Cancer of unknown primary

Cancer of unknown primary signs and symptoms

Some people with metastatic cancer have no symptoms, but common symptoms may include:

• breathlessness or discomfort in the chest

• bone pain, back pain

• swelling and discomfort in the abdomen, fluid collecting in the abdomen (ascites), yellowing of the skin and eyes (jaundice)

• swollen lymph glands such as those in the neck, underarm, chest or groin

• general symptoms such as weight loss, headaches, no appetite and feeling extremely tired

Causes of cancer of unknown primary

For patients with CUP, the primary cancer site is not known, therefore it is difficult to identify risk factors. Smoking may be an important risk factor, as more than half of cancer of unknown primary patients have a history of smoking. Other risk factors may include older age, diet, alcohol and obesity - common risk factors for many cancers.

Diagnosis of cancer of unknown primary

CUP is not diagnosed until a patient has metastatic cancer, and treatment is difficult because the primary cancer type cannot be determined.

Tests are ordered to ensure that cancers which are still curable or treatable, even when spread, are not missed.

Tests are done based on the site of the secondary cancer/s and any "clues" as to where the cancer may have started. The following tests may be used.

After a diagnosis of cancer of unknown primary

After being diagnosed with cancer of unknown primary, you may feel shocked, upset, anxious or confused. These are normal responses. A diagnosis of cancer of unknown primary affects each person differently. For most it will be a difficult time, however some people manage to continue with their normal daily activities.

You may find it helpful to talk about your treatment options with your doctors, family and friends. Ask questions and seek as much information as you feel you need. It is up to you as to how involved you want to be in making decisions about your treatment.

Find out more about the best cancer of unknown primary care:

What should happen next?

This resource can help guide you and your loved ones after your diagnosis.

Guide to best care for cancer of unknown primary  

Treatment for cancer of unknown primary

Treatment Team

• GP (General Practitioner) -

  looks after your general health and works with your specialists to coordinate treatment.

• Surgeon -

  surgically removes tumours and performs some biopsies.

• Gastroenterologist -

  specialises in diseases of the digestive system.

• Urologist -

  specialises in the treatment of diseases of the urinary system (male and female) and the male reproductive system

• Respiratory physician -

  investigates symptoms, is involved in diagnosis and determines initial treatment options.

• Haematologist -

  specialises in diagnosing and treating diseases of the blood and lymphatic system.

• Radiologist -

  interprets diagnostic scans (including CT, MRI and PET scans).

• Radiation oncologist -

  prescribes and coordinates radiation therapy treatment.

• Radiation therapist -

  plans and delivers radiation therapy.

• Medical oncologist -

  prescribes and coordinates the course of chemotherapy.

• Cancer care coordinators -

  coordinate your care, liaise with the multidisciplinary team and support you and your family throughout treatment.

• Palliative care team -

  assist with control of symptoms and help maintain quality of life as well as offering a range of support services.

• Other allied health professionals -

  such as social workers, pharmacists, and counsellors

Screening for cancer of unknown primary

There is currently no national screening program for CUP available in Australia.

Preventing cancer of unknown primary

Since the causes of CUP are unknown, there is no prevention advice specific to this disease. Having a generally healthy lifestyle - including not smoking, maintaining a healthy diet and weight and limiting alcohol consumption - may be protective.

Prognosis for cancer of unknown primary

It is not possible for a doctor to predict the exact course of a disease, as it will depend on each person's individual circumstances. However, your doctor may give you a prognosis - the likely outcome of the disease - based on the test results, the rate of tumour growth, as well as your age, fitness and medical history.

Although most cancers of unknown primary can't be cured, treatment can keep some cancers of unknown primary under control for months or years.