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+Expert,Simple
+Anal cancer is a type of cancer that starts in the anus. ,Anal cancer is a type of cancer that starts in the part of the body where bowel movement come out (anus). 
+Cancer starts when cells in the body begin to grow out of control. ,Cancer starts when cells in the body begin to grow out of control. 
+"To learn more about how cancers start and spread, see What Is Cancer?","To learn more about how cancers start and spread, see What Is Cancer?"
+Normal structure and function of the anus,Normal structure and function of the anus
+The anus is the opening at the lower end of the intestines. ,The anus is the opening where bowel movements come out of your body. 
+It's where the end of the intestines connect to the outside of the body. ,It's where the end of the intestines connect to the outside of the body. 
+"As food is digested, it passes from the stomach to the small intestine. ","As food is broken down in your body, it passes from the stomach to the section of the gut called the small intestine. "
+It then moves from the small intestine into the main part of the large intestine (called the colon ). ,It then moves from the small intestine into the main part of the gut or large intestine called the colon. 
+The colon absorbs water and salt from the digested food. ,The colon absorbs water and salt from the food that is broken down. 
+The waste matter that's left after going through the colon is known as feces or stool . ,The material that is left after going through the colon is what makes up your bowel movement (BM) or stool . 
+"Stool is stored in the last part of the large intestine, called the rectum . ","Stool is stored in the last part of the large intestine, called the rectum. "
+"From there, stool is passed out of the body through the anus as a bowel movement. ","From there, stool comes out of the body through the hole in your bottom (your anus) and this is called a bowel movement. "
+Gastrointestinal system (GI system) Structures of the anus The anus is connected to the rectum by the anal canal . ,"The stomach, small intestine, large intestine (colon), rectum and anus are all part of your gastrointestinal system (GI system). Parts of your anus: Your anus is attached to your rectum by the anal canal which is like a tube. "
+The anal canal has two ring-shaped muscles (called sphincter muscles ) that keep the anus closed and prevent stool from leaking out. ,Your anal canal has two round-shaped muscles that keep your anus closed and keep stool from spilling out. 
+The anal canal is about 1-1/2 to 2 inches (about 3 to 5 cm) long and goes from the rectum to the anal verge . ,Your anal canal is short.  It is only about 1-1/2 to 2 inches long and goes from your rectum to your anal verge. 
+The anal verge is where the canal connects to the outside skin at the anus. ,Your anal verge is where the canal attaches to the skin on the outside of your bottom at your anus. 
+This skin around the anal verge is called the perianal skin (previously called the anal margin ). ,The skin around the anal verge is called the perianal skin.
+The inner lining of the anal canal is the mucosa . ,The inner lining of the anal canal is the mucosa . 
+Most anal cancers start from cells in the mucosa. ,Most anal cancers start from cells in the mucosa. 
+Glands and ducts (tubes leading from the glands) are found under the mucosa. ,There are tubes (glands) found under the mucosa. 
+"The glands make mucus, which acts as a lubricating fluid. ","The glands make mucus, which acts as a moisturizer or lubricating fluid for the anus. "
+The cells of the anal canal change as they go from the rectum to the anal verge: >Cells above the anal canal (in the rectum) and in the part of the anal canal close to the rectum are shaped like tiny columns. ,The cells of the anal canal change as they go from the rectum to the anal verge: >Cells above the anal canal (in the rectum) and in the part of the anal canal close to the rectum are shaped like tiny columns. 
+>Most cells near the middle of the anal canal are shaped like cubes and are called transitional cells . ,>Most cells near the middle of the anal canal are shaped like cubes and are called transitional cells . 
+This area is called the transitional zone . ,This area is called the transitional zone . 
+">About midway down the anal canal is the dentate line , which is where most of the anal glands empty mucus into the anus. ",">About midway down the anal canal is the dentate line , which is where most of the anal glands empty mucus into the anus. "
+>Below the dentate line are flat (squamous) cells. ,>Below the dentate line are flat (squamous) cells. 
+">At the anal verge, the squamous cells of the lower anal canal merge with the skin just outside the anus. ",">At the anal verge, the squamous cells of the lower anal canal merge with the skin just outside the anus. "
+"This skin around the anal verge (called the perianal skin or the anal margin ) is also made up of squamous cells, but it also contains sweat glands and hair follicles, which are not found in the lining of the lower anal canal.","This skin around the anal verge (called the perianal skin or the anal margin ) is also made up of squamous cells, but it also contains sweat glands and hair follicles, which are not found in the lining of the lower anal canal."
+Types of anal cancer,Types of anal cancer
+Anal cancers are often divided into 2 groups based on where they start: ,Anal cancers are often divided into 2 groups based on where they start: 
+>Cancers of the anal canal (above the anal verge) ,>The anal canal (above the anal verge)
+>Cancers of the perianal skin (below the anal verge) – previously called cancers of the anal margin., >The perianal skin (below the anal verge) 
+"Sometimes, treatment may be different, depending on where the cancer is located. ",The cancer is named for the place where it starts.  The treatment can be different for each kind.  
+"But anal cancers can sometimes extend from one area into the other, so it’s hard to know exactly where they started.","Anal cancers can also extend from one area into the other, making it hard to know exactly where they started."
+Squamous cell carcinoma,Squamous cell carcinoma
+Most (nearly 9 out of 10 cases) anal cancers in the United States are squamous cell cancer. ,Most (nearly 9 out of 10 cases) anal cancers in the United States are squamous cell cancer. 
+These tumors start in the squamous cells that line most of the anal canal and the anal margin. ,These tumors start in cells called “squamous cells” that are found in the lining of most of the anal canal and the sides of anus. 
+Squamous cell cancers in the anal canal have grown beyond the surface and into the deeper layers of the lining. ,Squamous cell cancer in the anal canal grows deep into the wall of the anal canal.
+Squamous cell cancers of the anal margin (perianal skin) can be treated as an anal cancer or like squamous cell cancer of the skin . ,Squamous cell cancers of the anal lining (perianal skin) can be treated as an anal cancer or like cancer of the skin . 
+It is important to see an expert if you are diagnosed with perianal cancer to determine the best course of treatment. ,It is important to see an expert if you are diagnosed with perianal cancer to find out the best course of treatment. 
+The anal cancer information here focuses mainly on anal squamous cell carcinoma since it is the most common type of anal cancer.,The anal cancer information here focuses mainly on anal squamous cell carcinoma since it is the most common type of anal cancer.
+Rare types of anal cancers,Rare kinds of anal cancers
+Adenocarcinoma,Adenocarcinoma
+A small number of anal cancers are adenocarcinomas . ,A small number of anal cancers are adenocarcinomas . 
+These cancers start in cells that line the upper part of the anus near the rectum. ,These cancers start in cells that line the upper part of the anus near the rectum. 
+They can also start in the glands under the anal mucosa that release secretions into the anal canal. ,They can also start in the glands under the anal mucosa that release moist fluids (secretions) into the anal canal. 
+Most anal adenocarcinomas are treated the same as rectal carcinomas. ,Most anal adenocarcinomas are treated the same as rectal cancers. 
+"For more information, see Colorectal Cancer . ","For more information, see Colorectal Cancer . "
+Adenocarcinomas can also start in apocrine glands (a type of sweat gland of the perianal skin). ,Adenocarcinomas can also start in a type of sweat gland of the perineal skin called apocrine glands. 
+Paget’s disease is a type of apocrine gland carcinoma that spreads through the surface layer of the skin. ,Paget’s disease is a type of sweat gland (apocrine) cancer that spreads through the surface layer of the skin. 
+"Paget’s disease can affect skin anywhere in the body but most often affects skin of the perianal area, vulva , or breast . ","Paget’s disease can affect skin anywhere in the body but most often affects the skin of the area surrounding the anus (perianal area), outer area of the vagina (vulva) , or breast . "
+"This should not be confused with Paget’s disease of the bone, which is a different disease and is not cancer.","This should not be confused with Paget’s disease of the bone, which is a different disease and is not cancer."
+Basal cell carcinoma,Basal cell carcinoma
+Basal cell carcinomas are a type of skin cancer that can develop in the perianal skin. ,Basal cell cancer is a kind of skin cancer that can sometimes start in the perianal skin. 
+"These tumors are much more common in areas of skin exposed to the sun, such as the face and hands. ","These tumors are much more common in areas of skin exposed to the sun, such as the face and hands. "
+Very few anal cancers are basal cell carcinomas. ,Very few anal cancers are basal cell cancers. 
+They are often treated with surgery to remove the cancer. ,They are often treated with surgery to remove the cancer. 
+"For more information, see Skin Cancer: ","For more information, see Skin Cancer: "
+Basal and Squamous Cell .,Basal and Squamous Cell .
+Melanoma,Melanoma
+These cancers start in cells in the skin or anal lining that make the brown pigment called melanin . ,These cancers start in cells in the skin or anal lining that make the brown pigment called melanin . 
+Only a very small number of anal cancers are melanomas. ,Only a very small number of anal cancers are melanomas. 
+Melanomas are far more common on the skin in other parts of the body. ,Melanomas are far more common on the skin in other parts of the body. 
+"If melanomas are found at an early stage (before they have grown deeply into the skin or spread to lymph nodes) they can be removed with surgery, and the outlook for long-term survival is very good. ",If melanomas are found at an early stage (before they have grown deeply into the skin or spread to lymph nodes) they can be removed by surgery. Surgery for early-stage disease usually results in good long-term survival. 
+"But because anal melanomas are hard to see, most are found at a later stage. ","But because anal melanomas are hard to see, most are found at a later stage. "
+"If possible, the entire tumor is removed with surgery. ","If possible, the entire tumor is removed with surgery. "
+"If all of the tumor can be removed, a cure is possible. ","If all of the tumor can be removed, a cure is possible. "
+"Sometimes, an abdominoperineal resection (APR) might be recommended. ","Sometimes, an abdominoperineal resection (APR) might be recommended. "
+"If the melanoma has spread too far to be removed completely, other treatments may be given. ","If the melanoma has spread too far to be removed completely by surgery, other treatments may be given. "
+"For more on this, see Melanoma Skin Cancer .","For more on this, see Melanoma Skin Cancer ."
+Gastrointestinal stromal tumor (GIST),Gastrointestinal stromal tumor (GIST)
+"These cancers are much more common in the stomach or small intestine, and rarely start in the anal region. ","These cancers are much more common in the stomach or small intestine, and rarely start in the anal region. "
+"When these tumors are found at an early stage, they are removed with surgery. ","When these tumors are found at an early stage, they are removed with surgery. "
+"If they have spread beyond the anus, they can be treated with drug therapy. ","If they have spread beyond the anus, they can be treated with drug therapy. "
+"For more information, see Gastrointestinal Stromal Tumor (GIST) .","For more information, see Gastrointestinal Stromal Tumor (GIST) ."
+Anal conditions that are pre-cancer,Anal problems that are pre-cancer 
+"Some changes in the anal mucosa are harmless at first, but later might turn into cancer. ","Some changes in the anal mucosa are harmless at first, but later might turn into cancer. "
+These are called pre-cancers . ,These are called pre-cancers . 
+Pre-cancers might also be called dysplasia . ,Pre-cancers can also be called dysplasia . 
+"Some warts, for example, contain areas of dysplasia that can develop into cancer. ","Some warts, for example, contain areas of dysplasia that can develop into cancer. "
+Dysplasia in cells of the anus is called anal intraepithelial neoplasia (AIN) or anal squamous intraepithelial lesions (SILs) . ,Dysplasia (pre-cancer) cells in the anus is called anal intraepithelial neoplasia (AIN) or anal squamous intraepithelial lesions (SILs). 
+"Depending on how the cells look, AIN or anal SIL can be divided into 2 groups: >Low-grade SIL (or grade 1 AIN): The cells in low-grade SIL look like normal cells. ","Depending on how the cells look, (AIN or anal SIL), they can be divided into 2 groups: >Low-grade SIL or high grade SIL: "
+Low-grade SIL often goes away without treatment and has a low chance of turning into cancer. ,"The cells in low-grade SIL look like normal cells, and often goes away without treatment. Low SIL has a low chance of turning into cancer. "
+>High-grade SIL (or grade 2 AIN or grade 3 AIN) : ,>High-grade SIL (or grade 2 AIN or grade 3 AIN) : 
+The cells in high-grade SIL look abnormal. ,The cells in high-grade SIL look abnormal. 
+"High-grade SIL is less likely to go away without treatment and, with time, could become cancer. ","High-grade SIL is less likely to go away without treatment and, with time, could become cancer. "
+It needs to be watched closely and some cases of high-grade SIL need to be treated.,It needs to be watched closely and some cases of high-grade SIL need to be treated.
+Benign anal tumors,Anal tumors that are not cancer
+Many types of tumors can develop in the anus. ,Many types of tumors can develop in the anus. 
+Not all of these tumors are cancers – some are benign (not cancer).,Not all of these tumors are cancers – some are benign (not cancer).
+Polyps,Polyps
+"Polyps are small, bumpy, or mushroom-like growths that form in the mucosa or just under it. ","Polyps are small, bumpy, or mushroom-like growths that form in the mucosa or just under it. "
+"There are many kinds including inflammatory polyps, lymphoid polyps and fibroepithelial polyps.",There are many kinds of polyps.
+Skin tags,Skin tags
+Skin tags are benign growths of connective tissue that are covered by squamous cells. ,Skin tags are benign growths of connective tissue that are covered by squamous cells. 
+"Skin tags are often mistaken for hemorrhoids (swollen veins inside the anus or rectum), but they're not the same.","Skin tags are often mistaken for hemorrhoids (swollen veins inside the anus or rectum), but they're not the same."
+Anal warts,Anal warts
+Anal warts (also called condylomas ) are growths that form just outside the anus and in the lower anal canal below the dentate line. ,Anal warts (also called condylomas ) are growths that form just outside the anus and in the lower anal canal below the dentate line. 
+Sometimes they can be found just above the dentate line. ,Sometimes they can be found just above the dentate line. 
+They're caused by infection with human papilloma virus (HPV). ,They're caused by infection with human papilloma virus (HPV). 
+People who have or had anal warts are more likely to get anal cancer. ,People who have or had anal warts are more likely to get anal cancer. 
+(See “Anal conditions that are pre-cancer” above and Risk Factors for Anal cancer .),(See “Anal conditions that are pre-cancer” above and Risk Factors for Anal cancer .)
+Other benign tumors,Other tumors that are not cancer
+"In rare cases, benign tumors can grow in other tissues of the anus. ","Sometimes, tumors that are not cancer can grow in other parts of the anus. "
+These include: >Leiomyomas: Benign tumors that develop from smooth muscle cells >Granular cell tumors: Tumors that develop from nerve cells and are composed of cells that contain lots of tiny spots (granules) > Lipomas: Benign tumors that start from fat cells,These include: >Leiomyomas: Benign tumors that develop from smooth muscle cells >Granular cell tumors: Tumors that develop from nerve cells and are composed of cells that contain lots of tiny spots (granules) > Lipomas: Benign tumors that start from fat cells
+Bile duct cancer is a rare disease in which malignant (cancer) cells form in the bile ducts. ,Bile duct cancer is a rare disease in which malignant (cancer) cells form in the bile ducts. 
+Bile duct cancer is also called cholangiocarcinoma. ,Bile duct cancer is also called cholangiocarcinoma. 
+"A network of tubes, called ducts, connects the liver , gallbladder , and small intestine . ","A network of tubes, called ducts, connects the liver , gallbladder , and small intestine . "
+This network begins in the liver where many small ducts collect bile (a fluid made by the liver to break down fats during digestion). ,This network begins in the liver where many small ducts collect bile (a fluid made by the liver to break down fats from food during digestion). 
+"The small ducts come together to form the right and left hepatic ducts, which lead out of the liver. ","The small ducts come together to form the right and left hepatic ducts, which lead out of the liver. "
+The two ducts join outside the liver and form the common hepatic duct . ,The two ducts join outside the liver and form the common hepatic duct . 
+The cystic duct connects the gallbladder to the common hepatic duct. ,The cystic duct connects the gallbladder to the common hepatic duct. 
+"Bile from the liver passes through the hepatic ducts, common hepatic duct, and cystic duct and is stored in the gallbladder. ","Bile from the liver passes through the hepatic ducts, common hepatic duct, and cystic duct and is stored in the gallbladder. "
+"When food is being digested, bile stored in the gallbladder is released and passes through the cystic duct to the common bile duct and into the small intestine.","When food is being digested, bile stored in the gallbladder is released and passes through the cystic duct to the common bile duct and into the small intestine."
+Types of bile duct cancer,Types of bile duct cancer
+There are two types of bile duct cancer: >Intrahepatic bile duct cancer : This type of cancer forms in the bile ducts inside the liver. ,There are two kinds of bile duct cancer: >Intrahepatic bile duct cancer : This kind of cancer starts in the bile ducts inside the liver. 
+Only a small number of bile duct cancers are intrahepatic. ,Only a small number of bile duct cancers are intrahepatic. 
+Intrahepatic bile duct cancers are also called intrahepatic cholangiocarcinomas. ,Intrahepatic bile duct cancers are also called intrahepatic cholangiocarcinomas. 
+>Extrahepatic bile duct cancer : This type of cancer forms in the bile ducts outside the liver. ,>Extrahepatic bile duct cancer : This kind of cancer starts in the bile ducts outside the liver. 
+The two types of extrahepatic bile duct cancer are perihilar bile duct cancer and distal bile duct cancer:Perihilar bile duct cancer : This type of cancer is found in the area where the right and left bile ducts exit the liver and join to form the common hepatic duct. ,There two types of extrahepatic bile duct cancer: Perihilar and distal bile duct cancer. Perihilar bile duct cancer is found where the right and left bile ducts exit the liver and join to form the common hepatic duct.
+Perihilar bile duct cancer is also called a Klatskin tumor or perihilar cholangiocarcinoma. ,Perihilar bile duct cancer is also called a Klatskin tumor or perihilar cholangiocarcinoma. 
+Distal bile duct cancer : This type of cancer is found in the area where the ducts from the liver and gallbladder join to form the common bile duct. ,Distal bile duct cancer : This kind of cancer is found where the ducts from the liver and gallbladder connect to make the common bile duct. 
+The common bile duct passes through the pancreas and ends in the small intestine. ,The common bile duct passes through the pancreas and ends in the small intestine. 
+Distal bile duct cancer is also called extrahepatic cholangiocarcinoma. ,Distal bile duct cancer is also called extrahepatic cholangiocarcinoma. 
+>Perihilar bile duct cancer : This type of cancer is found in the area where the right and left bile ducts exit the liver and join to form the common hepatic duct. ,>Perihilar bile duct cancer : This type of cancer is found in the area where the right and left bile ducts exit the liver and join to form the common hepatic duct. 
+Perihilar bile duct cancer is also called a Klatskin tumor or perihilar cholangiocarcinoma. ,Perihilar bile duct cancer is also called a Klatskin tumor or perihilar cholangiocarcinoma. 
+>Distal bile duct cancer : This type of cancer is found in the area where the ducts from the liver and gallbladder join to form the common bile duct. ,>Distal bile duct cancer : This type of cancer is found in the area where the ducts from the liver and gallbladder join to form the common bile duct. 
+The common bile duct passes through the pancreas and ends in the small intestine. ,The common bile duct passes through the pancreas and ends in the small intestine. 
+Distal bile duct cancer is also called extrahepatic cholangiocarcinoma.,Distal bile duct cancer is also called extrahepatic cholangiocarcinoma.
+Signs and symptoms of bile duct cancer,Signs and symptoms of bile duct cancer
+These and other signs and symptoms may be caused by bile duct cancer or by other conditions. ,These and other signs and symptoms may be caused by bile duct cancer or by other conditions. 
+Check with your doctor if you have any of the following: >jaundice (yellowing of the skin or whites of the eyes) >dark urine >clay colored stool >pain in the abdomen >fever >itchy skin >nausea and vomiting >weight loss for an unknown reason. There are no routine screening tests to check for bile duct cancer before signs and symptoms occur. ,Check with your doctor if you have any of the following: >jaundice (yellowing of the skin or whites of the eyes) >dark urine >clay colored stool >pain in the abdomen >fever >itchy skin >unrelieved nausea and vomiting >weight loss for an unknown reason There are no routine screening tests to check for bile duct cancer before signs and symptoms occur. 
+"To learn about tests that are used to diagnose bile duct cancer, see Bile Duct Cancer Diagnosis . ","To learn about tests that are used to diagnose bile duct cancer, see Bile Duct Cancer Diagnosis . "
+">Updated:July 1, 2022 ",">Updated:July 1, 2022 "
+"If you would like to reproduce some or all of this content, see Reuse of NCI Information for guidance about copyright and permissions. ","If you would like to reproduce some or all of this content, see Reuse of NCI Information for guidance about copyright and permissions. "
+"In the case of permitted digital reproduction, please credit the National Cancer Institute as the source and link to the original NCI product using the original product's title; e.g., “What Is Bile Duct Cancer (Cholangiocarcinoma)? ","In the case of permitted digital reproduction, please credit the National Cancer Institute as the source and link to the original NCI product using the original product's title; e.g., “What Is Bile Duct Cancer (Cholangiocarcinoma)? "
+was originally published by the National Cancer Institute.” ,was originally published by the National Cancer Institute.” 
+Want to use this content on your website or other digital platform? ,Want to use this content on your website or other digital platform? 
+Our syndication services page shows you how.,Our syndication services page shows you how.
+Cancer is a disease in which cells in the body grow out of control. ,Cancer starts when cells in the body start to grow out of control.
+"When cancer starts in the colon or rectum, it is called colorectal cancer. ","When cancer starts in the colon or rectum, it is called colorectal cancer. "
+"Sometimes it is called colon cancer, for short. ","Sometimes it is called colon cancer, for short. "
+"Colorectal cancer is a leading cause of cancer death in the United States, but it doesn’t have to be. ","Colorectal cancer is a leading cause of cancer death in the United States, but it doesn’t have to be. "
+Colorectal cancer screening saves lives. ,Colorectal cancer screening saves lives. 
+Screening can find precancerous polyps—abnormal growths in the colon or rectum—that can be removed before they turn into cancer. ,Screening can help find growths in your colon or rectum called precancerous polyps. They can be removed before they turn into cancer. 
+"Screening also helps find colorectal cancer at an early stage, when treatment works best. ","Screening also helps find colorectal cancer at an early stage before it spreads, when treatment works best. "
+About nine out of every 10 people whose colorectal cancers are found early and treated appropriately are still alive five years later. ,About nine out of every 10 people whose colorectal cancers are found early and treated appropriately are still alive five years later. 
+"If you are 45 years old or older, get screened now. ","If you are 45 years old or older, get screened now. "
+"If you think you may be at increased risk for colorectal cancer, speak with your doctor about when to begin screening, which test is right for you, and how often to get tested. ","If you think you may have a higher chance of getting colorectal cancer, ask your doctor when you should start getting screening, which test is right for you, and how often to get tested. "
+Colorectal cancer is cancer that occurs in the colon or rectum. ,Colorectal cancer is cancer that starts in the colon or rectum. 
+"Sometimes it is called colon cancer, for short. ","Sometimes it is called colon cancer, for short. "
+"Your risk of getting colorectal cancer increases as you get older, and there are other risk factors. ","Your risk of getting colorectal cancer increases as you get older, and there are other risk factors. "
+The most effective way to reduce your risk of colorectal cancer is by having regular colorectal cancer screening tests beginning at age 45. ,The most effective way to reduce your risk of colorectal cancer is by having regular colorectal cancer screening tests beginning at age 45. 
+"Colorectal cancer doesn’t always cause symptoms, especially at first. ","Colorectal cancer doesn’t always cause symptoms, especially at first. "
+See a list of possible symptoms. ,See a list of possible symptoms. 
+"Screening tests can find precancerous polyps, so that they can be removed before they turn into cancer. ","Screening tests can find precancerous growths (polyps), so that they can be removed before they turn into cancer. "
+"Screening tests can also find colorectal cancer early, when treatment works best. ","Screening tests can also find colorectal cancer early, when treatment works best. "
+Several screening tests can be used to find polyps or colorectal cancer. ,There are a few tests that can help find polyps or colorectal cancer.  
+Each test has advantages and disadvantages. ,Each test has advantages and disadvantages. 
+"Talk to your doctor about the pros and cons of each test, and how often to be tested. ",Talk to your doctor about what is the best test for you and how often you should have the test.  
+Tell your doctor about any symptoms or risk factors you may have. ,Tell your doctor about any symptoms or risk factors you may have. 
+Discuss with your doctor which test is best for you. ,Discuss with your doctor which test is best for you. 
+>Facebook >Twitter >LinkedIn >Syndicate,>Facebook >Twitter >LinkedIn >Syndicate
+Gastrointestinal carcinoid tumors are a type of cancer that forms in the lining of the gastrointestinal (GI) tract. ,Gastrointestinal carcinoid tumors are a type of cancer that forms in the lining of the gastrointestinal (GI) tract. 
+Cancer starts when cells begin to grow out of control. ,Cancer starts when cells begin to grow out of control. 
+"To learn more about what cancer is and how it can grow and spread, see What Is Cancer? To understand gastrointestinal carcinoid tumors, it helps to know about the gastrointestinal system, as well as the neuroendocrine system.","To learn more about what cancer is and how it can grow and spread, see What Is Cancer? To understand gastrointestinal carcinoid tumors, it helps to know about the gastrointestinal system, as well as the neuroendocrine system."
+The gastrointestinal system,The gastrointestinal system
+"The gastrointestinal (GI) system, also known as the digestive system, processes food for energy and rids the body of solid waste. ","The gastrointestinal (GI) system, also called the digestive system, breaks down food for energy and helps the body get rid of waste.   "
+"After food is chewed and swallowed, it enters the esophagus. ","After food is chewed and swallowed, it enters into a tube called the esophagus. "
+This tube carries food through the neck and chest to the stomach. ,This tube takes food down through your neck and chest to your stomach. 
+The esophagus joins the stomach just beneath the diaphragm (the breathing muscle under the lungs). ,The esophagus joins the stomach just beneath the diaphragm (the breathing muscle under the lungs). 
+The stomach is a sac that holds food and begins the digestive process by secreting gastric juice. ,The stomach is a sac that holds food and begins the digestive process by releasing (secreting) gastric juice. 
+"The food and gastric juices are mixed into a thick fluid, which then empties into the small intestine. ","The food and gastric juices are mixed into a thick fluid, which then empties into the small intestine. "
+The small intestine keeps breaking down food and absorbs most of the nutrients. ,The small intestine keeps breaking down food and absorbs most of the nutrients. 
+"It is the longest section of the gastrointestinal (GI) tract, measuring more than 20 feet (6 meters). ","It is the longest section of the gastrointestinal (GI) tract, measuring more than 20 feet (6 meters). "
+The small intestine then joins the colon. ,The small intestine then connects to the colon. 
+"This is a wider, muscular tube about 5 feet (1.5 meters) long. ","This is a wider, muscular tube about 5 feet (1.5 meters) long. "
+The appendix is near the junction of small intestine and colon. ,The appendix is near the connection of small intestine and colon. 
+"The colon absorbs water, minerals, and nutrients from food and serves as a storage place for waste. ","The colon absorbs water, minerals, and nutrients from food and serves as a storage place for waste. "
+The waste that is left after this process goes into the rectum. ,The waste that is left after this process goes into the rectum. 
+From there it leaves the body through the anus as stool (feces).,From there it leaves the body through the anus as stool (feces).
+The neuroendocrine system,The neuroendocrine system
+The neuroendocrine system has cells that act like nerve cells in certain ways and like hormone-making endocrine cells in others. ,The neuroendocrine system has cells that act like nerve cells in certain ways and like hormone (making endocrine) cells in others. 
+These cells don’t form an actual organ like the adrenal or thyroid glands. ,These cells are not found in one place like other hormone producing areas of the body (adrenal or thyroid glands). 
+"Instead, they are scattered throughout organs like the esophagus, stomach, pancreas, intestines, appendix, and lungs. ","Instead, they are scattered throughout body in areas such as the esophagus, stomach, pancreas, intestines, appendix, and lungs. "
+The digestive system has more neuroendocrine cells than any other part of the body. ,The digestive system has more neuroendocrine cells than any other part of the body. 
+This might be why carcinoid tumors most often start there. ,This could be why so many carcinoid tumors start there. 
+Neuroendocrine cells help control the release of digestive juices and how fast food moves in the GI tract. ,Neuroendocrine cells help control the release of digestive juices and how fast food moves in the GI tract. 
+They may also help control the growth of other types of digestive system cells. ,They may also help control the growth of other types of digestive system cells. 
+"Like most cells in the body, GI tract neuroendocrine cells sometimes go through certain changes that cause them to grow too much and form cancers. ","Like most cells in the body, GI tract neuroendocrine cells sometimes go through certain changes that cause them to grow too much and form cancers. "
+These cancers as a group are called neuroendocrine tumors.,These cancers as a group are called neuroendocrine tumors.
+Neuroendocrine (carcinoid) tumors,Neuroendocrine (carcinoid) tumors
+"Neuroendocrine tumors (NETs) are mostly slow growing, but some are not and can possibly spread to other parts of the body They are classified by tumor grade which describes how quickly the cancer is likely to grow and spread.. ",Neuroendocrine tumors (NETs) are mostly slow growing. But some are not and can possibly spread to other parts of the body. They are classified by how quickly the cancer is likely to grow and spread (tumor grade) 
+>Grade 1 (low grade) NETs have cells that look more like normal cells and are not multiplying quickly. ,>Grade 1 (low grade) NETs have cells that look more like normal cells and grow slowly. 
+>Grade 2 (intermediate grade) NETs have features in between those of low- and high-grade tumors. ,>Grade 2 (intermediate grade) NETs have features in between those of low- and high-grade tumors. 
+>Grade 3 (high grade) NETs have cells that look very abnormal and are multiplying faster. ,>Grade 3 (high grade) NETs have cells that look very abnormal and are grow faster. 
+Cancers that are grade 1 or grade 2 are called GI neuroendocrine tumors. ,Cancers that are grade 1 or grade 2 are called GI neuroendocrine tumors. 
+These cancers tend to grow slowly and can possibly spread to other parts of the body. ,These cancers tend to grow slowly but may still spread to other parts of the body. 
+Cancers that are grade 3 are called GI neuroendocrine carcinomas (NECs). ,Cancers that are grade 3 are called GI neuroendocrine carcinomas (NECs). 
+These cancers tend to grow and spread quickly and can spread to other parts of the body. ,These cancers tend to grow and spread quickly and can spread to other parts of the body. 
+The term “carcinoid” is often used to describe grade 1 and grade 2 GI NETs. ,The term “carcinoid” is often used to describe grade 1 and grade 2 GI NETs. 
+The term carcinoid will be used here unless referring to NECs specifically. ,The term carcinoid will be used here unless referring to NECs specifically. 
+"Carcinoid tumors that start in the lungs are not covered here, but you can find more information in Lung Carcinoid Tumor .","Carcinoid tumors that start in the lungs are not covered here, but you can find more information in Lung Carcinoid Tumor ."
+Other gastrointestinal tumors,Other gastrointestinal tumors
+Neuroendocrine (carcinoid) tumors are different from the more common tumors of the GI tract. ,Neuroendocrine (carcinoid) tumors are different from the more common tumors of the GI tract. 
+Most GI tract tumors start from the glandular cells that produce mucus and make up the inner lining of the digestive system. ,Most GI tract tumors start from the glandular cells that make mucus (slimy liquid) and make up the inside covering of the walls of the digestive system. 
+Pancreatic neuroendocrine tumors are not the same as carcinoid tumors. ,Pancreatic neuroendocrine tumors are not the same as carcinoid tumors. 
+They have a different prognosis (course of disease and outlook) and respond differently to treatment. ,They have a different prognosis (course of disease and chance of recovery) and respond differently to treatment. 
+Neuroendocrine tumors of the pancreas are not covered here (see Pancreatic Neuroendocrine Tumors ). ,Neuroendocrine tumors of the pancreas are not covered here (see Pancreatic Neuroendocrine Tumors ). 
+"These tumors differ quite a lot in their symptoms, their outlook, and their treatment. ","These tumors differ quite a lot in their symptoms, their chances of recovery, and their treatment. "
+"For these reasons, it is important to know what type of tumor you have. ","For these reasons, it is important to know what type of tumor you have. "
+"Information about other kinds of tumors of the GI tract can be found in Esophagus Cancer , Stomach Cancer , Small Intestine Cancer , and Colorectal Cancer .","Information about other kinds of tumors of the GI tract can be found in Esophagus Cancer , Stomach Cancer , Small Intestine Cancer , and Colorectal Cancer ."
+Anatomy of the liver. ,Where is the liver and what does it look like?
+"The liver is in the upper abdomen near the stomach, intestines, gallbladder, and pancreas. ",The liver is near your stomach on the right side of your body.
+The liver has four lobes. ,The liver has four sections. 
+Two lobes are on the front and two small lobes (not shown) are on the back of the liver. ,Two sections are on the front and two smaller sections (not shown) are on the back. 
+Intrahepatic bile ducts are a network of small tubes that carry bileinsidethe liver.. ,A small network of small tubes called Intrahepatic (in-tra-ha-patic) bile ducts that carry a bitter fluid (bile) inside of the liver.
+"© 2010 Terese Winslow LLC, U.S. Govt. has certain rights. ","© 2010 Terese Winslow LLC, U.S. Govt. has certain rights. "
+Used with Permission. ,Used with Permission. 
+Contact artist atwww.teresewinslow.comfor licensing.. ,Contact artist atwww.teresewinslow.comfor licensing.. 
+Cancer is a disease in which cells in the body grow out of control. ,Cancer is a disease where normal cells in the body grow out of control. 
+"When cancer starts in the liver, it is called liver cancer. ","When cancer starts in the liver, it is called liver cancer. "
+"Each year in the United States, about 25,000 men and 11,000 women get liver cancer, and about 19,000 men and 9,000 women die from the disease. ","Every year in the United States, about 25,000 men and 11,000 women get liver cancer, and about 19,000 men and 9,000 women die from the sickness. "
+"The percentage of Americans who get liver cancer rose for several decades, but is now declining. ","The number of Americans who get liver cancer rose for several years, but that number has started to go down. "
+Liver cancer is more common in other parts of the world than in the United States..,Liver cancer is more common in other parts of the world than in the United States..
+What Is the Liver?,What Is the Liver?
+"The liver is located on the upper right side of the body, behind the lower ribs. ","The liver is located on the upper right side of the body, behind the lower ribs. "
+"The liver does many jobs, including—. ","The liver does many jobs, including—. "
+>Storing nutrients. ,>Storing nutrients. 
+>Removing waste products and worn-out cells from the blood. ,>Removing waste products and worn-out cells from the blood. 
+">Filtering and processing chemicals in food, alcohol, and medications. ",">Breaks down and filters food, alcohol and medications in the body. "
+">Producing bile, a solution that helps digest fats and eliminate waste products.",>Produce the bitter fluid (bile) that helps digest fats and get rid of waste products.
+What Are the Symptoms of Liver Cancer?,What Are the Symptoms of Liver Cancer?
+"In its early stages, liver cancer may not have symptoms that can be seen or felt. ","When liver cancer starts, it may not have symptoms that can be seen or felt. "
+"However, as the cancer grows larger, people may notice one or more of these common symptoms. ","As the cancer grows larger, people may notice one or more of these common symptoms. "
+It’s important to remember that these symptoms could also be caused by other health conditions. ,It’s important to remember that these symptoms could also be caused by other reasons. 
+"If you have any of these symptoms, talk to your doctor.. ","If you have any of these symptoms, talk to your doctor.. "
+Liver cancer symptoms may include—. ,Liver cancer symptoms may include—. 
+>Discomfort in the upper abdomen on the right side. ,>Discomfort in the upper abdomen on the right side. 
+>A swollen abdomen. ,>A swollen abdomen. 
+>A hard lump on the right side just below the rib cage. ,>A hard lump on the right side just below the rib cage. 
+>Pain near the right shoulder blade or in the back. ,>Pain near the right shoulder blade or in the back. 
+>Jaundice (yellowing of the skin and whites of the eyes). ,>Yellowing of the skin and whites of the eyes (Jaundice). 
+>Easy bruising or bleeding. ,>Easy bruising or bleeding. 
+>Unusual tiredness. ,>Being very tired
+>Nausea and vomiting. ,>Throwing up or feeling like you need to throw up
+>Loss of appetite. ,>Not wanting to eat. 
+>Weight loss for no known reason. ,>Weight loss for no known reason. 
+"An illness caught Gary off guard, and test results found something he never expected. ","An illness caught Gary off guard, and test results found something he never expected. "
+Read his story..,Read his story..
+What Causes Liver Cancer?,What Causes Liver Cancer?
+Behaviors and conditions that increase risk for getting liver cancer are—. ,Some things that can make liver cancer happen to you are—. 
+>Being overweight orhaving obesity. ,>If you weigh too much 
+>Having a long-termhepatitis B virus or hepatitis C virus infection. , If you have a sickness called long-term hepatitis B virus or hepatitis C virus infection. 
+>Smoking cigarettes. ,>Smoking cigarettes. 
+>Drinking alcohol. ,>Drinking alcohol. 
+">Having cirrhosis (scarring of the liver, which can also be caused by hepatitis and alcohol use). ",>Scarring of the liver called cirrhosis (which can also be caused by hepatitis and alcohol use). 
+>Having nonalcoholic fatty liver disease (extra fat in the liver that is not caused by alcohol). ,>Fatty liver disease (extra fat in the liver that is not caused by alcohol). 
+>Having diabetes. ,>Diabetes
+">Having hemochromatosis, a condition where the body takes up and stores more iron than it needs. ",">Having hemochromatosis,a condition where the body takes up and stores more iron than it needs. "
+">Eating foods that have a flatoxin (a fungus that can grow on foods, such as grains and nuts that have not been stored properly).",">Eating foods that have a fungus that can grow on foods such as grains and nuts that have not been stored properly (Aflatoxin),"
+How Can I Reduce My Risk for Liver Cancer?,How Can I Reduce My Risk for Liver Cancer?
+You can lower your risk of getting liver cancer in the following ways—. ,You can lower your chances of getting liver cancer in the following ways—. 
+>Keep a healthy weight. ,>Keep a healthy weight. 
+>Get vaccinated against Hepatitis B. The Hepatitis B vaccineis recommended for all infants at birth and for adults who may be at increased risk. ,>Get Hepatitis B vaccine if you qualify. (recommended for all infants at birth and for adults who may have increased chance of getting Hepatitis). 
+">Get tested for Hepatitis C, and get medical care if you have it. ",">Get tested to see if you have for Hepatitis C, and get medical care if you have it. "
+">Don’t smoke, or quit if you do. ",>Don’t smoke or quit if you do. 
+>Avoid drinking too much alcohol. ,>Avoid drinking too much alcohol. 
+Liver cancer can be caused by chronic infections with hepatitis C virus (HCV) or hepatitis B virus (HBV). ,Liver cancer can be caused by long lasting infections of hepatitis C (HCV) or B (HBV). 
+"The opioid epidemic has increased the number of people who inject drugs in the United States, which may lead to an increased risk of HCV and HBV transmission through use of shared equipment..",Widespread narcotic use has increased the number of people who inject drugs in the US.  This may lead to an increased risk of HCV and HBV spread through use of shared needles.
+Statistics,Statistics
+The Data Visualizations tool makes it easy for anyone to explore and use the latest official federal government cancer data from United States Cancer Statistics. ,There is a tool called The Data Visualizations tool that can tell you how many people have liver cancer in the United States.  
+It includes the latest cancer data covering the U.S. population.. ,The tool tells you what is happening with cancer in the United States.  
+>Liver and Bile Duct Cancer (National Cancer Institute) ,>Liver and Bile Duct Cancer (National Cancer Institute) 
+>Video: Hepatitis and Liver Cancer Statistics (National Cancer Institute) ,>Video: Hepatitis and Liver Cancer Statistics(National Cancer Institute) 
+>Alcohol and Cancer ,>Alcohol and Cancer 
+>Viral Hepatitis and Liver Cancer Prevention Profiles ,>Viral Hepatitis and Liver Cancer Prevention Profiles 
+>Facebook ,>Facebook 
+>Twitter ,>Twitter 
+>LinkedIn ,>LinkedIn 
+>Syndicate,>Syndicate
+Primary liver cancer is a disease in which malignant (cancer) cells form in the tissues of the liver. ,A cancer that starts in your liver is called primary liver cancer.  
+Cancer that forms in other parts of the body and spreads to the liver is not primary liver cancer. ,Cancer that forms in other parts of the body and spreads to the liver is not primary liver cancer. 
+The liver is one of the largest organs in the body. ,The liver is one of the biggest organs in your body. 
+It has two lobes and fills the upper right side of the abdomen inside the rib cage. ,It has two parts. It sits on your right side under your ribs.
+The main functions of the liver include the following:. ,The main functions of the liver: 
+>to make bile to help digest fat that comes from food ,>to make a liquid called bile that helps break down fat from food
+">to store glycogen (sugar), which the body uses for energy ",">to store sugar, which the body uses for energy "
+>to filter harmful substances from the blood so they can be passed from the body in stools and urine,>filter harmful materials from the blood so they can be passed through bowel movements (stool) and pee (urine).
+Types of liver cancer,Types of liver cancer
+Hepatocellular carcinoma and bile duct cancer (cholangio carcinoma) are the main types of adult primary liver cancer. ,Hepatocellular carcinoma and bile tube cancer (cholangiocarcinoma) are the main kinds of primary liver cancer in grown-ups.
+Most adult primary liver cancers are hepatocellular carcinomas. ,Most adult primary liver cancers are hepatocellular carcinomas. 
+This type of liver cancer is the third leading cause of cancer-related deaths worldwide. ,Many people all over the world can die from this cancer.  
+Primary liver cancer can occur in both adults and children. ,Primary liver cancer can occur in adults and children. 
+"However, treatment for children is different than treatment for adults. ",Treatment for children is different than for  adults. 
+"For more information, see Childhood Liver Cancer.","For more information, see Childhood Liver Cancer."
+Signs and symptoms of liver cancer,Signs and symptoms of liver cancer
+These and other signs and symptoms may be caused by adult primary liver cancer or by other conditions. ,Primary liver cancer can make these problems happen but other sickness can make them happen too.  
+Check with your doctor if you have any of the following:. ,Check with your doctor if you have any of the following:
+>a hard lump on the right side just below the rib cage ,>a hard bump on your right side under your ribs 
+>discomfort in the upper abdomen on the right side ,>discomfort in the upper abdomen on the right side 
+>a swollen abdomen ,>a swollen abdomen 
+>pain near the right shoulder blade or in the back ,>pain near the right shoulder blade or in the back 
+>jaundice (yellowing of the skin and whites of the eyes) ,> Yellowing of the skin and whites of the eyes (jaundice) 
+>easy bruising or bleeding ,>easy bruising or bleeding 
+>unusual tiredness or weakness ,>unusual tiredness or weakness 
+>nausea and vomiting ,> Throwing up or feeling like you need to throw up
+>loss of appetite or feelings of fullness after eating a small meal ,>not wanting to eat or feeling full after eating a small amount of food 
+>weight loss for no known reason ,>weight loss for no known reason 
+">pale, chalky bowel movements and dark urine ",>your poop looks like chalk and your pee is very dark
+>fever,>fever
+Pancreatic cancer is a type of cancer that starts in the pancreas. ,Pancreatic cancer is a kind of cancer that starts in the pancreas. 
+(Cancer starts when cells in the body begin to grow out of control. ,(Cancer starts when cells in the body start to grow out of control. 
+"To learn more about how cancers start and spread, see What Is Cancer? ) ","To learn more about how cancers start and spread, see What Is Cancer? ) "
+Pancreatic adenocarcinoma is the most common type of pancreatic cancer. ,Pancreatic adenocarcinoma is the most common type of pancreatic cancer. 
+Pancreatic neuroendocrine tumors (NETs) are a less common type and are discussed in Pancreatic Neuroendocrine Tumors .,Pancreatic neuroendocrine tumors (NETs) are a less common type and are discussed in Pancreatic Neuroendocrine Tumors .
+Where pancreatic cancer starts,Where pancreatic cancer starts
+The pancreas,The pancreas
+The pancreas is an organ that sits behind the stomach. ,The pancreas is an organ that sits behind the stomach. 
+"It's shaped a bit like a fish with a wide head, a tapering body, and a narrow, pointed tail. ","It's shaped a bit like a fish with a wide head, a smaller body, and a narrow, pointed tail. "
+In adults it's about 6 inches (15 centimeters) long but less than 2 inches (5 centimeters) wide. ,In adults it's about 6 inches (15 centimeters) long but less than 2 inches (5 centimeters) wide. 
+">The head of the pancreas is on the right side of the abdomen (belly), behind where the stomach meets the duodenum (the first part of the small intestine). ",">The head of your pancreas is on the right side of your belly, behind where your stomach meets the start of your small intestine. "
+>The body of the pancreas is behind the stomach. ,>The body of the pancreas is behind the stomach. 
+>The tail of the pancreas is on the left side of the abdomen next to the spleen. ,>The tail of the pancreas is on the left side of the abdomen next to the spleen. 
+"The most common type of pancreatic cancer, adenocarcinoma of the pancreas, starts when exocrine cells in the pancreas start to grow out of control. ","The most common type of pancreatic cancer, adenocarcinoma of the pancreas, starts when cells inside of the pancreas called exocrine start to grow out of control. "
+Most of the pancreas is made up of exocrine cells which form the exocrine glands and ducts. ,Most of the pancreas is made up of exocrine cells which form exocrine glands and ducts. 
+The exocrine glands make pancreatic enzymes that are released into the intestines to help you digest foods (especially fats). ,The exocrine glands make pancreatic enzymes that are released into the intestines to help you digest foods (especially fats). 
+The enzymes are released into tiny tubes called ducts which eventually empty into the pancreatic duct. ,The enzymes are released into tiny tubes called ducts which eventually empty into the pancreatic duct. 
+"The pancreatic duct merges with the common bile duct (the duct that carries bile from the liver), and empties into the duodenum (the first part of the small intestine) at the ampulla of Vater. ",The pancreatic duct joins with the common bile duct (carries bile from the liver). Then empties into the duodenum (the first part of the small intestine) at an area called the ampulla of Vater. 
+Endocrine cells make up a smaller percentage of the cells in the pancreas. ,Endocrine cells make up a smaller percentage of the cells in the pancreas. 
+"These cells make important hormones like insulin and glucagon (which help control blood sugar levels), and release them directly into the blood. ","These cells make important hormones like insulin and glucagon (which help control blood sugar levels), and release them directly into the blood. "
+Pancreatic neuroendocrine tumors start in the endocrine cells. ,Pancreatic neuroendocrine tumors start in the endocrine cells. 
+See Pancreatic Neuroendocrine Tumor for more about this type. ,See Pancreatic Neuroendocrine Tumor for more about this type. 
+"If you are diagnosed with pancreatic cancer, it’s very important to know if it's an endocrine cancer (see Pancreatic Neuroendocrine Tumor) or exocrine cancer (discussed here). ","If you are diagnosed with pancreatic cancer, it’s very important to know if it's an endocrine cancer (see Pancreatic Neuroendocrine Tumor) or exocrine cancer (discussed here). "
+"They have distinct risk factors and causes, have different signs and symptoms, are diagnosed with different tests, are treated in different ways, and have different outlooks.","They have distinct risk factors and causes, have different signs and symptoms, are diagnosed with different tests, are treated in different ways, and have different outlooks."
+Types of pancreatic cancer,Types of pancreatic cancer
+Exocrine cancers are by far the most common type of pancreas cancer. ,Exocrine cancers are by far the most common type of pancreas cancer. 
+"If you are told you have pancreatic cancer, it's most likely an exocrine pancreatic cancer. ","If you are told you have pancreatic cancer, it's most likely an exocrine pancreatic cancer. "
+Pancreatic adenocarcinoma: About 95% of cancers of the exocrine pancreas are adenocarcinomas . ,About 95% of cancers of the exocrine pancreas are adenocarcinomas. 
+These cancers usually start in the ducts of the pancreas. ,These cancers usually start in the ducts of the pancreas. 
+"Less often, they develop from the cells that make the pancreatic enzymes, in which case they are called acinar cell carcinomas . ","Less often, they develop from the cells that make the pancreatic enzymes. This is called acinar cell carcinomas . "
+"Less common types of exocrine cancer: Other, less common exocrine cancers include adenosquamous carcinomas, squamous cell carcinomas, signet ring cell carcinomas, undifferentiated carcinomas, and undifferentiated carcinomas with giant cells. ","Less common types of exocrine cancer: Other, less common exocrine cancers include adenosquamous carcinomas, squamous cell carcinomas, signet ring cell carcinomas, undifferentiated carcinomas, and undifferentiated carcinomas with giant cells. "
+Ampullary cancer (carcinoma of the ampulla of Vater): ,Ampullary cancer (cancer of the ampulla of Vater): 
+"This cancer starts in the ampulla of Vater, which is where the bile duct and pancreatic duct come together and empty into the small intestine. ","This cancer starts in the ampulla of Vater, which is where the bile duct and pancreatic duct come together and empty into the small intestine. "
+"Ampullary cancers aren’t technically pancreatic cancers, but they are included here because they are treated much the same. ","Ampullary cancers aren’t pancreatic cancers, but they are included here because they are treated much the same. "
+Ampullary cancers often block the bile duct while they're still small and have not spread far. ,Ampullary cancers often block the bile duct while they're still small and have not spread far. 
+"This blockage causes bile to build up in the body, which leads to yellowing of the skin and eyes (jaundice). ","This blockage causes bile to build up in the body, which leads to yellowing of the skin and eyes (jaundice). "
+"Because of this, these cancers are usually found earlier than most pancreatic cancers, and they usually have a better prognosis (outlook).","Because of this, these cancers are usually found earlier than most pancreatic cancers. They usually have a better prognosis (chance of recovery)."
+Benign and precancerous growths in the pancreas,Benign and precancerous growths in the pancreas
+"Some growths in the pancreas are simply benign (not cancer), while others might become cancer over time if left untreated (known as precancers ). ","Some growths in the pancreas are simply benign (not cancer), while others might become cancer over time if left untreated (known as precancers ). "
+"Because people are getting imaging tests such as CT scans more often than in the past (for a number of reasons), these types of pancreatic growths are now being found more often. ","Because people are getting imaging tests such as CT scans more often than in the past (for a number of reasons), these types of pancreatic growths are now being found more often. "
+Serous cystic neoplasms (SCNs) (also known as serous cystadenomas ) are tumors that have sacs (cysts) filled with fluid. ,Serous cystic neoplasms (SCNs) (also known as serous cystadenomas ) are tumors that have sacs (cysts) filled with fluid. 
+"SCNs are almost always benign, and most don’t need to be treated unless they grow large or cause symptoms. ","SCNs are almost always benign, and most don’t need to be treated unless they grow large or cause symptoms. "
+Mucinous cystic neoplasms (MCNs) (also known as mucinous cystadenomas ) are slow-growing tumors that have cysts filled with a jelly-like substance called mucin . ,Mucinous cystic neoplasms (MCNs) (also known as mucinous cystadenomas) are slow-growing tumors that have cysts filled with a jelly-like substance called mucin. 
+These tumors almost always occur in women. ,These tumors almost always occur in women. 
+"While they are not cancer, some of them can progress to cancer over time if not treated, so these tumors are typically removed with surgery. ","While they are not cancer, some of them can progress to cancer over time if not treated. These tumors are typically removed with surgery if found. "
+Intraductal papillary mucinous neoplasms (IPMNs) are benign tumors that grow in the pancreatic ducts. ,Intraductal papillary mucinous neoplasms (IPMNs) are benign tumors (not cancer) that grow in the pancreatic ducts. 
+"Like MCNs, these tumors make mucin, and over time they sometimes become cancer if not treated. ","Like MCNs, these tumors make mucin, and over time they sometimes become cancer if not treated. "
+"Some IPMNs can just be followed closely over time, but some might need to be removed with surgery if they have certain features, such as if they are in the main pancreatic duct. ","Some IPMNs can just be followed closely over time, but some might need to be removed with surgery if they have certain features, such as if they are in the main pancreatic duct. "
+"Solid pseudopapillary neoplasms (SPNs) are rare, slow-growing tumors that almost always develop in young women. ","Solid pseudopapillary neoplasms (SPNs) are rare, slow-growing tumors that almost always develop in young women. "
+"Even though these tumors tend to grow slowly, they can sometimes spread to other parts of the body, so they are best treated with surgery. ","Even though these tumors tend to grow slowly, they can spread to other parts of the body. They are best treated with surgery. "
+The outlook for people with these tumors is usually very good.,The outlook for people with these tumors is usually very good.
+Cancer starts when cells in the body begin to grow out of control. ,Cancer starts when cells in the body begin to grow out of control. 
+"Cells in nearly any part of the body can become cancer, and can spread to other areas of the body. ","Cells in nearly any part of the body can become cancer, and can spread to other areas of the body. "
+"To learn more about how cancers start and spread, see What Is Cancer? ","To learn more about how cancers start and spread, see What Is Cancer? "
+Small intestine cancer starts when cells in the small intestine start to grow out of control. ,Small intestine cancer starts when cells in the small intestine start to grow out of control. 
+"The small intestine is part of the gastrointestinal (GI) tract, also known as the digestive tract. ","The small intestine is part of the gastrointestinal (GI) tract, also known as the digestive tract. "
+The GI tract processes food for energy and rids your body of solid waste. ,The GI tract breaks down food for energy and rids your body of solid waste. 
+"Although the small intestine makes up the largest part of the GI tract, small intestine cancers are much less common than most other types of GI cancers (such as colon, rectal, stomach, and esophagus cancers) in the United States.","Although the small intestine makes up the largest part of the GI tract, small intestine cancers are much less common than other types of GI cancers (such as colon, rectal, stomach, and esophagus cancers) in the United States."
+How the small intestine works,How the small intestine works
+"To understand small intestine cancer, it helps to know about the small intestine and how it works. ","To understand small intestine cancer, it helps to know about the small intestine and how it works. "
+"After you chew and swallow your food, it goes through the esophagus , a tube that carries food through the neck and chest and into the stomach . ","After you chew and swallow your food, it goes through the esophagus , a tube that carries food through the neck and chest and into the stomach . "
+The stomach is a sac-like organ that helps the digestive process by mixing the food with gastric juices. ,The stomach is a sac-like organ that helps the continued breakdown of food (digestive process) by mixing the food with gastric juices preparing it for use by the body. 
+"The food and gastric juices are mixed into a thick fluid, which is then emptied into the small intestine (also known as the small bowel ). ","The food and gastric juices are mixed into a thick fluid, which is then emptied into the small intestine (also known as the small bowel ). "
+The small intestine continues breaking down the food and absorbs most of the nutrients. ,The small intestine continues breaking down the food and absorbs most of the nutrients. 
+"Even though it's called the small intestine, it's actually the longest section of the GI tract (about 20 feet long). ","Even though it's called the small intestine, it's actually the longest section of the GI tract (about 20 feet long). "
+The small intestine has 3 sections. ,The small intestine has 3 sections. 
+>The duodenum: ,>The duodenum: 
+This is the first section and is only about a foot long. ,This is the first section and is only about a foot long. 
+"A short distance from where the duodenum attaches to the stomach, the pancreatic duct and bile duct enter the duodenum at the ampulla of Vater. ","A short distance from where the duodenum attaches to the stomach, the pancreatic duct and bile duct enter the duodenum at an area called the ampulla of Vater. "
+"Fluids from the pancreas and liver enter the small intestine here, helping to further digest the food. ","Fluids from the pancreas and liver enter the small intestine here, helping to further digest the food. "
+>The jejunum and ileum: ,>The jejunum and ileum: 
+"These parts make up most of the small intestine, and are where most of the nutrients in food are absorbed into the bloodstream. ","These are the biggest part of the small intestine, and are where most of the nutrients in your food are soaked into your blood. "
+The ileum empties into the colon (the first part of the large intestine). ,The ileum goes into the colon (the first part of the large intestine). 
+This muscular tube is about 4 to 5 feet long. ,This muscular tube is about 4 to 5 feet long. 
+It absorbs water and some remaining mineral nutrients from the food matter. ,It absorbs water and some remaining mineral nutrients from the food matter. 
+"The waste left after this process goes into the rectum , where it is stored until it passes out of the body through the anus .","The waste left after this process goes into the rectum , where it is stored until it passes out of the body through the anus as a bowel movement (stool) ."
+Types of small intestine cancers,Types of small intestine cancers
+"The small intestine is made up of many different types of cells, so different types of cancer can start here. ","The small intestine is made up of many different types of cells, so different types of cancer can start here. "
+The 4 major types of small intestine cancers are: >Adenocarcinomas: ,The 4 major types of small intestine cancers are: >Adenocarcinomas: 
+These cancers start in the gland cells that line the inside of the intestine. ,These cancers start in the gland cells that line the inside of the intestine. 
+They account for about 1 in 3 small intestine cancers. ,They account for about 1 in 3 small intestine cancers. 
+">Carcinoid tumors: These tumors are a type of neuroendocrine tumor (NET), and they tend to be slow growing. ",">Carcinoid tumors: These tumors are a type of neuroendocrine tumor (NET), and they tend to be slow growing. "
+They are the most common type of small intestine tumor. ,They are the most common type of small intestine tumor. 
+"To learn more, see Gastrointestinal Carcinoid Tumors . ","To learn more, see Gastrointestinal Carcinoid Tumors . "
+>Lymphomas: These cancers start in immune cells called lymphocytes. ,>Lymphomas: These cancers start in cells that fight infections and protect the body (immune cells) called lymphocytes. 
+"Lymphomas can start almost anywhere in the body, including the small intestine. ","Lymphomas can start almost anywhere in the body, including the small intestine. "
+"For more on these cancers, see Non-Hodgkin Lymphoma . ","For more on these cancers, see Non-Hodgkin Lymphoma. "
+">Sarcomas: These are cancers that start in connective tissues, such as muscle. ",">Sarcomas: These are cancers that start in connective tissues, such as muscle. "
+The most common sarcomas in the intestine are known as gastrointestinal stromal tumors (GISTs) . ,The most common sarcomas in the intestine are known as gastrointestinal stromal tumors (GISTs) . 
+Most experts think that cancer of the small intestine develops much like colorectal cancer. ,Most experts think that cancer of the small intestine develops much like colorectal cancer. 
+"It first begins as a small growth on the inner lining of the intestine, called a polyp . ","It first begins as a small growth on the inner lining of the intestine, called a polyp . "
+"Over time, the polyp can change into a cancer. ","Over time, the polyp can change into a cancer. "
+Most small intestinal cancers (especially adenocarcinomas) develop in the duodenum. ,Most small intestinal cancers (especially adenocarcinomas) develop in the duodenum. 
+Cancers that develop in the duodenum are often found at the ampulla of Vater. ,Cancers that develop in the duodenum are often found at a place called the ampulla of Vater. 
+"But because this area is closely associated with the pancreas, cancers of the ampulla of Vater (also known as ampullary cancers) are treated like pancreatic cancer .","But because this area is closely associated with the pancreas, cancers of the ampulla of Vater (also known as ampullary cancers) are treated like pancreatic cancer ."
+Cancer starts when cells in the body begin to grow out of control. ,Cancer starts when cells in the body begin to grow out of control. 
+"Cells in nearly any part of the body can become cancer, and can then spread to other areas of the body. ","Cells in nearly any part of the body can become cancer, and can then spread to other areas of the body. "
+"To learn more about cancer and how it starts and spreads, see What Is Cancer? Stomach cancer, also called gastric cancer, begins when cells in the stomach start to grow out of control.","To learn more about cancer and how it starts and spreads, see What Is Cancer? Stomach cancer, also called gastric cancer, begins when cells in the stomach start to grow out of control."
+The stomach,The stomach
+"To understand stomach cancer, it helps to know about the normal structure and function of the stomach. ","To understand stomach cancer, it helps to know about the normal structure and function of the stomach. "
+The stomach is a sac-like organ that’s an important part of the digestive system. ,The stomach is a sac-like organ that’s an important part of the digestive system. 
+"After food is chewed and swallowed, it enters the esophagus , a tube that carries food through the throat and chest to the stomach. ","After food is chewed and swallowed, it enters the esophagus , a tube that carries food through the throat and chest to the stomach. "
+"The esophagus joins the stomach at the gastroesophageal (GE) junction , which is just beneath the diaphragm (the thin sheet of breathing muscle under the lungs). ","The esophagus joins the stomach at the gastroesophageal (GE) junction , which is just beneath the diaphragm (the thin sheet of breathing muscle found under the lungs). "
+The stomach then starts to digest the food by secreting gastric juice. ,The stomach then starts to digest the food by releasing gastric juice. 
+The food and gastric juice are mixed and then emptied into the first part of the small intestine called the duodenum . ,The food and gastric juice are mixed and then emptied into the first part of the small intestine called the duodenum . 
+Some people use the word 'stomach' to refer to the belly area. ,Some people use the word 'stomach' to refer to the belly area. 
+The medical term for this area is the abdomen . ,The medical term for this area is the abdomen . 
+"For instance, some people with pain in this area would say they have a 'stomach ache', when in fact the pain could be coming from some other organ in the area. ","For instance, some people with pain in this area would say they have a 'stomach ache', when in fact the pain could be coming from some other organ in the area. "
+"Doctors would call this symptom 'abdominal pain,' because the stomach is only one of many organs in the abdomen. ","Doctors would call this symptom 'abdominal pain,' because the stomach is only one of many organs in the abdomen. "
+"Stomach cancer is different from other cancers that can occur in the abdomen, like cancer of the colon or rectum (large intestine) , liver , pancreas , or small intestine . ","Stomach cancer is different from other cancers that can occur in the abdomen, like cancer of the colon or rectum (large intestine) , liver , pancreas , or small intestine . "
+"These cancers can have different symptoms, different outlooks, and different treatments.","Stomach cancers can have different symptoms,  outlooks, and treatments."
+Parts of the stomach,Parts of the stomach
+The stomach has 5 parts. ,The stomach has 5 parts. 
+"The first 3 parts make up the proximal stomach : >Cardia: the first part, which is closest to the esophagus >Fundus: the upper part of the stomach next to the cardia >Body (corpus): the main part of the stomach, between the upper and lower parts Some cells in these parts of the stomach make acid and pepsin (a digestive enzyme), which combine to make the gastric juice that helps digest food. ","The first 3 parts make up the proximal stomach : >Cardia: the first part, which is closest to the esophagus >Fundus: the upper part of the stomach next to the cardia >Body (corpus): the main part of the stomach, between the upper and lower parts. Some cells in these parts of the stomach make acid and pepsin (a digestive enzyme), which combine to make the gastric juice that helps digest food. "
+"They also make a protein called intrinsic factor , which the body needs to absorb vitamin B12. ","They also make a protein called intrinsic factor , which the body needs to absorb vitamin B12. "
+"The lower 2 parts make up the distal stomach : >Antrum: the lower portion (near the small intestine), where the food mixes with gastric juice >Pylorus: the last part of the stomach, which acts as a valve to control the emptying of the stomach contents into the small intestine. Other organs near the stomach include the small intestine, colon, liver, spleen, and pancreas. ","The lower 2 parts make up the distal stomach : >Antrum: the lower portion (near the small intestine), where the food mixes with gastric juice >Pylorus: the last part of the stomach, which acts as a valve to control the emptying of the stomach contents into the small intestine. Other organs near the stomach include the small intestine, colon, liver, spleen, and pancreas. "
+The stomach wall has 5 layers: >The innermost layer is the mucosa . ,The stomach wall has 5 layers: >The innermost layer is the mucosa . 
+This is where stomach acid and digestive enzymes are made. ,This is where stomach acid and digestive enzymes are made. 
+Most stomach cancers start in this layer. ,Most stomach cancers start in this layer. 
+">Next is a supporting layer called the submucosa . >Outside of this is the muscularis propria , a thick layer of muscle that helps move and mix the stomach contents. ","> The submucosa is the next layer which is a supporting layer. >The muscularis propria , a thick layer of muscle that helps move and mix the stomach contents is on the outside of the submucosa . "
+">The outer 2 layers, the subserosa and the outermost serosa , wrap the stomach. ",">2 outer layers called the subserosa and the outermost serosa , wrap the stomach. "
+"The layers are important in determining the stage (extent) of the cancer , which can affect a person’s treatment options and prognosis (outlook). ","The layers are important in determining the stage (how far the cancer has grown), which can affect a person’s treatment options and chances of recovery (prognosis). "
+"As a cancer grows from the mucosa into deeper layers, the stage becomes more advanced and treatment might need to be more extensive.","As a cancer grows from the mucosa into deeper layers, the stage becomes greater and treatment might need to be more aggressive."
+Development of stomach cancer,Development of stomach cancer
+Stomach cancers tend to develop slowly over many years. ,Stomach cancers tend to develop slowly over many years. 
+"Before a true cancer develops, pre-cancerous changes often occur in the inner lining (mucosa) of the stomach. ","Before a true cancer develops, pre-cancerous changes often occur in the inner lining (mucosa) of the stomach. "
+"These early changes rarely cause symptoms, so they often go undetected. ","These early changes rarely cause symptoms, so they often go undetected. "
+Cancers starting in different sections of the stomach can cause different symptoms and tend to have different outcomes. ,Cancers starting in different sections of the stomach can cause different symptoms and tend to have different results. 
+The cancer’s location can also affect treatment options. ,The cancer’s location can also affect treatment options. 
+"For example, cancers that start at or grow into the GE junction are usually staged and treated the same as cancers of the esophagus. ","For example, cancers that start at or grow into the GE junction are usually staged and treated the same as cancers of the esophagus. "
+"(For more information, see Esophagus Cancer .)","(For more information, see Esophagus Cancer .)"
+Types of stomach cancer,Types of stomach cancer
+Adenocarcinomas,Adenocarcinomas
+Most cancers of the stomach (about 90% to 95%) are adenocarcinomas. ,Most cancers of the stomach (about 90% to 95%) are adenocarcinomas. 
+These cancers develop from the gland cells in the innermost lining of the stomach (the mucosa). ,These cancers develop from the gland cells in the innermost lining of the stomach (the mucosa). 
+"If you are told you have stomach cancer (or gastric cancer), it will almost always be an adenocarcinoma. ","If you are told you have stomach cancer (or gastric cancer), it will most likely be an adenocarcinoma. "
+The information on the following pages that discusses stomach cancer refers to this type of cancer. ,The information on the following pages that discusses stomach cancer refers to this type of cancer. 
+There are 2 main types of stomach adenocarcinomas: >The intestinal type tends to have a slightly better prognosis (outlook). ,There are 2 main types of stomach cancers: (adenocarcinomas) >similar to the intestinal type tends to have a slightly better chance of recovery (prognosis). 
+The cancer cells are more likely to have certain gene changes that might allow for treatment with targeted drug therapy . ,Adenocarcinomas are more likely to have certain genetic changes that might allow for treatment with special drugs called targeted agents . 
+>The diffuse type tends to grow spread more quickly. ,>Diffuse cell cancers of the stomach tends to grow and spread more quickly. 
+"It is less common than the intestinal type, and it tends to be harder to treat.","It is less common than the intestinal type, and it tends to be harder to treat."
+Other types of cancer that can start in the stomach,Other types of cancer that can start in the stomach
+Gastrointestinal stromal tumors (GISTs),Gastrointestinal stromal tumors (GISTs)
+These uncommon tumors start in very early forms of cells in the wall of the stomach called interstitial cells of Cajal. ,These uncommon tumors start in very early forms of cells in the wall of the stomach called interstitial cells of Cajal. 
+Some GISTs are much more likely than others to grow into other areas or spread to other parts of the body. ,Some GISTs are much more likely than others to grow into other areas or spread to other parts of the body. 
+"Although GISTs can start anywhere in the digestive tract, most start in the stomach. ","Although GISTs can start anywhere in the digestive tract, most start in the stomach. "
+"For more information, see Gastrointestinal Stromal Tumor (GIST) .","For more information, see Gastrointestinal Stromal Tumor (GIST) ."
+Neuroendocrine tumors (including carcinoids),Neuroendocrine tumors (including carcinoids)
+Neuroendocrine tumors (NETs) start in cells in the stomach (or other parts of the digestive tract) that act like nerve cells in some ways and like hormone-making (endocrine) cells in others. ,Neuroendocrine tumors (NETs) start in cells in the stomach (or other parts of the digestive tract) that act like nerve cells in some ways and like hormone-making (endocrine) cells in others. 
+"Most NETs tend to grow slowly and do not spread to other organs, but some can grow and spread quickly. ","Most NETs tend to grow slowly and do not spread to other organs, but some can grow and spread quickly. "
+NETs are discussed in more detail in Gastrointestinal Neuroendocrine (Carcinoid) Tumors .,NETs are discussed in more detail in Gastrointestinal Neuroendocrine (Carcinoid) Tumors .
+Lymphomas,Lymphomas
+These cancers start in immune system cells called lymphocytes. ,These cancers start in the cells that fight infection and protect the body (immune system cells) called lymphocytes. 
+"Lymphomas usually start in other parts of the body, but some can start in the wall of the stomach. ","Lymphomas usually start in other parts of the body, but some can start in the wall of the stomach. "
+The treatment and outlook for these cancers depend on the type of lymphoma and other factors. ,The treatment and outlook for these cancers depend on the type of lymphoma and other factors. 
+"For more information, see Non-Hodgkin Lymphoma .","For more information, see Non-Hodgkin Lymphoma ."
+Other cancers,Other cancers
+"Other types of cancer, such as squamous cell carcinomas, small cell carcinomas, and leiomyosarcomas, can also start in the stomach, but these cancers are very rare.","Other types of cancer, such as squamous cell carcinomas, small cell carcinomas, and leiomyosarcomas, can also start in the stomach, but these cancers are very rare."
+Stomach (gastric) cancer is cancer that starts in the cells lining the stomach. ,Stomach (gastric) cancer is cancer that starts in the cells lining the stomach. 
+The stomach is an organ on the left side of the upper abdomen that digests food. ,The stomach is an organ on the left side of the upper abdomen that digests food. 
+"The stomach is part of the digestive tract, a series of hollow, muscular organs joined in a long, twisting tube from the mouth to the anus. ","The stomach is part of the digestive tract, a series of hollow, muscular organs joined in a long, twisting tube from the mouth to the anus. "
+The digestive tract processes nutrients in foods that are eaten and helps pass waste material out of the body: >Food moves from the throat to the stomach through a tube called the esophagus. ,The digestive tract takes in nutrients in foods that are eaten and helps the body get rid of waste: >Food moves from the throat to the stomach through a tube called the esophagus. 
+">After food enters the stomach, it is broken down by stomach muscles that mix the food and liquid with digestive juices. ",">After food goes into the stomach, it is broken down by stomach muscles that mix the food and liquid with digestive juices. "
+">After leaving the stomach, partly digested food passes into the small intestine and then into the large intestine . > ",">After leaving the stomach, the food that is being broken down goes into the small intestine and then into the large intestine . > "
+"The end of the large intestine, called the rectum, stores the waste from the digested food until it is pushed out of the anus during a bowel movement.","The end of the large intestine, called the rectum, stores the waste from the digested food until it is pushed out of the anus during a bowel movement."
+Types of stomach cancer,Types of stomach cancer
+Adenocarcinoma of the stomach begins in the mucus-producing cells in the innermost lining of the stomach. ,Adenocarcinoma of the stomach begins in the mucus-producing cells in the innermost lining of the stomach. 
+Nearly all stomach cancers are adenocarcinomas . ,Nearly all stomach cancers are adenocarcinomas . 
+"Adenocarcinoma of the stomach is divided into two main classes, depending on where it forms in the stomach: >Gastric cardia cancer begins in the top inch of the stomach, just below where it meets the esophagus. ","Adenocarcinoma of the stomach is divided into two main classes, depending on where it forms in the stomach: >Gastric cardia cancer begins in the top inch of the stomach, just below where it meets the esophagus. "
+Most adenocarcinomas are found in the gastric cardia. ,Most adenocarcinomas are found in the gastric cardia. 
+>Non-cardia gastric cancer is cancer that begins in all other sections of the stomach. ,>Non-cardia gastric cancer is cancer that begins in all other sections of the stomach. 
+"Adenocarcinoma of the stomach also may be described as intestinal or diffuse, depending on how the cells look under a microscope: >Intestinal adenocarcinomas are well differentiated, meaning the cancer cells look similar to normal cells under a microscope. ","Adenocarcinoma of the stomach also may be described as intestinal or diffuse, depending on how the cells look under a microscope. >Intestinal adenocarcinomas look similar to normal cells under a microscope. This is called “well differentiated”. "
+">Diffuse adenocarcinomas are undifferentiated or poorly differentiated, meaning the cancer cells look different from normal cells under a microscope. ",>Diffuse adenocarcinomas are undifferentiated or poorly differentiated.  This means the cancer cells do not look like normal cells under a microscope. 
+Diffuse adenocarcinomas tend to grow and spread more quickly than the intestinal type and be harder to treat. ,Diffuse adenocarcinomas tend to grow and spread more quickly than the intestinal type and be harder to treat. 
+Gastroesophageal junction adenocarcinoma (GEJ) is a cancer that forms in the area where the esophagus meets the gastric cardia. ,Gastroesophageal junction adenocarcinoma (GEJ) is a cancer that forms in the area where the esophagus meets the gastric cardia. 
+GEJ may be treated similarly to stomach cancer or esophageal cancer . ,GEJ may be treated like stomach cancer or esophageal cancer . 
+Gastrointestinal neuroendocrine tumors are cancers that begin in neuroendocrine cells (a type of cell that is like a nerve cell and a hormone-making cell) that line the gastrointestinal tract. ,Gastrointestinal neuroendocrine tumors are cancers that begin in neuroendocrine cells (a type of cell that is like a nerve cell and a hormone-making cell) that line the gastrointestinal tract. 
+Neuroendocrine cells make hormones that help control digestive juices and the muscles used in moving food through the stomach and intestines. ,Neuroendocrine cells make hormones that help control digestive juices and the muscles used in moving food through the stomach and intestines. 
+Learn about gastrointestinal neuroendocrine tumors . ,Learn about gastrointestinal neuroendocrine tumors . 
+Gastrointestinal stromal tumors (GIST) begin in nerve cells that are found in the wall of the stomach and other digestive organs. ,Gastrointestinal stromal tumors (GIST) begin in nerve cells that are found in the wall of the stomach and other digestive organs. 
+GIST is a type of soft tissue sarcoma. ,GIST is a type of soft tissue sarcoma. 
+Learn about gastrointestinal stromal tumors . ,Learn about gastrointestinal stromal tumors . 
+Primary gastric lymphoma is a type of non-Hodgkin lymphoma that forms in the stomach. ,Primary gastric lymphoma is a type of non-Hodgkin lymphoma that forms in the stomach. 
+Most primary gastric lymphomas are either mucosa-associated lymphoid tissue (MALT) gastric lymphoma or diffuse large B-cell lymphoma of the stomach. ,Most primary gastric lymphomas are either mucosa-associated lymphoid tissue called “MALT” gastric lymphoma or diffuse large B-cell lymphoma of the stomach. 
+"Rarely, other types of cancer, such as squamous cell carcinoma , small cell carcinoma, and leiomyosarcoma , can also begin in the stomach.","Rarely, other types of cancer, such as squamous cell carcinoma , small cell carcinoma, and leiomyosarcoma , can also begin in the stomach."
+Learn more about stomach cancer,Learn more about stomach cancer
+>Causes and Risk Factors,>Causes and Risk Factors
+"The causes of stomach cancer are not known, but there are several risk factors that may increase your chance of stomach cancer.","The causes of stomach cancer are not known, but there are several risk factors that may increase your chance of stomach cancer."
+Causes and Risk Factors,Causes and Risk Factors
+"The causes of stomach cancer are not known, but there are several risk factors that may increase your chance of stomach cancer. ","The causes of stomach cancer are not known, but there are several risk factors that may increase your chance of stomach cancer. "
+>SymptomsSymptoms of stomach cancer may include common conditions like indigestion and stomach pain. ,>Symptoms of stomach cancer may include common conditions like indigestion and stomach pain. 
+Learn more to recognize early and advanced stomach cancer symptoms.,Learn more to recognize early and advanced stomach cancer symptoms.
+Symptoms,Symptoms
+Symptoms of stomach cancer may include common conditions like indigestion and stomach pain. ,Symptoms of stomach cancer may include common conditions like indigestion and stomach pain. 
+Learn more to recognize early and advanced stomach cancer symptoms. ,Learn more to recognize early and advanced stomach cancer symptoms. 
+>Screening,>Screening
+There is no standard screening test for stomach cancer. ,There is no standard screening test for stomach cancer. 
+Learn about tests being studied for stomach cancer screening.,Learn about tests being studied for stomach cancer screening.
+Screening,Screening
+>Diagnosing Stomach CancerLearn about the tests that are used to diagnose and stage stomach cancer.,>Diagnosing Stomach Cancer Learn about the tests that are used to diagnose and stage stomach cancer.
+Diagnosing Stomach Cancer,Diagnosing Stomach Cancer
+Learn about the tests that are used to diagnose and stage stomach cancer. ,Learn about the tests that are used to diagnose and stage stomach cancer. 
+>Survival Rates and PrognosisLearn about stomach cancer survival rates and why this statistic doesn't predict exactly what will happen to you.,>Survival Rates and PrognosisLearn about stomach cancer survival rates and why this statistic doesn't predict exactly what will happen to you.
+Survival Rates and Prognosis,Survival Rates and Prognosis
+Learn about stomach cancer survival rates and why this statistic doesn't predict exactly what will happen to you.,Learn about stomach cancer survival rates and why this information doesn't predict exactly what will happen to you.
+Stages,Stages
+"Stage refers to the extent of your cancer, such as how large the tumor is and if it has spread. ","Stage refers to the extent of your cancer, such as how large the tumor is and if it has spread. "
+"Learn about stomach cancer stages, an important factor in deciding your treatment plan.","Learn about stomach cancer stages, an important factor in deciding your treatment plan."
+Treating Stomach Cancer,Treating Stomach Cancer
+"Stomach cancer treatments can include surgery, radiation therapy, chemotherapy, immunotherapy, and more. ","Stomach cancer treatments can include surgery, radiation therapy, chemotherapy, immunotherapy, and more. "
+Learn about the different ways stomach cancer can be treated.,Learn about the different ways stomach cancer can be treated.
+Childhood Stomach Cancer,Childhood Stomach Cancer
+Childhood stomach cancer is rare. ,Childhood stomach cancer is rare. 
+"Learn about symptoms and risk factors for stomach cancer in children, and how it is diagnosed and treated.","Learn about symptoms and risk factors for stomach cancer in children, and how it is diagnosed and treated."
+Coping with Stomach Cancer,Coping with Stomach Cancer
+Certain aspects of stomach cancer diagnosis and treatment are of special concern. ,Certain aspects of stomach cancer diagnosis and treatment are of special concern. 
+Gain a greater sense of control by knowing what to expect and what resources are available to help you cope.,Gain a greater sense of control by knowing what to expect and what resources are available to help you cope.

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+Expert,Simple
+Original Text,Simplified Text
+Many anal cancers can be found early.  ,Many anal cancers can be found early.  
+Early anal cancers often have signs and symptoms that lead people to see a doctor.  ,Early anal cancers often have signs and symptoms that lead people to see a doctor.  
+"Unfortunately, some anal cancers may not cause symptoms until they reach an advanced stage.  ",But some anal cancers may not cause symptoms until they reach a late stage.  
+Other anal cancers can cause symptoms like those of diseases other than cancer.  ,Other anal cancers may also have symptoms of other conditions that are not cancer. This may delay their diagnosis.  
+Anal cancers develop in a part of the digestive tract that your doctor can easily see and get to.  ,Anal cancers start in a part of the GI tract that your doctor can easily see and get to.  
+A digital rectal exam (DRE) can find some cases of anal cancer early.  ,A digital rectal exam (DRE) by finger can find some cases of anal cancer early.  
+"In this exam, the doctor inserts a gloved, lubricated finger into the anus to feel for unusual lumps or growths.  ","In this exam, the doctor inserts a gloved, lubricated finger into the anus to feel for lumps or growths.  "
+This test is sometimes used to look for prostate cancer in men (because the prostate gland can be felt through the rectum).  ,This test may also used to look for prostate cancer in men (because the prostate gland can be felt during this exam).  
+The rectal exam is also done routinely as part of a pelvic exam on women.  ,The rectal exam may also done as part of a pelvic exam on women.  
+The odds that anal cancer can be found early depend on the location and type of the cancer.  ,The chances of anal cancer being found early depends on the location and type of the cancer.  
+Cancers that begin higher up in the anal canal are less likely to cause symptoms and be found early.  ,Cancers that begin higher up in the anal canal may not cause symptoms and may not be found early by digital exam.  
+"Anal melanomas tend to spread earlier than other cancers, making them harder to diagnose them early.","Anal melanomas tend to spread earlier than other cancers, making them harder to diagnose them early."
+Screening people at high risk ,Screening people at high risk 
+Looking for a disease like cancer in someone with no symptoms is called screening .  ,Looking for a disease like cancer in someone with no symptoms is called screening .  
+"The goal of screening is to find cancer at an early stage, when treatment is likely to be most helpful.  ","The goal of screening is to find cancer at an early stage, when treatment is likely to be most helpful.  "
+"Anal cancer is not common in the United States, so screening the general public for anal cancer is not widely recommended at this time.  ",Anal cancer is not common in the United States.  Screening the general public for anal cancer is not widely recommended at this time.  
+"Still, some people at increased risk for anal intraepithelial neoplasia (AIN, a potentially pre-cancerous condition) and anal cancer might benefit from screening.  ",Some people are at increased risk for anal cancer and might benefit from screening. 
+"This includes men who have sex with men (regardless of HIV status), women who have had cervical cancer, vaginal cancer , or vulvar cancer , anyone who is HIV-positive, and anyone who is immunocompromised (such as people who have received an organ transplant or are on long-term steroids).  ","This includes >Known anal intraepithelial neoplasia (AIN, a potentially pre-cancerous condition). >men who have sex with men (regardless of HIV status). >women who have had cervical, vaginal or vulvar cancer. >anyone who is HIV-positive. >anyone who is immunocompromised (such as people who have received an organ transplant or are on long-term steroids).  "
+Some experts also recommend screening for anyone with a history of anal warts and women older than 45 years old who are HPV 16 positive.  ,Additional screening recommendations: >anyone with a history of anal warts. >women older than 45 years old who are HPV positive.  
+"For these people, some experts recommend screening with regular anal cytology testing (also known as an anal Pap test or anal Pap smear because it is much like a Pap test for cervical cancer).  ",For this group it is also recommended that they receive regular anal cytology testing. Also known as an anal Pap test or  smear because it is much like a Pap test for cervical cancer).  
+"For an anal Pap test, the anal lining is swabbed, and cells that come off on the swab are looked at closely in the lab.  ","For an anal Pap test, the lining of the anus is swabbed, and the cells are looked at closely in the lab for changes.  "
+The anal pap test can then be followed by a DRE or a procedure called an anoscopy .  ,The anal pap test can then be followed by a DRE or a procedure called an anoscopy (a small tube is inserted into the anus to view the tissue).  
+"The anal Pap test has not been studied enough to know how often it should be done, or if it actually reduces the risk of anal cancer by catching AIN early.  ",The anal Pap test has not been studied enough to know how often it should be done. Some experts recommend that the test be done in at-risk people who are: >Annually HIV-positive. >every 2 to 3 years in at-risk people who are HIV-negative.  
+"Some experts recommend that the test be done every year in at-risk people who are HIV-positive, and every 2 to 3 years in at-risk people who are HIV-negative.  ","Some experts recommend that the test be done every year in at-risk people who are HIV-positive, and every 2 to 3 years in at-risk people who are HIV-negative.  "
+"But there is no widespread agreement on the best screening schedule, or even exactly which groups of people can benefit from screening.  ","There is no widespread agreement on the best screening schedule, or even exactly which groups of people can benefit from screening.  "
+Patients with positive results on an anal Pap test should be referred for a biopsy.  ,Patients with positive results on an anal Pap test should receive a biopsy.  
+"If AIN is found on the biopsy, it might need to be treated (especially if it is high-grade).","If AIN is found on the biopsy, it might need to be treated (especially if it is high-grade)."
+Original Text,Simplified Text
+Only a small number of bile duct cancers are found before they have spread too far to be removed by surgery. ,Only a small number of bile duct cancers are found early.  Most are found when they have spread too far to be taken out with surgery. 
+"The bile ducts are deep inside the body, so small tumors can’t be seen or felt during routine physical exams. ","The bile ducts are way down inside the body, so small areas of cancer can’t be seen or felt when you go to the doctor for a regular visit. "
+There are no blood tests or other tests that can reliably detect bile duct cancers early enough to be useful as screening tests. ,Looking for cancer in people who are not having any problems is called screening.  There are no blood tests or other tests that can help screen people for bile duct cancer.
+(Screening is testing for cancer in people without any symptoms.) ,(Screening is testing for cancer in people without any symptoms.)
+"Because of this, most bile duct cancers are found only after the cancer has grown enough to cause signs or symptoms. ","Because of this, most bile duct cancers are found after the cancer has grown big enough to cause problems (or symptoms)."
+"The most common symptom is jaundice, a yellowing of the skin and eyes, which is caused by a blocked bile duct.","The most common symptom is jaundice, when your skin and the white part of your eyes look yellow. This is caused by a clogged up bile duct."
+Original Text,Simplified Text
+Anything that increases your chance of getting a disease is called a risk factor. ,Anything that increases your chance of getting a disease is called a risk factor. 
+There are several risk factors associated with bile duct cancer . ,There are several risk factors associated with bile duct cancer . 
+"Not everyone with one or more of these risk factors will develop the disease, and the disease will develop in some people who don’t have any known risk factors. ",Not everyone with one or more of these risk factors will develop the disease. The disease may develop in some people who don’t have any known risk factors. 
+People who think they may be at risk should discuss this with their doctor. ,People who think they may be at risk should discuss this with their doctor. 
+"Risk factors for bile duct cancer include the following conditions: >primary sclerosing cholangitis (a progressive disease in which the bile ducts become blocked by inflammation and scarring) >chronic ulcerative colitis >cysts in the bile ducts (cysts block the flow of bile and can cause swollen bile ducts, inflammation, and infection ) >infection with a Chinese liver fluke parasite There are actions you can take that can help to decrease your risk of getting cancer. ","Risk factors for bile duct cancer include the following conditions: >primary sclerosing cholangitis (a progressive disease in which the bile ducts become blocked by inflammation and scarring). >chronic ulcerative colitis >cysts in the bile ducts (cysts block the flow of bile and can cause swollen bile ducts, inflammation, and infection ). >infection with a Chinese liver parasite (Fluke). There are actions you can take that can help to decrease your risk of getting cancer. "
+"To learn more about ways to prevent cancer, see Cancer Prevention Overview . ","To learn more about ways to prevent cancer, see Cancer Prevention Overview . "
+"If you would like to reproduce some or all of this content, see Reuse of NCI Information for guidance about copyright and permissions. ","If you would like to reproduce some or all of this content, see Reuse of NCI Information for guidance about copyright and permissions. "
+"In the case of permitted digital reproduction, please credit the National Cancer Institute as the source and link to the original NCI product using the original product's title; e.g., “Bile Duct Cancer Causes and Risk Factors was originally published by the National Cancer Institute.” ","In the case of permitted digital reproduction, please credit the National Cancer Institute as the source and link to the original NCI product using the original product's title; e.g., “Bile Duct Cancer Causes and Risk Factors was originally published by the National Cancer Institute.” "
+Want to use this content on your website or other digital platform? ,Want to use this content on your website or other digital platform? 
+Our syndication services page shows you how.,Our syndication services page shows you how.
+Original Text,Simplified Text
+Screening is the process of looking for cancer or pre-cancer in people who have no symptoms of the disease. ,Screening is looking for cancer or pre-cancer in people who are not having any problems.  
+Regular colorectal cancer screening is one of the most powerful tools against colorectal cancer. ,Getting screened a lot is one of the most important ways to keep from getting colorectal cancer.  This is called regular screening.
+"Screening can often find colorectal cancer early , when it's small, hasn't spread, and might be easier to treat. ","A lot of the time, screening can find colorectal cancer early, when it is small, has not moved to other parts of the body, and might be easier to take care of.  "
+Regular screening can even prevent colorectal cancer . ,Regular screening can even keep you from getting colorectal cancer. 
+A polyp can take as many as 10 to 15 years to develop into cancer. ,It can take up to 10 to 15 years for a polyp to turn into cancer.   
+"With screening, doctors can find and remove polyps before they have the chance to turn into cancer.","By screening, doctors can find and take out polyps before they have time to turn into cancer."
+Why is colorectal cancer screening important?,Why is colorectal cancer screening important?
+Colorectal cancer is a leading cause of cancer death in the US. ,Colorectal cancer is one of the top cancers that cause people to die in the US. 
+"But the death rate (the number of deaths per 100,000 people per year) of colorectal cancer has been dropping for several decades. ",But the number of people who die from colorectal cancer each year gets lower all the time.  
+One reason for this is that colorectal polyps are now more often found by screening and removed before they can develop into cancers. ,One reason for this is that now more colorectal polyps are found by screening and taken out before they can turn into cancers. 
+"When colorectal cancer is found at an early stage before it has spread, the 5-year relative survival rate is about 90%. ","When colorectal cancer is found very early and before it has spread, most people who get treatment for it will still be alive 5 years later.  "
+But only about 4 out of 10 colorectal cancers are found at this early stage. ,But only about 4 out of 10 colorectal cancers are found when they are that early.    
+"When cancer has spread outside the colon or rectum, survival rates are lower. ","When cancer has spread outside the colon or rectum, the number of people who will still be alive 5 years later is much smaller.  "
+"Unfortunately, about 1 in 3 people in the US who should get tested for colorectal cancer have never been screened. ",About 1 out of 3 people in the US who need to get tested for colorectal cancer have never been screened. 
+"This may be because they don't know that regular testing could save their lives from this disease, or due to things like cost and health insurance coverage issues. ",This may be because they don't know that screening could keep them from getting colorectal cancer.  It may also be because it costs too much and their health insurance does not cover it.  
+See Colorectal Cancer Screening Tests for more on the tests used to screen for colorectal cancer. ,See Colorectal Cancer Screening Tests for more on the tests used to screen for colorectal cancer. 
+American Cancer Society Recommendations for Colorectal Cancer Early Detection has our guidelines for using these tests to find colorectal cancer and polyps.,American Cancer Society Recommendations for Colorectal Cancer Early Detection has our guidelines for using these tests to find colorectal cancer and polyps.
+Original Text,Simplified Text
+"Your risk of getting colorectal cancer increases as you get older, but getting regular physical activity and keeping a healthy weight may help lower your risk. ",Your risk of getting colorectal cancer increases as you get older. Getting regular physical activity and keeping a healthy weight may help lower your risk. 
+Your risk of getting colorectal cancer increases as you get older. ,Your risk of getting colorectal cancer increases as you get older.
+Other risk factors include having— >Inflammatory bowel disease such as Crohn’s disease or ulcerative colitis. ,Other risk factors include having >Inflammatory bowel disease such as Crohn’s disease or ulcerative colitis. 
+>A personal or family history of colorectal cancer or colorectal polyps. ,>A personal or family history of colorectal cancer or colorectal polyps. 
+>A genetic syndrome such as familial adenomatous polyposis (FAP) or hereditary non-polyposis colorectal cancer (Lynch syndrome). ,>A genetic syndrome such as familial adenomatous polyposis (FAP) or hereditary non-polyposis colorectal cancer (Lynch syndrome). 
+Lifestyle factors that may contribute to an increased risk of colorectal cancer include,Lifestyle factors that may contribute to an increased risk of colorectal cancer include 
+>Lack of regular physical activity. ,>Lack of regular physical activity. 
+>A diet low in fruit and vegetables. ,>A diet low in fruit and vegetables. 
+">A low-fiber and high-fat diet, or a diet high in processed meats. ",">A low-fiber and high-fat diet, or a diet high in processed meats. "
+>Overweight and obesity. ,>Overweight and obesity. 
+>Alcohol consumption. ,>Alcohol consumption. 
+>Tobacco use.,>Tobacco use.
+Original Text,Simplified Text
+"Abdominal pain, aches, or cramps may be symptoms of colorectal cancer. ","Stomach pain, aches, or cramps might be problems caused by colorectal cancer. "
+"If you have any symptoms that worry you, be sure to see your doctor right away. ","If you have any of these problems and they are bothering you, be sure to see your doctor right away (now). "
+"Colorectal polyps (abnormal growths in the colon or rectum that can turn into cancer if not removed) and colorectal cancer don’t always cause symptoms, especially at first. ","Colorectal polyps (lumps in the colon or rectum that can turn into cancer if they are not taken out) and colorectal cancer don’t always cause problems (symptoms), especially when they start. "
+Someone could have polyps or colorectal cancer and not know it. ,Someone could have polyps or colorectal cancer and not know it. 
+That is why getting screened regularly for colorectal cancer is so important. ,Getting screened a lot is one of the most important ways to keep from getting colorectal cancer.  This is called regular screening and it is very important.
+"If you have symptoms, they may include— >A change in bowel habits. ",Some of the symptoms can be: >A change in how often you poop. 
+>Blood in or on your stool (bowel movement). ,>Blood in or on your poop (bowel movement). 
+">Diarrhea, constipation, or feeling that the bowel does not empty all the way. ",">Diarrhea, constipation (not being able to poop), or feeling that you did not finish pooping. "
+">Abdominal pain, aches, or cramps that don’t go away. ",">Stomach pain, aches, or cramps that don’t go away. "
+>Weight loss and you don’t know why. ,>If you lose weight and don’t know why. 
+"If you have any of these symptoms, talk to your doctor. ","If you have any of these symptoms, talk to your doctor. "
+They may be caused by something other than cancer. ,They may be caused by a problem other than cancer. 
+The only way to know what is causing them is to see your doctor.,The only way to know what is making them happen is to see your doctor.
+Original Text,Simplified Text
+"Because carcinoid tumors usually start out very small and grow and spread slowly, about half of all gastrointestinal carcinoid tumors are found in an early or localized stage, often before they cause any problems. ","Since most carcinoid tumors start out very small and grow and spread slowly, about half of all gastrointestinal carcinoid tumors are found early, or before they cause any problems. "
+Carcinoid tumors often are found by accident. ,Carcinoid tumors are found by accident a lot of the time. 
+These tumors aren’t causing any symptoms but are found when tests are done for other reasons or diseases. ,"These tumors aren’t causing any problems, but they are found by accident when the doctor orders tests for other reasons."
+They may also be found when parts of the gastrointestinal system are removed to treat other diseases. ,They can also be found when parts of the gastrointestinal system are taken out to treat other sicknesses. 
+"When patients have parts of their stomach or small intestine removed to treat other diseases, taking a close look in the microscope often shows small groups of neuroendocrine cells that look like tiny carcinoid tumors. ","When patients have parts of their stomach or small intestine taken out to treat other problems, sometimes small groups of cells that look like tiny carcinoid tumors can be seen with a microscope. "
+"Researchers still do not know why some tumors stay small, but others grow large enough to cause symptoms. ","People who study cancer still do not know why some tumors stay small, but others grow big enough to cause problems. "
+"For example, a person with stomach pain or bleeding may have a test called an upper endoscopy to look for an ulcer. ","For example, a person with stomach pain or bleeding may have a test called an upper endoscopy to look for an ulcer. "
+"In this test, the doctor looks at the stomach lining through a flexible lighted tube. ","In this test, the doctor looks at the inside of the stomach through a bendable tube with a light on it. "
+"During this test, the doctor might notice a small bump in the stomach wall that turns out to be a carcinoid tumor. ","During this test, the doctor might notice a small bump in the stomach wall that turns out to be a carcinoid tumor.  Another test doctors use is a colonoscopy.  In this test, a bendable tube with a light is used to look at the large bowel.  "
+"Sometimes during colorectal cancer screening, a routine sigmoidoscopy, or colonoscopy (looking at the large bowel through a flexible lighted tube) will incidentally find a small carcinoid tumor. ","Sometimes during colorectal cancer screening tests (like an endoscopy or colonoscopy), a small carcinoid tumor can be found by accident. "
+"Sometimes when the appendix is removed (to treat appendicitis or as part of a larger operation), a small carcinoid tumor is found at the tip. ","Sometimes when the appendix is taken out for another reason, a small carcinoid tumor is found at the tip. "
+This happens in about 1 of every 300 people who have appendix surgery. ,This happens to about 1 of every 300 people who have appendix surgery so not very much. 
+Most of these carcinoids were too small to have caused any symptoms.,Most of these carcinoids were too small to cause any problems.
+Original Text,Simplified Text
+It is often hard to find liver cancer early because signs and symptoms often do not appear until it is in its later stages. ,It is often hard to find liver cancer early because signs and symptoms often do not appear until it is in its later stages. 
+Small liver tumors are hard to detect on a physical exam because most of the liver is covered by the right rib cage. ,Small liver tumors are hard to detect on a physical exam because most of the liver is covered by the right rib cage. 
+"By the time a tumor can be felt, it might already be quite large. ","By the time a tumor can be felt, it might already be quite large. "
+"At this time, there are no widely recommended screening tests for liver cancer in people who are at average risk. ","At this time, there are no widely recommended screening tests for liver cancer in people who are at average risk. "
+(Screening means testing for cancer in people who have no symptoms or history of cancer.) ,(Screening means testing for cancer in people who have no symptoms or history of cancer.) 
+But testing might be recommended for some people at higher risk.,But testing might be recommended for some people at higher risk.
+Original Text,Simplified Text
+"Worldwide, liver cancer is the sixth most common cancer and the third leading cause of cancer death. ","In the whole world, liver cancer is ranked #6 on the list of cancers that most people have and #3 in the list of cancers that cause people to die.   "
+"In the United States, rates are highest in American Indian or Alaska Native individuals. ","In the United States, the people who get liver cancer the most are American Indian or Alaska Native people."
+Liver cancer is the sixth leading cause of cancer deaths in the United States.,Liver cancer is ranked #6 on the list of cancers that cause people to die in the United States.
+Liver cancer causes and risk factors,Liver cancer causes and risk factors
+"The most common type of liver cancer in adults, hepatocellular carcinoma (HCC), typically develops in people with chronic (long-lasting) liver disease caused by hepatitis virus infection or cirrhosis. ","Hepatocellular carcinoma (HCC) is the kind of liver cancer that most adults have.  Most of the time, it happens in people who have a bad liver caused by sickness that has been there a long time. "
+Men are more likely to develop HCC than women. ,Men usually have HCC more than women.
+People with multiple risk factors have an even higher risk. ,_______________________more of a chance of getting liver cancer.  These are called risk factors.  
+Many risk factors have been associated with liver cancer. ,People with more than one risk factor have an even bigger chance. 
+"Not everyone with one or more of these risk factors will develop the disease, and the disease will develop in some people who don’t have any known risk factors. ","Not everybody with one or more of these risk factors will get liver cancer, and some people can get liver cancer and not have any risk factors. "
+"Risk factors include the following: >Hepatitis B virus (HBV) infection : HBV can be transmitted in blood, semen , or other body fluids. ",Some risk factors are: >Hepatitis B virus (HBV) infection : HBV is a virus that you can get from someone else’s blood or other liquids that come from their body. 
+"The infection can be passed from mother to child during childbirth, through sexual contact, or by sharing needles that are used to inject drugs. ","HBV can be passed from a mother to her baby when the mother is having the baby, or through having sex, or using the same needle as someone else.  "
+It can cause inflammation (swelling) of the liver that leads to cancer. ,It can cause problems with the liver that can turn into cancer.   
+Routine HBV vaccination in infancy is reducing the incidence of HBV infection. ,Getting a shot for HBV when you are a baby can help keep you from getting HBV.   
+Chronic HBV infection is the leading cause of liver cancer in Asia and Africa. ,HBV is the #1 reason that people get liver cancer in Asia and Africa. 
+>Hepatitis C virus (HCV) infection : HCV can be transmitted in the blood. ,>Hepatitis C virus (HCV) infection : You can get HCV from someone else’s blood. 
+"The infection can be spread by sharing needles that are used to inject drugs or, less often, through sexual contact. ",You can get HCV by using the same needle as someone else or sometimes from having sex.  
+"In the past, it was also spread during blood transfusions or organ transplants . ",You used to have a chance of getting HCV by getting blood through a vein or during a kind of surgery called an organ transplant. 
+"Today, blood banks test all donated blood for HCV, which greatly lowers the risk of getting the virus from blood transfusions. ","Now, when a person gives blood, it is checked for HCV, and that means that there is less of a chance of someone getting the virus when they get blood through their vein.   "
+It can cause cirrhosis that may lead to liver cancer. ,HCV can cause a disease called cirrhosis that may cause liver cancer. 
+"Chronic HCV infection is the leading cause of liver cancer in North America, Europe, and Japan. ","HCV is the #1 reason that people get liver cancer in North America, Europe, and Japan. "
+">Cirrhosis : The risk of developing liver cancer is increased for people who have cirrhosis, a disease in which healthy liver tissue is replaced by scar tissue . ",">Cirrhosis : You have a bigger chance of getting liver cancer if you have cirrhosis, which is a disease where a healthy liver becomes unhealthy.  "
+The scar tissue blocks the flow of blood through the liver and keeps it from working as it should. ,"When the liver becomes unhealthy, blood cannot get to the liver and it stops working like it should.  "
+Chronic alcoholism and chronic hepatitis infections are common causes of cirrhosis. ,Drinking too much alcohol and having infections in your liver can be reasons for getting cirrhosis. 
+People with HCV-related cirrhosis have a higher risk of developing liver cancer than people with cirrhosis related to HBV or alcohol use. ,People with cirrhosis that is caused by HCV will have a bigger chance of getting liver cancer than people who have cirrhosis caused by alcohol or HBV.
+>Heavy alcohol use : ,>Drinking too much alcohol:  
+"Heavy alcohol use can cause cirrhosis, which is a risk factor for liver cancer. ","Drinking too much alcohol can cause cirrhosis, which gives you a bigger chance of getting liver cancer.  "
+Liver cancer can also occur in heavy alcohol users who do not have cirrhosis. ,People who drink too much alcohol and do not have cirrhosis can still get liver cancer. 
+"Heavy alcohol users who have cirrhosis are ten times more likely to develop liver cancer, compared with heavy alcohol users who do not have cirrhosis. ",People who drink too much alcohol and have cirrhosis have a much bigger chance of getting liver cancer than people who drink too much and do not have cirrhosis. 
+Studies have shown there is also an increased risk of liver cancer in people with HBV or HCV infection who use alcohol heavily. ,Some people who study cancer believe that people with HBV or HCV who drink a lot of alcohol have a bigger chance of getting liver cancer.  
+">Aflatoxin B1 : The risk of developing liver cancer may be increased by eating foods that contain aflatoxin B1 (poison from a fungus that can grow on foods, such as corn and nuts, that have been stored in hot, humid places). ",">Aflatoxin B1 : Eating foods that have aflatoxin B1 in them can give you a bigger chance of getting liver cancer.  Aflatoxin is poisonous and can grow on foods, corn and nuts, that have been kept in hot, steamy places.  "
+"It is most common in sub-Saharan Africa, Southeast Asia, and China. ","This happens most in sub-Saharan Africa, Southeast Asia, and China. "
+>Nonalcoholic steatohepatitis (NASH) : ,>Nonalcoholic steatohepatitis (NASH) : 
+NASH is a condition that can cause cirrhosis that may lead to liver cancer. ,NASH is a problem that can cause cirrhosis which can lead to liver cancer. 
+"It is the most severe form of nonalcoholic fatty liver disease, where there is an abnormal amount of fat in the liver. ","NASH is the worst kind of nonalcoholic (not caused by alcohol) fatty liver disease, where there is too much fat in the liver. "
+"In some people, this can cause inflammation and injury to the cells of the liver. ","In some people, this can hurt the liver.   "
+Having NASH-related cirrhosis increases the risk of developing liver cancer. ,People who have the NASH kind of cirrhosis have a bigger chance of getting liver cancer. 
+Liver cancer has also been found in people with NASH who do not have cirrhosis. ,People who have NASH who do not have cirrhosis can also get liver cancer. 
+>Cigarette smoking : Cigarette smoking has been linked to a higher risk of liver cancer. ,>Smoking Cigarettes can give you a bigger chance of getting liver cancer. 
+The risk increases with the number of cigarettes smoked per day and the number of years the person has smoked. ,It depends on the number of cigarettes that a person smokes each day and for how many years.  
+>Other conditions : Certain rare medical and genetic conditions may increase the risk of liver cancer. ,>Some other problems can give you a bigger chance of getting liver cancer. 
+These conditions include the following:,These problems are:
+>untreated hereditary hemochromatosis ,>untreated hereditary hemochromatosis 
+>alpha-1 antitrypsin deficiency ,>alpha-1 antitrypsin deficiency 
+>glycogen storage disease ,>glycogen storage disease 
+>porphyria cutanea tarda ,>porphyria cutanea tarda 
+>Wilson disease,>Wilson disease
+Liver cancer prevention,Liver cancer prevention
+Cancer prevention is action taken to lower the chance of getting cancer. ,Cancer prevention = things that you can do to help keep you from getting cancer. 
+"By preventing cancer, the number of new cases of cancer in a group or population is lowered. ","By doing these things, the number of people who get cancer will be lower.   "
+"Hopefully, this will lower the number of deaths caused by cancer. ",The hope is that this will also lower the number of people who die from cancer. 
+Anything that increases your chance of getting cancer is called a risk factor. ,Anything that gives you a bigger chance of getting cancer is called a risk factor. 
+Anything that lowers your chance of getting cancer is called a cancer protective factor. ,Anything that gives you a smaller chance of getting cancer is called a protective factor. 
+Prevention includes avoiding risk factors and increasing protective factors. ,Part of Prevention is keeping away from risk factors and trying to do more protective factors. 
+The following are protective factors for liver cancer: >Getting the hepatitis B vaccine : ,These are protective factors to help keep you from getting liver cancer: >Get the hepatitis B vaccine: 
+Preventing HBV infection (by being vaccinated for HBV as a newborn) has been shown to lower the risk of liver cancer in children. ,Giving the HBV vaccine to babies can lower the chance of them getting liver cancer when they are a child.  
+It is not yet known if being vaccinated lowers the risk of liver cancer in adults. ,But we do not know yet if that will lower the chance of them getting liver cancer when they are an adult.  
+>Getting treatment for chronic hepatitis B infection : Treatment options for people with chronic HBV infection include interferon and nucleos(t)ide analog therapy. ,>Get treatment for chronic hepatitis B infection: Different kinds of treatment for people with chronic HBV infection are interferon and nucleos(t)ide analog therapy. 
+These treatments may reduce the risk of developing liver cancer. ,These treatments can help lower the chance of getting liver cancer. 
+>Reducing exposure to aflatoxin B1 : Replacing foods that contain high amounts of aflatoxin B1 with foods that contain a much lower level of the poison can reduce the risk of liver cancer.,">Make sure you don’t eat foods that have a lot of aflatoxin B1 in them.  Instead, eat foods with a much smaller about of the poison in them.  This can lower the chance of getting liver cancer."
+Original Text,Simplified Text
+Pancreatic cancer is hard to find early. ,Pancreatic cancer is hard to find early. 
+"The pancreas is deep inside the body, so early tumors can’t be seen or felt by health care providers during routine physical exams. ",The pancreas is deep inside the body. Early tumors can’t be seen or felt by health care providers during routine physical exams. 
+People usually have no symptoms until the cancer has become very large or has already spread to other organs. ,People usually have no symptoms until the cancer has become very large or has spread to other organs. 
+"For certain types of cancer, screening tests or exams are used to look for cancer in people who have no symptoms (and who have not had that cancer before). ",There are screening tests or exams that are used to look for cancer in people who have no symptoms (and who have not had that cancer before). 
+"But for pancreatic cancer, no major professional groups currently recommend routine screening in people who are at average risk. ","But for pancreatic cancer, there are currently no recommended routine screening in people who are at average risk. "
+This is because no screening test has been shown to lower the risk of dying from this cancer.,This is because no screening test has been shown to lower the risk of dying from this cancer.
+Genetic testing for people who might be at increased risk,Genetic testing for people who might be at increased risk
+Some people might be at increased risk of pancreatic cancer because of a family history of the disease (or a family history of certain other cancers). ,Some people might be at increased risk of pancreatic cancer because of a family history of the disease (or a family history of certain other cancers). 
+Sometimes this increased risk is due to a specific genetic syndrome . ,Sometimes this increased risk is due to a specific genetic change. 
+Genetic testing looks for the gene changes that cause these inherited conditions and increase pancreatic cancer risk. ,Genetic testing looks for the gene changes that cause these inherited conditions and increase pancreatic cancer risk. 
+"The tests look for these inherited conditions, not pancreatic cancer itself. ","Your risk may be increased if you have one of these conditions, but it doesn’t mean that you have (or definitely will get) pancreatic cancer. "
+"Your risk may be increased if you have one of these conditions, but it doesn’t mean that you have (or definitely will get) pancreatic cancer. ","Knowing if you are at increased risk can help you and your doctor make decisions on screening. Screening before symptoms occur, when it might be easier to treat. "
+"Knowing if you are at increased risk can help you and your doctor decide if you should have tests to look for pancreatic cancer early, when it might be easier to treat. ",Determining whether you might be at increased risk is not a simple process. 
+"The American Cancer Society strongly recommends that anyone thinking about genetic testing talk with a genetic counselor, nurse, or doctor (qualified to interpret and explain the test results) before getting tested. ","The American Cancer Society has strong recommendations for anyone thinking about genetic testing. This includes talking with a genetic counselor, nurse, or doctor (qualified to interpret and explain the test results) before getting tested. "
+"It’s important to understand what the tests can − and can’t − tell you, and what any results might mean, before deciding to be tested.","It’s important to understand what the tests can − and can’t − tell you, and what any results might mean, before deciding to be tested."
+Testing for pancreatic cancer in people at high risk,Testing for pancreatic cancer in people at high risk
+"For people in families at high risk of pancreatic cancer, newer tests for detecting pancreatic cancer early may help. ","For people in families at high risk of pancreatic cancer, newer tests for detecting pancreatic cancer early may help. "
+The two most common tests used are an endoscopic ultrasound or MRI. ,The two most common tests used are an endoscopic ultrasound or MRI. 
+(See Tests for Pancreatic Cancer .) ,(See Tests for Pancreatic Cancer .) 
+"These tests are not used to screen the general public, but might be used for someone with a strong family history of pancreatic cancer or with a known genetic syndrome that increases their risk. ",These tests are not used to screen the general public. But might be used with a strong family history of pancreatic cancer or with a known genetic syndrome that increases their risk. 
+"Doctors have been able to find early, treatable pancreatic cancers in some members of high-risk families with these tests. ","Doctors have been able to find early, treatable pancreatic cancers in some members of high-risk families with these tests. "
+Doctors are also studying other new tests to try to find pancreatic cancer early. ,Doctors are also studying other new tests to try to find pancreatic cancer early. 
+(See What's New in Pancreatic Cancer Research? ) ,(See What's New in Pancreatic Cancer Research? ) 
+Interested families at high risk may wish to take part in studies of these new screening tests.,Interested families at high risk may wish to take part in studies (clinical trials) of these new screening tests.
+Original Text,Simplified Text
+Screening is testing for diseases like cancer in people who do not have any symptoms. ,Screening is testing for diseases like cancer in people who do not have any symptoms. 
+"Screening tests can find some types of cancer early, when treatment is most likely to be effective. ",Screening tests can find some types of cancer early when treatment is most likely to be effective. 
+"But small intestine adenocarcinomas are rare, and no effective screening tests have been found for these cancers, so routine testing for people without any symptoms is not recommended.","Small intestine cancers are rare, and no effective screening tests have been found for these cancers. Routine testing for people without any symptoms is not recommended."
+For people at high risk,For people at high risk
+"For people with certain inherited genetic syndromes who are at increased risk of small intestine cancer, doctors might recommend regular tests to look for cancer early, especially in the duodenum (the first part of the small intestine). ",Some people with certain inherited genetic syndromes are at increased risk of small intestine cancer.  Doctors may recommend regular tests to look for this cancer before symptoms are present. Especially for disease in the duodenum (the first part of the small intestine). 
+"Tests that might be done include upper endoscopy (in which a long tube with a tiny video camera on the end is passed down the throat, through the stomach, and into the duodenum), CT scans, and endoscopic ultrasound (EUS). ","Tests that might be done include >upper endoscopy (in which a long tube with a tiny video camera on the end is passed down the throat, through the stomach, and into the duodenum). >CT scans. >endoscopic ultrasound (EUS). "
+See Tests for Small Intestine Cancer (Adenocarcinoma) to learn more about these tests.,See Tests for Small Intestine Cancer (Adenocarcinoma) to learn more about these tests.
+Original Text,Simplified Text
+"Screening is testing for a disease, such as cancer, in people without symptoms. ","Screening is checking for disease, like cancer, in people who are not having any problems."
+"Some of the tests that can be used to screen for stomach cancer (also known as gastric cancer), such as upper endoscopy, are described in Tests for Stomach Cancer .","Some of the tests that doctors can use to screen people for stomach cancer (also known as gastric cancer), like upper endoscopy, are talked about in Tests for Stomach Cancer ."
+Stomach cancer screening in people at average risk,Stomach cancer screening in people at average risk
+No major medical organizations in the United States recommend routine screening for stomach cancer in people at average risk. ,Most groups of doctors agree that you should not have routine screening for stomach cancer if you do not have problems that would give you a bigger chance of getting it.  
+"This is largely because this disease isn’t common in the US, so the benefits of screening most likely would not outweigh the possible harms (such as needing additional tests or procedures, even in some people who might not end up having stomach cancer). ","This is mostly because this cancer does not happen very often in the US, so getting the screening tests would probably cause more bad than good."
+"Because routine screening for stomach cancer is not done in the United States, most people are not diagnosed with stomach cancer until they have certain signs and symptoms that point to the need for medical tests. ","Because routine screening for stomach cancer is not done in the United States, most people do not find out they have stomach cancer until they are having problems and need to have tests.   "
+"In some countries in East Asia and South America, where stomach cancer is much more common, mass screening of the population has helped find many stomach cancers at an early, possibly more curable stage. ","In some countries in East Asia and South America, where many more people have stomach cancer, it has been helpful to do more routine screening to find more stomach cancers when they are just starting and might be cured. "
+"However, it’s not clear if this has led to a lower number of stomach cancer deaths.","But, no one is sure if this will help lower the number of people who die from stomach cancer."
+Stomach cancer screening in people at increased risk,Stomach cancer screening in people at increased risk
+"The benefits of screening might outweigh the risks in some people who are at increased risk for stomach cancer because they have certain risk factors (for example, certain potentially pre-cancerous stomach conditions or inherited conditions such as Lynch syndrome or familial adenomatous polyposis [FAP]). ",It might be helpful to screen people who have risk factors that give them a bigger chance of getting stomach cancer.  Some of these factors are potentially pre-cancerous stomach conditions or inherited conditions such as Lynch syndrome or familial adenomatous polyposis [FAP]). 
+"For example, upper endoscopy might be recommended at regular intervals in these people. ",People with these risk factors might need to get endoscopies when their doctor says they should. 
+"If you have risk factors that might increase your risk of stomach cancer, talk to your doctor about the possible pros and cons of stomach cancer screening for you. ","If you have risk factors that might give you a bigger chance of getting stomach cancer, talk to your doctor to see if you need to have cancer screening.  "
+Screening isn't usually recommended for people in families with hereditary diffuse gastric cancer (HDGC). ,"Most of the time, doctors do not think that people in families with hereditary diffuse gastric cancer (HDGC) need to have screening tests.  "
+"Instead, doctors often recommend that people who have changes in the CDH1 gene that causes this syndrome consider having their stomach removed (total gastrectomy), because their risk of stomach cancer is very high.","But, a lot of the time, doctors want people who have changes in the CDH1 gene that causes this syndrome to think about having their stomach taken out (total gastrectomy), because their chance of getting stomach cancer is very big."
+Original Text,Simplified Text
+"Stomach cancer is caused by certain changes to the way stomach cells function, especially how they grow and divide into new cells. ","Stomach cancer is caused by changes in stomach cells, mostly how they grow and split into new cells. "
+"There are many risk factors for stomach cancer, but many do not directly cause cancer. ","There are a lot of risk factors for stomach cancer, but a lot of them do not actually cause cancer. "
+"Instead, they increase the chance of DNA damage in cells that may lead to stomach cancer. ","But, they give you a bigger chance of having changes in your cells that can turn in to stomach cancer. "
+"To learn more about how cancer develops, see What Is Cancer? . ","To learn more about how cancer develops, see What Is Cancer? . "
+A risk factor is anything that increases the chance of getting a disease. ,A risk factor is anything that gives you a bigger chance of getting a disease (sickness). 
+"Some risk factors for stomach cancer, like tobacco use, can be changed. ","Some risk factors for stomach cancer, like using tobacco, can be changed. "
+"However, risk factors also include things people cannot change, like their age and family history . ","But, risk factors can also be things people cannot change, like their age and sicknesses in their family. "
+Learning about risk factors for stomach cancer is important because it can help you make choices that might prevent or lower your risk of getting it.,Learning about risk factors for stomach cancer is important because it can help you make choices (or do things) that might keep you from or give you a smaller chance of getting it.
+Who gets stomach cancer,Who gets stomach cancer
+Stomach cancer is the fifth most common cancer worldwide. ,Stomach cancer is ranked #5 on the list of cancers that most people have.
+"It is more common in countries in East Asia, Eastern Europe, and South and Central America than in the United States and other Western countries. ","It happens more in countries in East Asia, Eastern Europe, and South and Central America than in the United States and other Western countries. "
+Anyone can get stomach cancer. ,Anybody can get stomach cancer. 
+"In the United States, the disease occurs more often among Black, Hispanic, Asian/Pacific Islander, and American Indian/Alaska Native individuals than among White individuals. ","In the United States, the disease happens more in Black, Hispanic, Asian/Pacific Islander, and American Indian/Alaska Native people than in White people. "
+"Males are nearly twice as likely as females to be diagnosed with stomach cancer, and Black males are nearly twice as likely as White males to die of it. ",Men get it more than women and Black men get it more than White men.   
+"In recent years, stomach cancer rates have been increasing in younger females, particularly among Hispanic females. ","In these past few years, the number of people who are getting stomach cancer has grown in younger women, mostly Hispanic women.  "
+"Stomach cancer can be diagnosed at any age, but the risk increases as a person gets older.","You can get stomach cancer at any age, but your chances of getting it gets bigger as you get older."
+Risk factors for stomach cancer,Risk factors for stomach cancer
+There are several risk factors for stomach cancer. ,There are some risk factors for stomach cancer. 
+Different risk factors may increase the risk of cancer in different parts of the stomach. ,Some risk factors can give you more of a chance of cancer in different parts of the stomach.  
+"For example, Helicobacter pylori (H. pylori) infection increases the risk of cancer in the lower and middle part of the stomach, while obesity and gastroesophageal reflux disease (GERD) increase the risk of cancer in the upper stomach.","Like, Helicobacter pylori (H. pylori) infection gives you more of a chance of getting cancer in the bottom and middle part of the stomach, and being too big and having gastroesophageal reflux disease (GERD) gives you more of a chance in upper stomach."
+H. pylori infection,H. pylori infection
+Chronic infection of the mucosal layer of the stomach with H. pylori is a major risk factor for stomach cancer. ,H. pylori infection in the wall of the stomach that does not get better is a big risk factor for stomach cancer. 
+"This bacterium spreads from person to person through direct contact with saliva, vomit, or stool. ","You can get this infection from someone who has the infection by touching their spit, throw-up or poop. "
+"Although many people with chronic H. pylori infections do not have symptoms, some develop stomach ulcers or an inflammation of the stomach called atrophic gastritis. ","Many people who have had H. pylori infection for a long time do not have problems, but some get stomach ulcers or a swollen stomach called atrophic gastritis. "
+"In some people, atrophic gastritis leads to increasingly severe changes in the stomach lining and eventually to stomach cancer or gastric MALT lymphoma (see What Is Stomach Cancer? ). ","In some people, atrophic gastritis can cause big changes in the wall of the stomach and can later turn into stomach cancer or gastric MALT lymphoma.   "
+Treatment of H. pylori infections reduces the risk of these types of stomach cancer.,Getting treatment for H. pylori infections gives you a small chance of getting one of these types of stomach cancer.
+Other medical conditions,Other medical conditions
+The risk of stomach cancer is increased in people who have ,The chance of getting stomach cancer is bigger in people who have 
+>chronic atrophic gastritis (thinning of the stomach lining caused by long-term inflammation of the stomach) ,>chronic atrophic gastritis (change in the wall of the stomach caused by swelling of the stomach that has been there a long time)
+>atrophic gastritis with intestinal metaplasia (a condition in which the cells that line the stomach are replaced by cells that normally line the intestines) ,>atrophic gastritis with intestinal metaplasia (when the cells that are in the wall of the stomach are switched out by cells that are normally in the wall of the intestines)  
+>Epstein-Barr virus infection ,>Epstein-Barr virus infection 
+">pernicious anemia (an autoimmune condition in which the intestines can’t properly absorb vitamin B12 , resulting in a low red blood cell count) ",>pernicious anemia (a disease where the intestines can’t take in vitamin B12 like they should which causes a low red blood cell count) 
+>obesity (excess body weight) ,>obesity (weighing too much or being too big) 
+>gastroesophageal reflux disease (a condition in which stomach acid repeatedly flows back into the esophagus),>gastroesophageal reflux disease (when the acid in the stomach keeps going back up into the esophagus).
+Genetics and family history,Genetics and family history
+"The risk of stomach cancer is increased, sometimes to very high levels, in people who have ",The chance of getting stomach cancer can be higher or very high in people who have 
+">a first-degree relative (parent, sibling, or child) who has had stomach cancer ",">a first-degree relative (mom/dad, brother/sister, or son/daughter) who has had stomach cancer."
+>familial adenomatous polyposis ,>familial adenomatous polyposis 
+">familial intestinal gastric cancer (FIGC), a type of stomach cancer that runs in families but does not have a known genetic cause ",">familial intestinal gastric cancer (FIGC), a kind of stomach cancer that people in the same family can have but the reason is not known.  "
+>gastric adenocarcinoma and proximal polyposis of the stomach (GAPPS) ,>gastric adenocarcinoma and proximal polyposis of the stomach (GAPPS) 
+"(To learn more, see GAPPS .) ","(To learn more, see GAPPS .) "
+">hereditary diffuse gastric cancer (HDGC) (To learn more, see HDGC .) ",">hereditary diffuse gastric cancer (HDGC) (To learn more, see HDGC .) "
+>juvenile polyposis syndrome ,>juvenile polyposis syndrome 
+>Li-Fraumeni syndrome ,>Li-Fraumeni syndrome 
+>Lynch syndrome (also called hereditary nonpolyposis colon cancer and HNPCC) ,>Lynch syndrome (also called hereditary nonpolyposis colon cancer and HNPCC) 
+>Peutz-Jeghers syndrome ,>Peutz-Jeghers syndrome 
+">Type A blood (To learn more, see the MedlinePlus page on blood types .)",">Type A blood (To learn more, see the MedlinePlus page on blood types .)"
+Diet,Diet
+"Eating a diet that is low in fruits and vegetables or that is high in salted, smoked, or poorly preserved foods may increase the risk of stomach cancer.","Not eating enough fruits and vegetables or eating foods that are salty, smoked or not kept fresh can give you a bigger chance of getting stomach cancer."
+Tobacco use,Tobacco use
+People who smoke have a higher risk of stomach cancer than nonsmokers. ,People who smoke have a bigger chance of getting stomach cancer than people who do not smoke. 
+Smoking also makes treatment for H. pylori infection less effective. ,Smoking also makes treatment for H. pylori infection not work as well.   
+Smokers who stop smoking lower their risk of having stomach cancer over time. ,Smokers who stop smoking can have a smaller and smaller chance of having stomach cancer the longer they don’t smoke.  
+Learn about different tools to help you quit smoking and how to use them.,Learn about different tools to help you quit smoking and how to use them.
+Environmental and occupational exposures,Environmental and occupational exposures
+The risk of stomach cancer is increased in people who ,The chance of getting stomach cancer is bigger in people who
+>work in the rubber or coal industry ,>work in the rubber or coal business 
+>have been exposed to very high levels of radiation ,>have worked around high levels of (or a lot of) radiation 
+Having one or more of these risk factors does not necessarily mean you will get stomach cancer. ,Just because you have one or more of these risk factors doesn’t mean that you will definitely get stomach cancer.  
+"Many people with risk factors never develop stomach cancer, whereas others with no known risk factors do. ","A lot of people with risk factors never get stomach cancer, but others with no risk factors (that they know about) do. "
+Talk with your doctor if you think you might be at increased risk. ,Talk to your doctor if you think you might have a bigger chance of getting stomach cancer.  
+"Stomach cancer screening or preventive surgery may be available to people at very high risk of stomach cancer, such as those with certain genetic conditions or family histories. ",People who have a very big chance of getting stomach cancer (like people who have genetic problems or family members with cancer) might be able to get checked for stomach cancer or have surgery that will keep them from getting stomach cancer.   
+Learn about stomach cancer screening .,Learn about stomach cancer screening .

val.csv

@@ -0,0 +1,295 @@
+Expert,Simple
+Intrahepatic bile duct cancers,Intrahepatic bile duct cancers
+These cancers start in the smaller bile duct branches inside the liver. ,These cancers start in the smaller bile duct branches inside the liver. 
+"Sometimes they're confused with cancers that start in the liver cells ( hepatocellular carcinomas ), and they are often treated the same way.","Sometimes they are confused with cancers that start in the liver cells ( hepatocellular carcinomas ), and they usually get the same treatment."
+Perihilar (also called hilar) bile duct cancers,Perihilar (also called hilar) bile duct cancers
+"These cancers start at the hilum, where the left and right hepatic ducts have joined and are just leaving the liver. ","These cancers start at the hilum, where the left and right hepatic ducts have joined and are just leaving the liver. "
+These are also called Klatskin tumors. ,These cancers are also called Klatskin tumors. 
+These cancers are grouped with distal bile duct cancers as extrahepatic bile duct cancers .,These cancers are grouped with distal bile duct cancers as extrahepatic bile duct cancers .
+Distal bile duct cancers,Distal bile duct cancers
+"These cancers are found farther down the bile duct, closer to the small intestine. ","These cancers are found farther down the bile duct, closer to the small intestine. "
+"Like perihilar cancers, these are extrahepatic bile duct cancers because they start outside of the liver. ","Like perihilar cancers, these are extrahepatic bile duct cancers because they start outside of the liver. "
+Cancers that start in different parts of the bile ducts can cause different symptoms .,Cancers that start in different parts of the bile ducts can cause different symptoms .
+Types of bile duct cancer by cell type,Types of bile duct cancer by cell type
+Bile duct cancers can also be divided into types based on how the cancer cells look under the microscope. ,Bile duct cancers can also be divided into types based on how the cancer cells look under the microscope. 
+Nearly all bile duct cancers are cholangiocarcinomas . ,Nearly all bile duct cancers are cholangiocarcinomas . 
+"These cancers are a type of adenocarcinoma, which is a cancer that starts in gland cells. ","These cancers are a type of adenocarcinoma, which is a cancer that starts in gland cells. "
+Cholangiocarcinomas start in the gland cells that line the inside of the ducts. ,Cholangiocarcinomas start in the gland cells that line the inside of the ducts in or near the liver. 
+Other types of bile duct cancers are much less common. ,Other types of bile duct cancers are much less common. 
+"These include sarcomas, lymphomas, and small cell cancers. ","These include sarcomas, lymphomas, and small cell cancers. "
+Our information does not cover these rare types of bile duct cancer.,Our information does not cover these rare types of bile duct cancer.
+Benign bile duct tumors,Benign bile duct tumors
+Not all bile duct tumors are cancer. ,Not all bile duct tumors are cancer. 
+"For example, bile duct hamartomas and bile duct adenomas are types of benign (non-cancer) tumors.","For example, bile duct hamartomas and bile duct adenomas are types of benign (non-cancer) tumors."
+Other cancers in the liver,Other cancers in the liver
+The most common type of cancer that starts in the liver – much more common than cholangiocarcinoma – is hepatocellular carcinoma . ,The most common type of cancer that starts in the liver is hepatocellular carcinoma . 
+This type of cancer starts in the main cells that make up the liver. ,This type of cancer starts in the main cells that make up the liver. 
+"Cancers that start in other organs, such as the colon or rectum, can sometimes spread (metastasize) to the liver. ","Cancers that start in other organs, such as the colon or rectum, can sometimes spread (metastasize) to the liver. "
+These metastatic cancers are not true liver cancers. ,These metastatic cancers are not true liver cancers. 
+"For example, colorectal cancer that has spread to the liver is still colorectal cancer, not liver cancer. ","For example, colorectal cancer that has spread to the liver is still colorectal cancer, not liver cancer. "
+The treatment and outlook for cancer that metastasizes to the liver is not the same as for a cancer that starts in the liver. ,The treatment and outlook for cancer that metastasizes to the liver is not the same as for a cancer that starts in the liver. 
+"For this reason, it’s important to know whether a tumor in the liver started in bile ducts (cholangiocarcinoma), the liver tissue itself (hepatocellular carcinoma), or another organ and has spread to the liver.","For this reason, it’s important to know whether a tumor in the liver started in bile ducts (cholangiocarcinoma), the liver tissue itself (hepatocellular carcinoma), or another organ and has spread to the liver."
+Colorectal cancer starts in the colon or the rectum. ,Colorectal cancer starts in the gut (colon) or the (bowels)rectum. 
+"These cancers can also be called colon cancer or rectal cancer, depending on where they start. ","These cancers can also be called colon cancer or rectal cancer, depending on where they start. "
+Colon cancer and rectal cancer are often grouped together because they have many features in common. ,Colon cancer and rectal cancer are often grouped together because they have many features in common. 
+Cancer starts when cells in the body start to grow out of control. ,Cancer starts when cells in the body start to grow out of control. 
+"To learn more about how cancers start and spread, see What Is Cancer?","To learn more about how cancers start and spread, see What Is Cancer?"
+The colon and rectum,The colon and rectum
+"To understand colorectal cancer, it helps to know about the normal structure and function of the colon and rectum. ","To learn more about colorectal cancer, it helps to know about what the colon and rectum look like and what they do.  "
+"The colon and rectum make up the large intestine (or large bowel), which is part of the digestive system, also called the gastrointestinal (GI) system (see illustration below). ","The colon and rectum make up the large intestine (or large bowel). Which is part of the digestive system, also called the gastrointestinal (GI) system which breaks down and absorbs the food/liquids that you eat. (see illustration below). "
+"Most of the large intestine is made up of the colon, a muscular tube about 5 feet (1.5 meters) long. ","Most of the colon is made up of the large intestine, a muscular tube about 5 feet (1.5 meters) long. "
+The parts of the colon are named by which way the food is traveling through them. ,The parts of the colon are named by which way the food is traveling through them. 
+>The first section is called the ascending colon . ,>The first part is called the ascending colon . 
+"It starts with a pouch called the cecum, where undigested food comes in from the small intestine. ","It starts with a pouch called the cecum, where food that has not been completely broken down (undigested) comes into the large intestines from the small intestine. "
+It continues upward on the right side of the abdomen (belly). ,It continues travel upward (ascending) on the right side of the abdomen (belly). 
+>The second section is called the transverse colon. It goes across the body from the right to the left side. ,>The second section is called the transverse colon. It goes across the body from the right to the left side. 
+>The third section is called the descending colon because it descends (travels down) on the left side. ,>The third section is called the descending colon because it descends (travels down) on the left side. 
+>The fourth section is called the sigmoid colon because of its “S” shape. ,>The fourth section is called the sigmoid colon because it is shaped like the letter “S”. 
+"The sigmoid colon joins the rectum, which then connects to the anus. ",The sigmoid colon is attached to your rectum which connects to your anus. 
+The ascending and transverse sections together are called the proximal colon . ,The parts that go up the right side and across your belly are called the proximal colon . 
+The descending and sigmoid colon are called the distal colon .,The part that goes down the left side and the part shaped like an “S” are called the distal colon .
+How do the colon and rectum work?,How do the colon and rectum work?
+The colon absorbs water and salt from the remaining food matter after it goes through the small intestine (small bowel). ,The colon large intestines) absorbs water and salt from the remaining food matter after it goes through the small intestine (small bowel). 
+"The waste matter that's left after going through the colon goes into the rectum , the final 6 inches (15cm) of the digestive system. ","The waste matter that's left after going through the colon goes into the rectum , the final 6 inches of the digestive system. "
+It's stored there until it passes through the anus . ,It's stored there until it passes through the anus in the form of a bowel movement or stool. . 
+Ring-shaped muscles (also called a sphincter ) around the anus keep stool from coming out until they relax during a bowel movement.,Ring-shaped muscles (also called a sphincter ) around the anus keep stool from coming out until they relax during a bowel movement.
+How does colorectal cancer start?,How does colorectal cancer start?
+Polyps in the colon or rectum,Polyps in the colon or rectum
+Most colorectal cancers start as a growth on the inner lining of the colon or rectum. ,Most colorectal cancers start as a growth on the inner lining of the colon or rectum. 
+These growths are called polyps . ,These growths are called polyps . 
+"Some types of polyps can change into cancer over time (usually many years), but not all polyps become cancer. ","Some types of polyps can change into cancer over time (usually many years), but not all polyps become cancer. "
+The chance of a polyp turning into cancer depends on the type of polyp it is. ,The chance of a polyp turning into cancer depends on the type of polyp it is. 
+There are different types of polyps. ,There are different kinds of polyps. 
+>Adenomatous polyps (adenomas): These polyps sometimes change into cancer. ,>Adenomatous polyps (adenomas): These polyps sometimes change into cancer. 
+"Because of this, adenomas are called a pre-cancerous condition . ","Because they can turn into cancer, adenomas are called pre-cancerous."
+"The 3 types of adenomas are tubular, villous, and tubulovillous. ","There are 3 types of adenomas are tubular, villous, and tubulovillous. "
+">Hyperplastic polyps and inflammatory polyps: These polyps are more common, but in general they are not pre-cancerous. ",Sessile serrated polyps (SSP) and traditional serrated adenomas (TSA): These polyps are often treated like adenomas because they have a higher risk of colorectal cancer.
+Some people with large (more than 1cm) hyperplastic polyps might need colorectal cancer screening with colonoscopy more often. ,Some people with large (more than 1cm) hyperplastic polyps might need colorectal cancer screening with colonoscopy more often. 
+>Sessile serrated polyps (SSP) and traditional serrated adenomas (TSA): These polyps are often treated like adenomas because they have a higher risk of colorectal cancer. ,>Sessile serrated polyps (SSP) and traditional serrated adenomas (TSA): These polyps are often treated like adenomas because they have a higher risk of colorectal cancer. 
+Other factors that can make a polyp more likely to contain cancer or increase someone’s risk of developing colorectal cancer include: ,These things might mean that a polyp can turn in to colorectal cancer: 
+>If a polyp larger than 1 cm is found ,>If a polyp larger than 1 cm is found.
+>If more than 3 polyps are found ,>If more than 3 polyps are found 
+>If dysplasia is seen in the polyp after it's removed. ,>If dysplasia (pre-cancer cells) is found in the polyp after it has been taken out.   
+Dysplasia is another pre-cancerous condition. ,Dysplasia is another pre-cancerous condition. 
+"It means there's an area in a polyp or in the lining of the colon or rectum where the cells look abnormal, but they haven't become cancer. ","It means there's an area in a polyp or in the lining of the colon or rectum where the cells look abnormal, but they haven't become cancer. "
+"For more details on the types of polyps and conditions that can lead to colorectal cancer, see Understanding Your Pathology Report: Colon Polyps .","For more details on the types of polyps and conditions that can lead to colorectal cancer, see Understanding Your Pathology Report: Colon Polyps ."
+How colorectal cancer spreads,How colorectal cancer spreads
+"If cancer forms in a polyp, it can grow into the wall of the colon or rectum over time. ","If cancer forms in a polyp, it can grow into the wall of the colon or rectum over time. "
+The wall of the colon and rectum is made up of many layers. ,The wall of the colon and rectum is made up of many layers. 
+Colorectal cancer starts in the innermost layer (the mucosa) and can grow outward through some or all of the other layers (see picture below). ,"Colorectal cancer starts in the inner layer called the mucosa, and can grow outward through some or all of the other layers of the colon (see picture below). "
+"When cancer cells are in the wall, they can then grow into blood vessels or lymph vessels (tiny channels that carry away waste and fluid). ","When cancer cells are in the wall, they can then grow into blood vessels or lymph vessels (tiny channels that carry away waste and fluid). "
+"From there, they can travel to nearby lymph nodes or to distant parts of the body. ","From there, they can travel to nearby lymph nodes or to distant parts of the body. "
+The stage (extent of spread) of a colorectal cancer depends on how deeply it grows into the wall and if it has spread outside the colon or rectum. ,The stage (extent of spread) of a colorectal cancer depends on how deeply it grows into the wall and if it has spread outside the colon or rectum. 
+"For more on staging, see Colorectal Cancer Stages .","For more on staging, see Colorectal Cancer Stages ."
+Types of cancer in the colon and rectum,Types of cancer in the colon and rectum
+Most colorectal cancers are adenocarcinomas . ,Most colorectal cancers are adenocarcinomas . 
+These cancers start in cells that make mucus to lubricate the inside of the colon and rectum. ,These cancers start in cells that make mucus (slimy liquid) to make the inside of the colon and rectum more slippery. 
+"When doctors talk about colorectal cancer, they're almost always talking about this type. ","When doctors talk about colorectal cancer, they're almost always talking about this type. "
+"Some sub-types of adenocarcinoma, such as signet ring and mucinous, may have a worse prognosis (outlook) than other subtypes of adenocarcinoma. ","Some sub-types of adenocarcinoma, such as signet ring and mucinous, may have a worse prognosis (chance of recovery) than other subtypes of adenocarcinoma. "
+"Other, much less common types of tumors can also start in the colon and rectum. ","Other, much less common types of tumors can also start in the colon and rectum. "
+These include: >Carcinoid tumors. ,These include: >Carcinoid tumors. 
+These start from special hormone-making cells in the intestine. ,These start from special hormone-making cells in the intestine. 
+See Gastrointestinal Carcinoid Tumors . ,See Gastrointestinal Carcinoid Tumors . 
+>Gastrointestinal stromal tumors (GISTs) start from special cells in the wall of the colon called the interstitial cells of Cajal . ,>Gastrointestinal stromal tumors (GISTs) start from special cells in the wall of the colon called the interstitial cells of Cajal . 
+Some are benign (not cancer). ,Some are benign (not cancer). 
+"These tumors can be found anywhere in the digestive tract, but are not common in the colon. ","These tumors can be found anywhere in the GI (digestive) tract, but are not common in the colon. "
+See Gastrointestinal Stromal Tumor (GIST) . ,See Gastrointestinal Stromal Tumor (GIST) . 
+>Lymphomas are cancers of immune system cells. ,>Lymphomas are cancers of immune system cells. 
+"They mostly start in lymph nodes , but they can also start in the colon, rectum, or other organs. ","They mostly start in lymph nodes , but they can also start in the colon, rectum, or other organs. "
+Information on lymphomas of the digestive system can be found in Non-Hodgkin Lymphoma . ,Information on lymphomas of the digestive system can be found in Non-Hodgkin Lymphoma . 
+">Sarcomas can start in blood vessels, muscle layers, or other connective tissues in the wall of the colon and rectum. ",">Sarcomas can start in blood vessels, muscle layers, or other connective tissues in the wall of the colon and rectum. "
+Sarcomas of the colon or rectum are rare. ,Sarcomas of the colon or rectum are rare. 
+See Soft Tissue Sarcoma .,See Soft Tissue Sarcoma .
+"This diagram shows the location of the stomach, small intestine, cecum, ascending colon, transverse colon, descending colon, sigmoid colon, and rectum. ","This picture shows where the stomach, small intestine, cecum, ascending colon, transverse colon, descending colon, sigmoid colon, and rectum are in your body. "
+Colorectal cancer is a disease in which cells in the colon or rectum grow out of control. ,Colorectal cancer is a disease in which cells in the colon or rectum grow out of control. 
+"Sometimes it is called colon cancer, for short. ","Sometimes it is called colon cancer, for short. "
+The colon is the large intestine or large bowel. ,The colon is the large intestine or large bowel. 
+The rectum is the passageway that connects the colon to the anus. ,The rectum is the part that connects your colon to your anus (where your poop comes out). 
+"Sometimes abnormal growths, called polyps, form in the colon or rectum. ","Sometimes abnormal growths, called polyps, form in the colon or rectum. "
+"Over time, some polyps may turn into cancer. ","Over time, some polyps may turn into cancer. "
+Screening tests can find polyps so they can be removed before turning into cancer. ,Screening tests can find polyps so they can be removed before turning into cancer. 
+"Screening also helps find colorectal cancer at an early stage, when treatment works best. ",Screening can also help find colorectal cancer when it first starts.  This is when treatment works best. 
+>Facebook >Twitter >LinkedIn >Syndicate,>Facebook >Twitter >LinkedIn >Syndicate
+Cancer starts when cells in the body begin to grow out of control. ,Cancer starts when cells in the body begin to grow out of control. 
+"Cells in nearly any part of the body can become cancer, and then can spread to other areas of the body. ","Cells in almost any part of the body can turn into cancer, and then can move to other areas of the body. "
+"To learn more about cancer and how it starts and spreads, see What Is Cancer? ","To learn more about cancer and how it starts and spreads, see What Is Cancer? "
+"Gastrointestinal stromal tumors (GISTs) are uncommon cancers that start in special cells in the wall of the gastrointestinal (GI) tract, also known as the digestive tract. ","Gastrointestinal stromal tumors (GISTs) are uncommon cancers that start in special cells in the wall of the gastrointestinal (GI) tract, also known as the digestive tract. "
+"To understand GISTs, it helps to know something about the structure and function of the GI tract .","To understand GISTs, it helps to know something about the structure and function of the GI tract ."
+How the gastrointestinal (GI) tract works,How the gastrointestinal (GI) tract works
+The GI tract processes food for energy and rids the body of solid waste. ,Your GI tract breaks down food for energy and gets rid of waste.  
+"After food is chewed and swallowed, it goes through the esophagus, a tube that carries food down the throat and chest to the stomach. ","After food is chewed and swallowed, it goes through the esophagus, a tube that carries food down the throat and chest to the stomach. "
+The esophagus joins the stomach just beneath the diaphragm (the thin band of muscle below the lungs). ,The esophagus joins the stomach just beneath the diaphragm (the thin band of muscle below the lungs). 
+The stomach is a sac-like organ that helps the digestive process by mixing the food with gastric juices. ,The stomach is a sac-like organ that helps the breakdown of food (digestive process) by mixing the food with gastric juices. 
+The food and gastric juices are then emptied into the small intestine. ,The food and gastric juices then move into the small intestine. 
+"The small intestine, which is about 20 feet long, continues breaking down the food and absorbs most of the nutrients into the bloodstream. ","The small intestine, which is about 20 feet long, continues breaking down the food and absorbs most of the nutrients into the bloodstream. "
+"The small intestine joins the large intestine, the first part of which is the colon, a muscular tube about 5 feet long. ","The small intestine joins to the large intestine. The first part of the large intestine is called the colon, a muscular tube about 5 feet long. "
+The colon absorbs water and mineral nutrients from the remaining food matter. ,"The colon absorbs water, mineral and nutrients from the remaining food matter. "
+"The waste left after this process (stool) goes into the rectum, where it is stored until it passes out of the body through the anus.","What is left of the food after that is called waste.  Your colon holds the waste until it is ready to go to your rectum.  Then it leaves the body through your anus (the hole in your bottom) as poop, which is also called stool or feces."
+Gastrointestinal stromal tumors,Gastrointestinal stromal tumors
+Gastrointestinal stromal tumors (GISTs) start in very early forms of special cells in the wall of the GI tract called the interstitial cells of Cajal (ICCs). ,Gastrointestinal stromal tumors (GISTs) start in special cells in the wall of your GI tract called the interstitial cells of Cajal (ICCs). 
+ICCs are sometimes called the “pacemakers” of the GI tract because they signal the muscles in the GI tract to contract to move food and liquid along. ,ICCs are sometimes called the “pacemakers” of the GI tract because they signal the muscles in the GI tract to contract to move food and liquid along. 
+More than half of GISTs start in the stomach. ,More than half of GISTs start in the stomach. 
+"Most of the others start in the small intestine, but GISTs can start anywhere along the GI tract. ","Most of the others start in the small intestine, but GISTs can start anywhere along the GI tract. "
+A small number of GISTs start outside the GI tract in nearby areas such as the omentum (an apron-like layer of fatty tissue that hangs over the organs in the abdomen) or the peritoneum (the thin lining over the organs and walls inside the abdomen). ,A small number of GISTs start outside the GI tract.  In nearby areas such as the omentum (an apron-like layer of fatty tissue that hangs over the organs in the abdomen) or the peritoneum (the thin lining over the organs and walls inside the abdomen). 
+Some GISTs seem to be much more likely than others to grow into other areas or spread to other parts of the body. ,Some GISTs seem to be much more likely than others to grow into other areas or spread to other parts of the body. 
+"Doctors look at certain factors to help tell whether a GIST is likely to grow and spread quickly, such as: ","Doctors look at certain factors to help tell whether a GIST is likely to grow and spread quickly, such as: "
+>The size of the tumor ,>The size of the tumor 
+>Where it's located in the GI tract ,>Where it's located in the GI tract 
+">How fast the tumor cells are dividing (its mitotic rate , described in Tests for Gastrointestinal Stromal Tumors )",>how fast the cells are starting to grow
+Other GI tract cancers,Other GI tract cancers
+"GISTs are not the same as other, more common types of GI tract cancers that develop from other types of cells. ",There are other kinds of cancer in the GI tract that are not GISTs.  These start from other kinds of cells.   
+Cancers can occur anywhere in the GI tract − from the esophagus to the anus. ,Cancers can occur anywhere in the GI tract − from the esophagus to the anus. 
+"Most cancers that start in the GI tract, including most esophagus cancers, stomach cancers, and colon and rectum cancers, start in the gland cells that line almost all of the GI tract. ",Most cancers that start in the GI tract start in the cells in the wall of the GI tract. These are called gland cells.
+The cancers that develop in these cells are called adenocarcinomas . ,The cancers that start in these cells are called adenocarcinomas . 
+"Cancers can also start in squamous cells, which are flat cells that line some parts of the GI tract, like the upper part of the esophagus and the end of the anus. ","Cancers can also start in squamous cells, which are flat cells that line some parts of the GI tract, like the upper part of the esophagus and the end of the anus. "
+Cancers starting in these cells are called squamous cell carcinomas . ,Cancers that start in these cells are called squamous cell carcinomas . 
+The GI tract also has neuroendocrine cells. ,The GI tract also has neuroendocrine cells. 
+These cells have some features in common with nerve cells but also have other features in common with hormone-producing (endocrine) cells. ,These cells have some features in common with nerve cells but also have other features in common with hormone-producing (endocrine) cells. 
+Cancers that develop from these cells are called neuroendocrine tumors (NETs) . ,Cancers that start from these cells are called neuroendocrine tumors (NETs).  
+These cancers are rare in the GI tract. ,These cancers are rare in the GI tract. 
+Carcinoid tumors are an example of a neuroendocrine tumor found in the GI tract. ,Carcinoid tumors are an example of a neuroendocrine tumor found in the GI tract. 
+"Other rare types of cancer in the GI tract include different types of soft tissue sarcomas , such as: ",Other rare types of cancer in the GI tract include. 
+>Leiomyosarcomas: cancers of smooth muscle cells ,> Leiomyosarcomas -soft tissue sarcomas 
+>Angiosarcomas: cancers of blood vessel cells ,>Angiosarcomas: cancers of smooth muscle cells  
+>Malignant peripheral nerve sheath tumors (MPNSTs): cancers of cells that support and protect nerves GISTs are different from these other types of GI tract cancers. ,>Malignant peripheral nerve sheath tumors (MPNSTs): cancers of cells that support and protect nerves GISTs are different from these other types of GI tract cancers. 
+"They start in different types of cells, need different types of treatment, and have a different prognosis (outlook). ","They start in different types of cells, need different types of treatment, and have a different prognosis (chances of recovery). "
+"This is why doctors need to figure out whether a person with a tumor in the GI tract has a GIST, some other type of cancer, or a non-cancerous condition.","This is why doctors need to figure out whether a person with a tumor in the GI tract has a GIST, some other type of cancer, or a non-cancerous condition."
+Original Text,Simplified Text
+Intrahepatic bile duct cancers,Intrahepatic bile duct cancers
+These cancers start in the smaller bile duct branches inside the liver. ,These cancers start in the smaller bile ducts inside the liver.  The bile ducts are tubes that carry bile from one place to the next.  
+"Sometimes they're confused with cancers that start in the liver cells ( hepatocellular carcinomas ), and they are often treated the same way.","Sometimes they are confused with cancers that start in the liver cells ( hepatocellular carcinomas ), and they usually get the same treatment."
+Perihilar (also called hilar) bile duct cancers,Perihilar (also called hilar) bile duct cancers
+"These cancers start at the hilum, where the left and right hepatic ducts have joined and are just leaving the liver. ",These cancers start where the left and right liver ducts (tubes) connect.  This place is called the hilum.   
+These are also called Klatskin tumors. ,These cancers are also called Klatskin tumors. 
+These cancers are grouped with distal bile duct cancers as extrahepatic bile duct cancers .,These cancers are in the same group as distal bile duct cancers (see below).  This group is called extrahepatic bile duct cancers.  Extrahepatic means that they start outside of the liver.
+Distal bile duct cancers,Distal bile duct cancers
+"These cancers are found farther down the bile duct, closer to the small intestine. ","These cancers are found farther down the bile duct, closer to the small intestine. "
+"Like perihilar cancers, these are extrahepatic bile duct cancers because they start outside of the liver. ",These cancers are in the same group as the perihilar cancers (extrahepatic bile duct cancers).  
+Cancers that start in different parts of the bile ducts can cause different symptoms .,Cancers that start in different parts of the bile ducts can cause different problems.
+Benign bile duct tumors,Benign bile duct tumors
+Not all bile duct tumors are cancer. ,Not all bile duct tumors are cancer. 
+"For example, bile duct hamartomas and bile duct adenomas are types of benign (non-cancer) tumors.",Bile duct hamartomas and bile duct adenomas are kinds of benign (non-cancer) tumors.
+Other cancers in the liver,Other cancers in the liver
+The most common type of cancer that starts in the liver – much more common than cholangiocarcinoma – is hepatocellular carcinoma . ,The kind of cancer that starts in the liver and happens the most is hepatocellular carcinoma . 
+This type of cancer starts in the main cells that make up the liver. ,This kind of cancer starts in the main cells that the liver is made of.  
+"Cancers that start in other organs, such as the colon or rectum, can sometimes spread (metastasize) to the liver. ","Sometimes, cancers that start in other parts of the body, like the colon or rectum, can grow or spread (metastasize) to the liver. "
+These metastatic cancers are not true liver cancers. ,These metastatic cancers are not real liver cancers. 
+"For example, colorectal cancer that has spread to the liver is still colorectal cancer, not liver cancer. ","So, colorectal cancer that has moved into the liver is still called colorectal cancer because that is where it started.  It did not start in the liver.   "
+The treatment and outlook for cancer that metastasizes to the liver is not the same as for a cancer that starts in the liver. ,The way that doctors treat cancer that metastasizes to the liver is not the same as for a cancer that starts in the liver. 
+"For this reason, it’s important to know whether a tumor in the liver started in bile ducts (cholangiocarcinoma), the liver tissue itself (hepatocellular carcinoma), or another organ and has spread to the liver.","So, it is important to know if the cancer started in the bile ducts (cholangiocarcinoma), the liver itself (hepatocellular carcinoma), or another part of the body and has spread to the liver."
+Original Text,Simplified Text
+Intrahepatic bile duct cancers,Intrahepatic bile duct cancers
+These cancers start in the smaller bile duct branches inside the liver. ,These cancers start in the smaller bile duct branches inside the liver. 
+"Sometimes they're confused with cancers that start in the liver cells ( hepatocellular carcinomas ), and they are often treated the same way.","Sometimes they're confused with cancers that start in the liver cells (hepatocellular carcinomas), and they are often treated the same way."
+Perihilar (also called hilar) bile duct cancers,Perihilar (also called hilar) bile duct cancers
+"These cancers start at the hilum, where the left and right hepatic ducts have joined and are just leaving the liver. ","These cancers start at the hilum, where the left and right hepatic ducts (tubes) have joined and are just leaving the liver. "
+These are also called Klatskin tumors. ,These are also called Klatskin tumors. 
+These cancers are grouped with distal bile duct cancers as extrahepatic bile duct cancers .,These cancers are grouped with distal bile duct cancers as extrahepatic (outside of the liver) bile duct cancers .
+Distal bile duct cancers,Distal bile duct cancers
+"These cancers are found farther down the bile duct, closer to the small intestine. ","These cancers are found farther down the bile duct, closer to the small intestine. "
+"Like perihilar cancers, these are extrahepatic bile duct cancers because they start outside of the liver. ","Like perihilar cancers, these are extrahepatic bile duct cancers because they start outside of the liver. "
+Cancers that start in different parts of the bile ducts can cause different symptoms .,Cancers that start in different parts of the bile ducts can cause different symptoms .
+Types of bile duct cancer by cell type,Types of bile duct cancer by cell type
+Bile duct cancers can also be divided into types based on how the cancer cells look under the microscope. ,Bile duct cancers can also be divided into types based on how the cancer cells look under the microscope. 
+Nearly all bile duct cancers are cholangiocarcinomas . ,Nearly all bile duct cancers are cholangiocarcinomas . 
+"These cancers are a type of adenocarcinoma, which is a cancer that starts in gland cells. ","These cancers are a type of adenocarcinoma, which is a cancer that starts in gland cells. "
+Cholangiocarcinomas start in the gland cells that line the inside of the ducts. ,Cholangiocarcinomas start in the cells that line the inside of the ducts. 
+Other types of bile duct cancers are much less common. ,Other types of bile duct cancers are much less common. 
+"These include sarcomas, lymphomas, and small cell cancers. ","These include sarcomas, lymphomas, and small cell cancers. "
+Our information does not cover these rare types of bile duct cancer.,Our information does not cover these rare types of bile duct cancer.
+Benign bile duct tumors,Benign bile duct tumors
+Not all bile duct tumors are cancer. ,Not all bile duct tumors are cancer. 
+"For example, bile duct hamartomas and bile duct adenomas are types of benign (non-cancer) tumors.","For example, bile duct hamartomas and bile duct adenomas are types of benign (non-cancer) tumors."
+Other cancers in the liver,Other cancers in the liver
+The most common type of cancer that starts in the liver – much more common than cholangiocarcinoma – is hepatocellular carcinoma . ,The most common type of cancer that starts in the liver is hepatocellular carcinoma . 
+This type of cancer starts in the main cells that make up the liver. ,This type of cancer starts in the main cells that make up the liver. 
+"Cancers that start in other organs, such as the colon or rectum, can sometimes spread (metastasize) to the liver. ","Cancers that start in other organs, such as the colon or rectum, can sometimes spread (metastasize) to the liver. "
+These metastatic cancers are not true liver cancers. ,These metastatic cancers are not true liver cancers. 
+"For example, colorectal cancer that has spread to the liver is still colorectal cancer, not liver cancer. ","For example, colorectal cancer that has spread to the liver is still colorectal cancer, not liver cancer. "
+The treatment and outlook for cancer that metastasizes to the liver is not the same as for a cancer that starts in the liver. ,The treatment and chances of recovery for cancer that metastasizes to the liver is not the same as for a cancer that starts in the liver. 
+"For this reason, it’s important to know whether a tumor in the liver started in bile ducts (cholangiocarcinoma), the liver tissue itself (hepatocellular carcinoma), or another organ and has spread to the liver.","For this reason, it’s important to know whether a tumor started in the liver, or in another organ and has spread to the liver."
+Liver cancer is a type of cancer that starts in the liver. ,Liver cancer is a type of cancer that starts in your liver. 
+Cancer starts when cells in the body begin to grow out of control. ,Cancer starts when cells in the body begin to grow out of control. 
+"To learn more about how cancers start and spread, see What Is Cancer?. ","To learn more about how cancers start and grow, see What Is Cancer?. "
+"To understand liver cancer, it helps to know about the normal structure and function of the liver.. ","To know about liver cancer, it helps to know what the liver looks like and how it works."
+The liver,The liver
+The liver is the largest internal organ. ,The liver is the biggest organ in your body. 
+It lies under your right ribs just beneath your right lung. ,It lies on the right side under the rib cage.  
+It has two lobes (sections).. ,It has two sections (lobes).. 
+The liver is made up mainly of cells called hepatocytes. ,The liver is made up mainly of cells called hepatocytes (ha-pat-o-cites). 
+"It also has other types of cells, including cells that line its blood vessels and cells that line small tubes in the liver called bile ducts. ","It also has other kinds of cells, like cells that line its veins and small tubes called bile ducts."
+The bile ducts carry bile from the liver to the gallbladder or directly to the intestines.. ,The bile ducts carry bitter fluids made by the liver (bile) from the liver to the gallbladder or to the gut (intestines).
+You cannot live without your liver. ,You cannot live without your liver. 
+It has many important functions:. ,It has many important jobs
+>It breaks down and stores many of the nutrients absorbed from the intestine that your body needs to function. ,It breaks down and stores many of the important nutrients absorbed in the gut (intestine).
+Some nutrients must be changed (metabolized) in the liver before they can be used for energy or to build and repair body tissues. ,Some foods must be changed in the liver before they can be used for energy or to build and fix the body. 
+>It makes most of the clotting factors that keep you from bleeding too much when you are cut or injured. ,It makes the ingredients to help blood stick together (clot) when you are cut and bleeding
+>It delivers bile into the intestines to help absorb nutrients (especially fats). ,It sends bile to the gut (intestines) to help absorb nutrition and fat
+">It breaks down alcohol, drugs, and toxic wastes in the blood, which then pass from the body through urine and stool ",">It breaks down alcohol, drugs, and bad waste in the blood, which then comes out of the body when you pee or poop."
+The different types of cells in the liver can form several types of malignant (cancerous) and benign (non-cancerous) tumors. ,The cells in the liver can make tumors.  Some tumors turn in to cancer and some do not. 
+"These tumors have different causes, are treated differently, and have a different prognosis (outlook).. ","Liver tumors have different causes and treatments. Depending on the type of tumor, it is easier or harder to cure."
+Primary liver cancer,Primary liver cancer
+A cancer that starts in the liver is called primary liver cancer. ,A cancer that starts in the liver is called “primary” liver cancer. 
+There is more than one kind of primary liver cancer.. ,There is more than one kind of primary liver cancer.. 
+Hepatocellular carcinoma (HCC),Hepatocellular carcinoma (HCC)
+This is the most common form of liver cancer in adults.. ,(hep-to-cell-ular) This is the most common form of liver cancer in adults.. 
+Hepatocellular cancers can have different growth patterns:. ,Hepatocellular cancers grow in different ways.
+>Some begin as a single tumor that grows larger. ,>Some start as one tumor that grows bigger. 
+Only late in the disease does it spread to other parts of the liver. ,Then later spreads to other parts of the liver. 
+">A second type seems to start as many small cancer nodules throughout the liver, not just a single tumor. ",">Another kind of cancer can start as many small tumors in the liver, not just one tumor. "
+This is seen most often in people with cirrhosis (chronic liver damage) and is the most common pattern seen in the United States. ,This is seen most often in people with cirrhosis (liver damage) and is the most usual kind in the United States. 
+Doctors can classify several subtypes of HCC. ,There are several types of HCC. 
+Most often these subtypes do not affect treatment or prognosis (outlook). ,Most often these types do not affect treatment or chances of recovery (prognosis)
+"But one of these subtypes, fibrolamellar, is important to recognize. ","One of these types, fibrolamellar, is important to know about. "
+"It is rare, making up less than 1% of HCCs and is most often seen in women younger than age 35. ",It only happens in less than 1 in 100 HCCs (or a very small amount) and is mostly seen in women younger than age 35. 
+Often the rest of the liver is not diseased. ,"Most of the time, the rest of the liver is normal. "
+This subtype tends to have a better outlook than other forms of HCC.. ,People with this kind of cancer usually do better than people with other kinds of HCC.. 
+Most ofthe rest of this content refers only to hepatocellular carcinoma and is called liver cancer.. ,Most of the rest of this content refers only to HCC hepatocellular carcinoma and is called liver cancer.. 
+Intrahepatic cholangiocarcinoma (bile duct cancer),Intrahepatic cholangiocarcinoma (bile duct cancer)
+About 10% to 20% of cancers that start in the liver are intrahepatic cholangiocarcinomas. ,A small amount of cancers that start in the liver are “Intrahepatic cholangiocarcinomas” (Bile duct cancer). 
+These cancers start in the cells that line the small bile ducts (tubes that carry bile to the gallbladder) within the liver. ,These cancers start in the cells that line the small bile ducts (tubes that carry bile to the gallbladder) within the liver. 
+"Most cholangiocarcinomas, however, actually start in the bile ducts outside the liver.. ","But most cholangiocarcinomas, really start in the bile ducts outside the liver.. "
+"Although the rest of this information is mainly about hepatocellular cancers, cholangiocarcinomas are often treated the same way. ","Although the rest of this information is mainly about HCC cancers, bile duct cancer is often treated the same way. "
+"For more detailed information on this type of cancer, seeBile Duct Cancer.. ","For more detailed information on this type of cancer, see Bile Duct Cancer.. "
+Angiosarcoma and hemangiosarcoma,Angiosarcoma (an-gio-sar-coma) and hemangiosarcoma (he-man-gio-sar-coma)
+These are rare cancers that begin in cells lining the blood vessels of the liver. ,These are rare cancers that begin in cells lining the blood vessels of the liver. 
+"People who have been exposed to vinyl chloride or to thorium dioxide (Thorotrast) are more likely to develop these cancers (seeLiver cancer risk factors). Some other cases are thought to be caused by exposure to arsenic or radium, or to an inherited condition known as hereditary hemochromatosis. ","People who have been exposed to certain chemicals, toxic substances or have an inherited condition, have a higher risk of developing these cancers (seeLiver cancer risk factors). "
+"In about half of all cases, no likely cause can be identified.. ","In about half of all cases, the reason for the cancer is not known. "
+These tumors grow quickly and are usually too widespread to be removed surgically by the time they are found. ,"These tumors grow very fast.  Most of the time, they have spread too far when they are found to be taken out with surgery. "
+"Chemotherapy and radiation therapy may help slow the disease, but these cancers are usually very hard to treat. ","(Drugs) Chemotherapy and (Beam)radiation therapy may help slow the disease, but these cancers are usually very hard to treat. "
+These cancers are treated like other sarcomas. ,These cancers are treated like another cancer called sarcomas. 
+"For more information, see Soft Tissue Sarcoma.. ","For more information, see Soft Tissue Sarcoma.. "
+Hepatoblastoma,Hepatoblastoma (Hep-ato-blast-oma)
+"Thisis a very rare kind of cancer that develops in children, usually in those younger than 4 years old. ",This is a very rare kind of cancer that develops in children less than 4 years old. 
+The cells of hepatoblastoma are similar to fetal liver cells. ,The cells of hepatoblastoma are similar to liver cells in a human before it is born (when it is being formed in the womb)
+"About 2 out of 3 children with these tumors are treated successfully with surgery and chemotherapy, although the tumors are harder to treat if they have spread outside the liver.. ","About 2 out of 3 children with these tumors are treated successfully with surgery and Drugs (chemotherapy,  The tumors are harder to treat if they have spread outside the liver.. "
+Secondary liver cancer (metastatic liver cancer),Secondary liver cancer (liver cancer that has spread to the liver from somewhere else in the body)
+"Most of the time when cancer is found in the liver it did not start there but has spread (metastasized) from somewhere else in the body, such as the pancreas, colon, stomach, breast, or lung. ","Most of the time when cancer is found in the liver it did not start there but has spread (metastasized) from somewhere else in the body (such as the pancreas, colon, stomach, breast, or lung). "
+"Because this cancer has spread from its original (primary) site, it is called  a secondaryliver cancer. ","Because this cancer has spread from its original (primary) site, it is called a secondary liver cancer. "
+These tumors are named and treated based on their primary site (where they started). ,These tumors are named and treated based on the primary site where they started. 
+"For example, cancer that started in the lung and spread to the liver is called lung cancer with spread to the liver, not liver cancer. ","For example, cancer that started in the lung and spread to the liver is called lung cancer with spread to the liver, not liver cancer. "
+It is also treated as lung cancer.. ,It is also treated as lung cancer.. 
+"In the United States and Europe, secondary (metastatic) liver tumors are more common than primary liver cancer. ","In the United States and Europe, cancer spreading from another site (metastatic) to the liver are more common than cancer that starts in the liver. (primary) "
+The opposite is true for many areas of Asia and Africa.. ,"In Asia and Africa, most cancers found in the liver started in the liver. "
+"For more information on liver metastases from different types of cancer, see specific cancer types, as well as Advanced Cancer.. ","For more info on liver metastases from different types of cancer, see specific cancer types, as well as Advanced Cancer.. "
+Benign liver tumors,Benign (not cancer) liver tumors
+"Benign tumors sometimes grow large enough to cause problems, but they do not grow into nearby tissues or spread to distant parts of the body. ","Benign (not cancer) tumors can grow big enough to cause problems, but they do not grow into other parts of the body."
+"If they need to be treated, the patient can usually be cured with surgery.. ","If they need to be treated, the patient can usually be cured with surgery.. "
+Hemangioma,Hemangioma
+"The most common type of benign liver tumor, hemangiomas, start in blood vessels. ","The most common type of benign liver tumor, hemangiomas (he-man-gi-omas), start in blood vessels. "
+Most hemangiomas of the liver cause no symptoms and do not need treatment. ,Most hemangiomas of the liver do not cause any problems and do not need treatment. 
+But some may bleed and need to be removed with surgery.. ,But some may bleed and need to be taken out with surgery.. 
+Hepatic adenoma,Hepatic adenoma
+Hepatic adenoma is a benign tumor that starts from hepatocytes (the main type of liver cell). ,Hepatic adenoma (ad-e-noma) is a benign tumor that starts from hepatocytes (the main type of liver cell). 
+Most cause no symptoms and do not need treatment. ,Most cause no symptoms and do not need treatment. 
+"But some eventually cause symptoms, such as pain or a lump in the abdomen (stomach area) or blood loss. ","But some can cause trouble later, like pain or a lump in the stomach area or losing blood.  "
+"Because there is a risk that the tumor could rupture (leading to severe blood loss) and a small risk that it could eventually develop into liver cancer, most experts will usually advise surgery to remove the tumor if possible.. ","Because there is a chance that the tumor could burst open and cause bleeding and a small chance that it might turn into liver cancer, most doctors will usually suggest surgery to take out the tumor."
+Using certain drugs may increase the risk of getting these tumors. ,Certain drugs may also increase the risk of getting these tumors. 
+"Women have a higher chance of having one of these tumors if they take birth control pills, although this is rare. ","Women have a higher chance of having one of these tumors if they take birth control pills, although this is rare. "
+Men who use anabolic steroids may also develop these tumors. ,Men who use drugs to help build muscles may also get these tumors. 
+Adenomas may shrink when these drugs are stopped.. ,Adenomas may shrink when these drugs are stopped.. 
+Focal nodular hyperplasia,Focal nodular hyperplasia
+"Focal nodular hyperplasia (FNH) is a tumor-like growth made up of several cell types (hepatocytes, bile duct cells, and connective tissue cells). ",Focal nodular hyperplasia (FNH) is a growth that is like a tumor made up of a few types of cells 
+"Although FNH tumors are benign, they might cause symptoms. ","Even though FNH tumors are not cancer, they can cause problems. "
+It can be hard to tell them apart from true liver cancers and doctors sometimes remove them when the diagnosis is unclear.. ,It can be hard to tell FNH tumors apart from true liver cancers. This results in doctors removing them with surgery when it is unclear. 
+Both hepatic adenomas and FNH tumors are more common in women than in men.. ,Both hepatic adenomas and FNH tumors are more common in women than in men..