Cancer of Unknown Primary (CUP)

Tumors are defined as cancer of unknown primary (CUP) when cancer cells are found in the body, but the site where they originated cannot be determined. Studies have shown that CUP is often found in the lungs or pancreas. Some other common CUP sites include the colon, rectum, breast, bile ducts, stomach and kidney. CUP is responsible for up to 5% of all diagnosed cancers, although the percentage varies because of the extent of evaluation.

Diagnosis

Diagnosing cancer of unknown primary (CUP) starts with a full patient history, physical examination and blood tests, as well as X-ray, CT scan and other radiologic studies as needed. Usually a biopsy is done early and reviewed thoroughly under a microscope and a pathology report is created.

A patient’s personal history (e.g., heavy smoking), family history of cancer, pattern of presentation (whether the cancer was seen in the lungs or bones or liver) and pathology can help a doctor narrow down the possible primary sites. Some specialists are even using state-of-the-art genetic and proteomic testing to derive a “signature” from cancer cells that can identify their origins.

Treatment

Patients with cancer of unknown primary (CUP) are treated without knowing the cancer type. The treatment of CUP depends on several factors:

Extent: the number of areas of the body affected by CUP tumor and the size of these cancerous areas
Site: what organs are affected - lymph nodes, liver, lungs, bones, etc.
Performance status: determining if the patient will be able to tolerate treatment

Surgery may be used for patients whose cancer is in only one area, depending on the site. For some patients, surgery may be combined with chemotherapy or radiation therapy.

Chemotherapy is usually used on patients with metastases in many areas of the body.

Clinical trials may offer new, innovative treatments for CUP.

Cancer is a journey that no one needs to take alone. There are many forms of support to help you through every stage: diagnosis, treatment and survivorship. Whether you meet with other cancer survivors like yourself, use complementary therapies or individual coping mechanisms, support is available. Listed below are just some of the ways to find help...and hope.

Learn more about patient and family support programs

Support Groups

Getting together with other cancer patients in a support group is a valuable coping tool. Support groups are usually focused on a single disease or topic, such as breast cancer survivors or people coping with life-changing side effects from their cancer or cancer therapy. These groups allow participants to meet others like themselves and seek strength from each other. Most major cities and cancer hospitals offer support groups that meet weekly or monthly. There are also dozens of online support web sites or message boards for those who may not have access to a traditional meeting.

Find a support group

Complementary Therapies

Complementary therapies are used in conjunction with cancer treatment, in an effort to reduce treatment side effects, ease depression and anxiety and help cancer patients take their mind off the negative aspects of their situation. Complementary therapies may include mind-body exercises like yoga, tai chi and Qi gong; visualization or guided imagery; using art or music as therapy and self-expression and traditional Eastern medicine such as acupuncture.

Find complementary therapies at M. D. Anderson

Physical Activity

Staying physically active as much as possible during cancer treatment has many positive benefits. Physical activity stimulates the release of endorphins, a hormone that helps elevate mood, as well as decreasing feelings of fatigue.

Exercises for cancer patients can range from simple stretches done in the bed or chair, to more active pursuits such as walking or light gardening work. However, it’s important not to push yourself too hard. Check with your doctor before attempting any physical activity to make sure you are up to it.

Journaling/Blogging

Many people find it helpful to keep a journal of their cancer treatment experience. It may be as simple as recording symptoms and side effects into a notebook, or may include personal emotions and opinions about what they may be going through. Journals can be private, like a diary, or shared with loved ones and even strangers.

Increasingly, people are turning to the Internet to share their cancer journey with the world at large and to seek out others with similar experiences. Many cancer patients have begun their own web log, or “blog” to publicize their battle with cancer. Twitter, a mini-blogging technology that limits posts to 140 characters, has also proven to be a helpful tool for cancer patients to keep friends updated and reach out to others.