癌症
Cancer

context: zh_tw: 許多癌症都可以預防，預防的方式包括戒菸、不要攝取太多酒精、多吃蔬菜水果及全穀類食品、減少紅肉與速食（包含加工食品）的攝取、維持健康體重、多運動、減少陽光曝曬、以及施打疫苗預防某些感染症等等。透過篩檢早期發現，對於部分的癌症（包括大腸直腸癌和子宮頸癌等）有用，但乳癌篩檢的價值則有爭議性。對癌症的治療方式通常結合化學療法、放射療法、手術以及標靶治療等。疼痛控制與症狀控制是癌症治療中重要的一環，而安寧緩和醫療對於癌症晚期的病人來說相當重要。癌症病人的存活率端看癌症的種類與開始治療時的疾病狀況。在已開發國家兒童癌症病人的五年存活率平均高達 80%，在美國的成年癌症病人的平均五年存活率則有 66%。而病症的嚴重程度取決於癌細胞所在部位以及惡性生長的程度。多數癌症根據其型別、所處的部位和發展的階段可以治療甚至治癒。一旦診斷確定，癌症通常以結合手術、化療和放射療法的方式進行治療。隨著科學研究的進步，開發出許多針對特定型別癌症的藥物，也增進治療上的效果。如果癌症未經治療，通常最終結果將導致死亡，也有出現因癌症未及時治療或是改用另類療法而延誤正規治療，因此影響病情的情形。
en: Cancer is a group of diseases involving abnormal cell growth with the potential to invade or spread to other parts of the body. These contrast with benign tumors, which do not spread. Possible signs and symptoms include a lump, abnormal bleeding, prolonged cough, unexplained weight loss, and a change in bowel movements. While these symptoms may indicate cancer, they can also have other causes. Over 100 types of cancers affect humans.Tobacco use is the cause of about 22% of cancer deaths. Another 10% are due to obesity, poor diet, lack of physical activity or excessive drinking of alcohol. Other factors include certain infections, exposure to ionizing radiation and environmental pollutants. In the developing world, 15% of cancers are due to infections such as Helicobacter pylori, hepatitis B, hepatitis C, human papillomavirus infection, Epstein–Barr virus and human immunodeficiency virus (HIV). These factors act, at least partly, by changing the genes of a cell. Typically, many genetic changes are required before cancer develops. Approximately 5–10% of cancers are due to inherited genetic defects from a person's parents. Cancer can be detected by certain signs and symptoms or screening tests. It is then typically further investigated by medical imaging and confirmed by biopsy.Many cancers can be prevented by not smoking, maintaining a healthy weight, not drinking too much alcohol, eating plenty of vegetables, fruits and whole grains, vaccination against certain infectious diseases, not eating too much processed and red meat and avoiding too much sunlight exposure. Early detection through screening is useful for cervical and colorectal cancer. The benefits of screening in breast cancer are controversial. Cancer is often treated with some combination of radiation therapy, surgery, chemotherapy and targeted therapy. Pain and symptom management are an important part of care. Palliative care is particularly important in people with advanced disease. The chance of survival depends on the type of cancer and extent of disease at the start of treatment. In children under 15 at diagnosis, the five-year survival rate in the developed world is on average 80%. For cancer in the United States, the average five-year survival rate is 66%.In 2015, about 90.5 million people had cancer. About 14.1 million new cases occur a year (not including skin cancer other than melanoma). It caused about 8.8 million deaths (15.7% of deaths). The most common types of cancer in males are lung cancer, prostate cancer, colorectal cancer and stomach cancer. In females, the most common types are breast cancer, colorectal cancer, lung cancer and cervical cancer. If skin cancer other than melanoma were included in total new cancer cases each year, it would account for around 40% of cases. In children, acute lymphoblastic leukemia and brain tumors are most common, except in Africa where non-Hodgkin lymphoma occurs more often. In 2012, about 165,000 children under 15 years of age were diagnosed with cancer. The risk of cancer increases significantly with age, and many cancers occur more commonly in developed countries. Rates are increasing as more people live to an old age and as lifestyle changes occur in the developing world. The financial costs of cancer were estimated at $1.16 trillion USD per year as of 2010.
qas: question: zh_tw: 15 歲以下兒童患者的五年存活率是多少？
en: What is the five-year survival rate for children under 15 with the diagnosis?
answers: zh_tw: text: 80%
en: text: 80%

context: zh_tw: 目前治療方法有五種：外科手術、放射線治療、生物療法（包括激素治療、細胞免疫治療、標靶藥物與疫苗等）、基因療法及藥物化學療法，新的治療方法不斷推陳出新，已在臨床使用的有標靶治療、光動力療法等。治療方式的選擇取決於腫瘤的位置、惡性程度、發展程度以及病人身體狀態。一些實驗性治療癌症的方法也在發展當中。目前對於癌症治療方法的尋找，均是基於徹底清除癌細胞而不損害到其他的細胞的想法。而手術切除的方式，常因為癌細胞入侵蔓延到鄰近組織或遠端轉移而效果有限。化療則受限於對於體內其他正常組織的毒性。輻射也同樣會對正常組織造成傷害。因為「癌症」這個疾病包含許多不同種細胞產生的腫瘤，因此不會像治療一般疾病時會有單一的治療處方，也就是說單一的「癌症治療法」是不存在的。目前治療癌症通常都是依據病程的發展而綜合使用各種療法，以求達到最大的效果。例如，若是腫瘤是可藉由手術切除，通常醫生仍會並用放射線照射患處，讓癌細胞能徹底被消除。或者是因為腫瘤擴散過大，無法用手術切除，此時也可先使用化療縮小腫瘤後再尋求手術切除。
en: Targeted therapy is a form of chemotherapy that targets specific molecular differences between cancer and normal cells. The first targeted therapies blocked the estrogen receptor molecule, inhibiting the growth of breast cancer. Another common example is the class of Bcr-Abl inhibitors, which are used to treat chronic myelogenous leukemia (CML). Currently, targeted therapies exist for many of the most common cancer types, including bladder cancer, breast cancer, colorectal cancer, kidney cancer, leukemia, liver cancer, lung cancer, lymphoma, pancreatic cancer, prostate cancer, skin cancer, and thyroid cancer as well as other cancer types.The efficacy of chemotherapy depends on the type of cancer and the stage. In combination with surgery, chemotherapy has proven useful in cancer types including breast cancer, colorectal cancer, pancreatic cancer, osteogenic sarcoma, testicular cancer, ovarian cancer and certain lung cancers. Chemotherapy is curative for some cancers, such as some leukemias, ineffective in some brain tumors, and needless in others, such as most non-melanoma skin cancers. The effectiveness of chemotherapy is often limited by its toxicity to other tissues in the body. Even when chemotherapy does not provide a permanent cure, it may be useful to reduce symptoms such as pain or to reduce the size of an inoperable tumor in the hope that surgery will become possible in the future.
qas: question: zh_tw: 什麼限制了化療對患者的有效性？
en: What limits how effective chemotherapy might be for patients?
answers: zh_tw: text: 毒性
en: text: its toxicity