Frequently Asked Questions About Carcinoma of Unknown Primary Origin

Here are answers to some frequently asked questions about carcinoma of the unknown primary.

Q: What is carcinoma of unknown primary origin (CUP)?

A: The location where cancer begins is called the site of the primary tumor. Many cancers are named for the part of the body in which they begin. For example, liver cancer is cancer that begins in the liver. When cancer has spread to other areas of the body, it is said to have metastasized. Cancer that has metastasized keeps the name where it started. For instance, lung cancer that spreads to the bone is called metastatic lung cancer. CUP is cancer that starts in an unknown location and then spreads, often to a lymph node, lung, liver, brain, or the bones. Another name for this cancer is unknown primary cancer or UPC. The cancer is discovered in one of these distant places, while the original starting place remains unknown. 

Q: What are the symptoms of CUP?

A: People with CUP may have any or all of these symptoms, depending on which organs their cancer affects the most:

  • Swollen lymph nodes

  • Pain in the bones

  • Chest or abdominal pain or fullness

  • Poor appetite or weight loss

  • Fatigue or weakness

  • Tumors or unusual lesions on the skin

  • Shortness of breath

  • Confusion, headache, blurry vision, vomiting, or seizures

It is important to remember that all of these symptoms can be caused by many other medical problems. If a person has any of these symptoms, he or she should see the doctor as soon as possible.

Q: How is CUP treated?

A: CUP may be treated using chemotherapy, radiation, hormone therapy, surgery, or a combination of these.

Phpt of person getting CT scan.

Q: Should everyone get a second opinion if they are told they have CUP?

A: Many people with cancer get a second opinion from another doctor. These are some reasons to get a second opinion:

  • If the person is not comfortable with the treatment decision

  • If the type of cancer is rare

  • If there are different ways to treat the cancer

  • If the person is not able to see a cancer expert

Many people have a hard time deciding which treatment to have. It may help to have a second doctor review the diagnosis and treatment options before starting treatment. It is important to remember that in most cases, a short delay in treatment will not lower the chance that it will work. Some health insurance companies even require that a person with cancer seek a second opinion, and many other companies will pay for a second opinion if asked.

Q: How can someone get a second opinion?

A: There are many ways to get a second opinion. Here are some of them:

  • Ask a primary care doctor. He or she may be able to suggest a specialist. This may be a surgeon, medical oncologist, or radiation oncologist. Sometimes, specialists work together at cancer centers or hospitals. Never be afraid to ask for a second opinion.

  • Call the National Cancer Institute’s Cancer Information Service. The number is 800-4-CANCER (800-422-6237). They have information about treatment facilities. These include cancer centers and other programs supported by the National Cancer Institute.

  • Seek other options. Check with a local medical society or a nearby hospital or medical school for doctors who can give you a second opinion. Or ask other people who’ve had cancer or members of a support group for their suggestions.

Q: What are clinical trials?

A: Clinical trials are studies of new kinds of cancer treatments. Doctors and nurses conduct clinical trials to learn how well new treatments work. They also use clinical trials to understand which side effects may occur. If the treatment looks promising, it is then compared with the current treatment. Doctors want to know if it works better or has fewer side effects. People who participate in these studies may benefit. That’s because they have access to new treatments before the FDA approves them for the general public. People who join trials also help further our understanding of cancer. This helps future cancer patients.


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