pain has progressed over the past 3 months and has acutely worsened over the past 3 days. the pt's wife also notes that the pt has had difficulty with his balance while walking during the past three days. the patient has also noted bilateraly ue numbness in the past 3 days as well. previously seen by ortho, evaluated for anterior c5 questionable pathologic fracture; now wearing a soft neck brace for the past month. 10 lbs weight loss over the past month. pt's family also notes clear rhinorrhea, productive cough w/ yellow sputum x past 2 weeks. pain poorly controlled at home with tramadol, tylenol with codeine. was not able to tolerate mri during ed workup pain. he is being admitted to omed from clinic via ed for pain control and expedited evaluation of his nsclc and questionable pathologic cervical fracture. . vitals in the ed were: temp:99.9 hr:85 bp:179/112 resp:16 o(2)sat:98 ra. the patient received 10 mg morphine in ed with pain relief. past medical history: past oncologic history: nsclc found after cervical compression fractures. . other past medical history: 1. hypertension for over 10 years, controlled 2. hypercholesterolemia for over 5 years, controlled 3. benign prostatic hypertrophy with some urologic symptoms 4. possible parkinson's disease (work-up not performed) 5. osteoporosis by report. bmd not on file. social history: the patient is originally from . he lives with family in us. he started smoking cigarettes at around age 13 and continues to smoke at age 78. average of 1 pack plus per day for an estimated 70 pack-years of smoking. most currently smoking less than 3 cigarettes per day due to pain. denies heavy alcohol use. denies exposure to asbestos, radiation or heavy chemicals. family history: unknown from mother and father. one brother had nasopharyngeal carcinoma. denies other family members with cancer. physical exam: on admission: general: elderly, frail appearing gentleman. he is alert, awake, and oriented x 3. heent: perla, eomi, mmm. anicteric sclerae. no oral lesions. neck: supple, flat jvd. no cervical lad respiratory: coarse rhonchi bilaterally, no wheezing. 5cm right anterior chest wall mass present, tender to touch. cardiovascular: rrr, nl s1/s2 w/o m/r/g abdomen: soft, nt/nd, no hs, bs+ extremities: wwp, no edema, diminished periperal pulses. musculoskeletal: no spinal tenderness. ue strength, le strength bilaterally. decreased right knee and hip flexion. neurologic: cn ii-xii grossly intact, sensation to lt intact throughout, no hyper-reflexia noted. babinski (-). skin: no evidence of active rashes. on dischage: gen: nad, thin, responds to voice heent: sclera anicteric, cv: rrr, no r/m/g lungs: coarse breath sounds anteriorly, transmitted upper airways sounds, posterior exam deferred abd: soft, nt, nd ext: no edema, warm; pertinent results: admission labs: . 12:25pm glucose-95 urea n-12 creat-0.6 sodium-136 potassium-3.3 chloride-99 total co2-25 anion gap-15 12:25pm estgfr-using this 12:25pm wbc-5.7 rbc-4.78 hgb-14.2 hct-41.7 mcv-87 mch-29.7 mchc-34.1 rdw-13.8 12:25pm neuts-80.5* lymphs-13.2* monos-3.9 eos-1.3 basos-1.0 12:25pm plt count-287 . studies . ct spine : 1. pathologic fracture of c5 vertebral body. posterior aspect of c5 likely contacts the spinal cord. if patient can tolerate, mri of the cervical spineis recommended. additionally, erosion of the transverse process at this level is present. if indicated, evaluation of the vertebral arteries may be performed with mra neck or cta of the neck. 2. multiple pulmonary nodules, better evaluated on ct examination dated . 3. asymmetry of the paraspinal muscles on the right could indicate additional metastatic disease and/or intramuscular hematoma. 4. multiple additional lucencies in the cervical spine concerning for metastatic disease, most notable in the c7 vertebral body. . mri spine . impression: 1. metastatic involvement at multiple cervical levels, centered around a c5 vertebral body which demonstrates compression deformity, and retropulsion due to complete invasion by metastatic tumor. there is associated central canal stenosis, with spinal cord compression, though there is no intrinsic cord abnormality at present. 2. metastatic involvement of t3, l1, and the left iliac bone, with no expansion outside of the bony confines. 3. mass in the soft tissues of the posterior neck most consistent with hematoma, which should be correlated linically . lenis : impression: no evidence of right lower extremity dvt. brief hospital course: 78 m w/recently diagnosed nsclc p/w severe neck pain s/p anterior c4-6 diskectomy with anterior fusion on and posterior fusion , admitted to sicu for difficult airway s/p extubation transferred back to oncology floor for pain control. . #agitation: delirium was initially thought to be due to large amount of narcotics that patient was recieving in icu and patient was started on haldol. on the oncology floor, the haldol was initially stopped and the pain regimen was modified but the patient continued to have agitation and restlessness. it was felt that the agitation was most likely secondary to either pain or dyspnea associated with mucus/secretion accumulation. mental status changes may also be related to prolonged hospitalization/sundowning. the patient's agitation/restlessness tended to improve greatly with prn pain medications and/or suctioning. he was started on prn olanzapine for agitation as well. vitals overnight were held. our recommendation is to avoid restraints, hold vitals overnight, provide a bed next to a window if at all possible, use pain medications and suctioning as first line treatment for agitation and to use olanzapine as back-up. . #neck pain: secondary to cancer mets as well as post-op pain. neck pain difficult to assess give patient's mental status and language barriers. palliative care was consulted to determine an appropriate pain regimen. patient was npo after failing speech and swallow several times including video swallow evaluation. his pain was managed with a fentanyl patch and sl morphine. radiation-oncology was consulted for palliative radiation options and the decision was made with the family not to pursue any radiation at this time. . #nutrition: the patient failed speech and swallow in the icu and was made npo. a doboff was placed but he pulled it out and the decision was made in conjuction with the family not to pursue another doboff. he failed repeat speech and swallow including video swallow study, which was attributed more to post-op changes/neck swelling rather than mental status. per speech and swallow, the patient will aspirate if he takes pos but we can make pt comfortable and minimize cough by feeding him thin liquids and pureed solids by spoon. family meeting was held with medical-oncology team, palliative care, and primary oncologist. decision was made not to pursue feeding tube at this time. . #nsclc: biopsy proven on , initially presenting with neck pain and ?pathologic c5 fracture evaluated by orthopedic surgery. ct chest reveals multiple mets. s/p anterior c4-6 diskectomy with anterior fusion on and posterior fusion . patient had previously communicated wishes to family that he would not want chemotherapy or radiation. family meeting was held and the family again stated that they are not interested in chemotherapy or radiation, and would like patient to go to with hospice with primary focus on his comfort and pain control. . # pna: he was started on 7 day cefepime course in sicu for pna. bal ctx grew out moraxella. cxr appeared improved and he completed a 7 day course on . he remained afebrile throughout hospital course. on , however, he had increased secretions that were thick and yellow. cbc showed new leukocytosis. cxr showed: "as compared to , there is interval improvement of bibasilar aeration but still present bilateral right more than left pleural effusion and right basal opacity, findings that might be representing interval development of new right lower lobe process, but residual findings reflecting the prior process cannot be entirely excluded. no new abnormalities have been demonstrated as compared to multiple prior studies. bilateral pleural effusion is present, most likely subpulmonic on the right." vanc and cefepime were initially started but were discontinued after family meeting as antibiotic treatment not in line with goals of care. . #htn: has history of htn. pt not taking any pos and is not receiving any blood pressure medications given goals of care. bp fluctuates broadly, ranging from sbp 100-170s. . #tachycardia: he became tachycardic in the sicu and was started on iv metoprolol. hr was regular on the floor. stopped metoprolol . . #incontinence: likely related to mental status. urine cx negative. has some urinary retention for which he has a foley. . note: pt was made cmo per discussion with the family. he expired the afternoon of with family by the bedside. medications on admission: simvastatin 20mg daily finasteride 5mg qhs flomax 0.4mg daily alendronate 70mg q weekly tylenol with codeine #3 1 tab q 6hrs prn pain tramadol 100mg daily discharge medications: expired discharge disposition: expired discharge diagnosis: metastatic nsclc discharge condition: expired discharge instructions: expired followup instructions: expired procedure: continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube other intubation of respiratory tract closed [endoscopic] biopsy of bronchus other cervical fusion of the anterior column, anterior technique excision of intervertebral disc excision of bone for graft, other bones open biopsy of soft tissue biopsy of bone, other bones other cervical fusion of the posterior column, posterior technique insertion or replacement of skull tongs or halo traction device plastic operation on pharynx insertion or replacement of skull tongs or halo traction device plastic operation on pharynx insertion of interbody spinal fusion device fusion or refusion of 2-3 vertebrae fusion or refusion of 4-8 vertebrae insertion of recombinant bone morphogenetic protein diagnoses: pneumonia due to other gram-negative bacteria pure hypercholesterolemia tobacco use disorder unspecified pleural effusion unspecified essential hypertension secondary malignant neoplasm of other specified sites pulmonary collapse paralysis agitans cachexia osteoporosis, unspecified retention of urine, unspecified other constipation malignant neoplasm of other parts of bronchus or lung other encephalopathy do not resuscitate status phlebitis and thrombophlebitis of superficial veins of upper extremities secondary and unspecified malignant neoplasm of intrathoracic lymph nodes delirium due to conditions classified elsewhere secondary malignant neoplasm of bone and bone marrow urinary incontinence, unspecified leukocytosis, unspecified secondary and unspecified malignant neoplasm of lymph nodes of head, face, and neck neoplasm related pain (acute) (chronic) myelopathy in other diseases classified elsewhere pathologic fracture of vertebrae body mass index less than 19, adult other acute postoperative pain 

Answer: The patient is high likely exposed to