Here is a post from another one of our molers about CUP. Hope it is helpful.
Christine
Dear Friend: I am sorry that it took me so long to gather these web sites
for you; but it was not so easy. However, in the end I have many sites
for you to explore and wish you much luck. We have a really wonderful
forum here, hope you will chat with us and if we may be of further help
pls. ask. Your friend, lillian
Description of Carcinoma Of Unknown Primary
Carcinoma of unknown primary (CUP) is a disease in which cancer (malignant)
cells are found somewhere in the body, but the place where they first
started growing (the origin or primary site) cannot be found. This occurs
in about 2%-9% of cancer patients.
Actually, CUP can be described as a group of different types of cancer all
of which become known by the place or places in the body where the cancer
has spread (metastasized) from another part of the body. Because all of
these diseases are not alike, chance of recovery (prognosis) and choice of
treatment may be different for each patient.
If CUP is suspected, your doctor will order several tests, one of which may
be a biopsy. This means a small piece of tissue is cut from the tumor and
looked at under a microscope. Your doctor may also do a complete history
and physical examination, and order chest x-rays along with blood, urine,
and stool tests. A cancer can be called CUP when your doctor cannot tell
from the test results where the cancer began.
The pattern of how CUP has spread may also give the doctor information to
help determine where it started. For example, lung metastases are more
common when cancer begins above the diaphragm (the thin muscle under the
lungs that helps you breathe). Most large studies have shown that CUP often
starts in the lungs or pancreas. Less often, it may start in the colon,
rectum, breast, or prostate.
An important part of trying to find out where the cancer started is to see
how the cancer cells look under a microscope (histology). Other special
tests may also be done that help the doctor find out where the cancer
started and choose the best type of treatment.
Stages Of Carcinoma Of Unknown Primary
When cancer is diagnosed, more tests are usually done to find out if cancer
cells have spread to other parts of the body. This is called staging. But,
when CUP is diagnosed, the number and type of tests done may be different
for each patient. The treatment options in this statement are based on
whether the cancer has just been found (newly diagnosed) or the cancer has
come back after it has been treated (recurrent).
The treatment options are also based on where the cancer is found or what
it looks like. Your doctor may find that your cancer fits into one of the
following groups:
- Cancer in the cervical lymph nodes: cancer in the small, bean-shaped
organs that make and store infection-fighting cells (lymph nodes) in the
neck area - Poorly differentiated carcinomas: the cancer cells look very
different from normal cells - Metastatic melanoma to a single nodal site:
cancer of the cells that color the skin (melanocytes) that has spread to
lymph nodes in only one part of the body - Isolated axillary metastasis:
cancer that has spread only to lymph nodes in the area of the armpits -
Inguinal node metastasis: cancer that has spread to lymph nodes in the
groin area - Multiple involvement: cancer that has spread to several
different areas of the body
How Carcinoma Of Unknown Primary Is Treated
Many different treatments are used either alone or in combination to treat
CUP. Some of the treatments that are used are: surgery (taking out the
cancer in an operation) radiation therapy (using high-dose x-rays to kill
cancer cells) chemotherapy (using drugs to kill cancer cells) hormone
therapy (using hormones to stop the cancer cells from growing).
Surgery is a common treatment for CUP. Your doctor may remove the cancer
and some of the healthy tissue around it. Different operations are used
depending on where the cancer is found. If the cancer has spread to lymph
nodes, the lymph nodes may be removed (lymph node dissection). If the nodes
involved are in the groin, this operation is called a superficial groin
dissection. If the cancer has spread to lymph nodes and also to some
surrounding areas, your doctor may have to remove a larger portion of
tissue around the nodes. When muscles, nerves, and other tissue in the neck
are removed, this is called a radical neck dissection.
Radiation therapy uses x-rays or other high-energy rays to kill cancer
cells and shrink tumors. Radiation may be used alone or before or after
surgery.
Chemotherapy uses drugs to kill cancer cells. Chemotherapy may be taken by
mouth or it may be put into the body by a needle in a vein or muscle.
Chemotherapy is called a systemic treatment because the drugs enter the
bloodstream, travel through the body, and can kill cancer cells throughout
the body. Chemotherapy may be used alone or after surgery. Therapy given
after an operation when there are no cancer cells that can be seen is
called adjuvant therapy.
Hormone therapy is used to stop the hormones in the body that help cancer
cells grow. This may be done by using drugs that change the way hormones
work or by surgery that takes out organs that make hormones, such as the
testicles (orchiectomy).
Treatment By Stage
Treatment for CUP depends on where the doctor thinks the cancer started,
what the cancer cells look like under a microscope, and other factors.
Surgery and tests may be done to find where the cancer started.
You may receive treatment that is considered standard based on its
effectiveness in a number of patients in past studies, or you may choose to
go into a clinical trial. Not all patients are cured with standard therapy
and some standard treatments may have more side effects than are desired.
For these reasons, clinical trials are designed to find better ways to
treat cancer patients and are based on the most up-to-date information.
Clinical trials are going on in most parts of the country for CUP. If you
want more information, call the Cancer Information Service at
1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615.
NEWLY DIAGNOSED CARCINOMA OF UNKNOWN PRIMARY
If the cancer is in the neck area (cervical lymph nodes), your treatment
may be one of the following: 1. Surgery to remove the tonsils
(tonsillectomy). 2. Radiation therapy. 3. Radiation therapy followed by
surgery. 4. Neck surgery (radical neck dissection). 5. Neck surgery
followed by radiation therapy. More information is available in the PDQ
patient information statement for metastatic squamous neck cancer with
occult primary.
If the cancer is a poorly differentiated carcinoma (the cancer cells look
very different than normal cells), your treatment will probably be
chemotherapy. Surgery or radiotherapy has also been used for patients with
neuroendocrine (nervous system and hormonal system) cancer.
If the cancer is an isolated axillary nodal metastasis, it is likely that
the cancer started in the lung or breast. If you are female, you will have
a mammogram (an x-ray picture of the breast) to check for breast cancer.
After tests to check for lung and breast cancer, your treatment may be one
of the following: 1. Surgery to remove the lymph nodes with or without
surgery to remove the breast (mastectomy) or radiation therapy to the
breast. 2. Treatment as described above plus chemotherapy that is used for
breast cancer.
If the cancer is in the inguinal nodes, your treatment may be one of the
following: 1. Surgery to remove the cancer. 2. Groin surgery (superficial
groin dissection). 3. Surgery to remove some of the tumor (biopsy) with or
without radiation therapy, surgery to remove the lymph nodes, or
chemotherapy.
If the cancer is melanoma that has spread to a single nodal site, your
treatment will probably be surgery to remove the lymph nodes.
If there is cancer in several different areas of the body and the doctor
thinks that the origin of the cancer is one for which there is standard
systemic therapy, then that therapy should be given. The following are
examples: 1. Hormone therapy for prostate cancer. 2. Chemotherapy or
hormone therapy for breast cancer. 3. Chemotherapy for ovarian cancer.
If the source of the cancer cannot be found, then the best treatment may
not be known. You may want to consider taking part in a clinical trial.
RECURRENT CARCINOMA OF UNKNOWN PRIMARY
Treatment for recurrent CUP depends on the type of cancer, what treatment
was received before, the part of the body where the cancer has come back,
and other factors. You may want to consider taking part in a clinical
trial.
Carcinoma of Unkown Primary.
International cancer support and information site.Non commercial site with
no advertising. Cancer chats, newsgroups, cancer internet radio live,free
webspace offer,hundreds of links. Search and find feature.Oncologist links
and much much more.
Found at: http://www.cancer-info.com/carcnoma.htm
72% Better Health -- Carcinoma Of Unknown Primary - Carcinoma Of Unknown
Primary Carcinoma of unknown primary (CUP) is a disease in which cancer
(malignant) cells are found somewhere in the body, but the place where they
first started growing (the origin or primary site) cannot be found.
http://www.betterhealth.com/HK/ArticleMain/0,1349,161-424-20...
Search for more documents like this one
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General Oncology - Unknown Primary Tumors
Department of Clinical Investigation Section of General Oncology The
Section of General Oncology is engaged in patient care, research, and
education with respect to suspected unknown primary tumors. Unknown Primary
Carcinoma (UPC) is defined as the.
Found at: http://www.mdacc.tmc.edu/~genonc/
General Oncology - Unknown Primary Tumors
Department of Clinical Investigation Section of General Oncology The
Section of General Oncology is engaged in patient care, research, and
education with respect to suspected unknown primary tumors. Unknown Primary
Carcinoma (UPC) is defined as the.
Found at: http://www.mdanderson.org/~genonc/
Unknown Primary Carcinoma - Subset Six
Unknown Primary Carcinoma Favorable Subset Neuroendocrine carcinoma
presenting in the liver. Patients with cytologic or histologic features
consistent with neuroendocrine carcinoma have a 3-5 times longer survival
over the common epithelial...
Found at: http://www.mdanderson.org/~genonc/ssix.html
Unknown Primary Carcinoma - Questions Five
Unknown Primary Carcinoma Questions Answers How successful is the minimal
focused evaluation in diagnosing a primary tumor? This minimal focused
evaluation can successfully identify a primary or a non-epithelial cell
type (e.g. lymphoma, melanoma.
Found at: http://www.mdanderson.org/~genonc/qfive.html
Unknown Primary Carcinoma - Subset Four
Unknown Primary Carcinoma Favorable Subset Inguinal node metastasis.
Inguinal node metastasis of unknown orgin is a rare clinical presentation.
Careful inspection of the skin, endoscopic evaluation of the anal canal and
rectum, and gynecologic...
Found at: http://www.mdanderson.org/~genonc/sfour.html
Unknown Primary Carcinoma - Question Nine
Unknown Primary Carcinoma Questions Answers What are the favorable subsets
of UPC? Males Women who present with peritoneal carcinomatosis .
Adenocarcinoma or poorly differentiated carcinoma confined to the axillary
nodes in women. Inguinal node...
Found at: http://www.mdanderson.org/~genonc/qnine.html
Unknown Primary Carcinoma - Question One
Unknown Primary Carcinoma Questions Answers What is the benefit of
diagnosing the primary tumor? Detecting a primary tumor may have a
favorable influence on patient survival or quality of life if the tumor is
amenable to effective treatment...
Found at: http://www.mdanderson.org/~genonc/qtwo.html
Unknown Primary Carcinoma - Subset Three
Unknown Primary Carcinoma Favorable Subset Adenocarcinoma or poorly
differentiated carcinoma confined to the axillary nodes in women. The most
common cause of adenocarcinoma or poorly differentiated carcinoma confined
to the axillary nodes is...
Found at: http://www.mdanderson.org/~genonc/sthree.html
Unknown Primary Carcinoma - Subset Two
Unknown Primary Carcinoma Favorable Subset Women who present with
peritoneal carcinomatosis . Even in the absence of detectable ovarian
disease, women who present with peritoneal carcinomatosis should be treated
according to the guidelines...
Found at: http://www.mdanderson.org/~genonc/stwo.html
Unknown Primary Carcinoma - Subset Seven
Unknown Primary Carcinoma Favorable Subset Lymph node involvement. In UPC
patients, lymph nodes are the most frequently involved site. Generally,
survival is more favorable when lymph node involvement is present,
particularly when metastatic...
Found at: http://www.mdanderson.org/~genonc/sseven.html
Unknown Primary Carcinoma - Question Six
Unknown Primary Carcinoma Questions Answers What are the most commonly
diagnosed primaries? In order of frequency, from a consecutive series of
patients with suspected UPC, the seven most commonly diagnosed primaries
were lung, pancreas, breast..
Found at: http://www.mdanderson.org/~genonc/qsix.html
Unknown Primary Carcinoma - Subset One
Unknown Primary Carcinoma Favorable Subset Males Historically, this
presentation has been termed the extragonadal germ cell syndrome. Adequate
pathologic review will identify the patients with germ-cell histologies and
these patients should be...
Found at: http://www.mdanderson.org/~genonc/sone.html
Unknown Primary Carcinoma - Subset Five
Unknown Primary Carcinoma Favorable Subset Squamous cell carcinoma found in
patients whose involved nodes are high in the neck or midneck. Squamous
cell carcinoma is found in >70% of patients whose involved nodes are high
in the neck or midneck...
Found at: http://www.mdanderson.org/~genonc/sfive.html
Unknown Primary Carcinoma - Question Seven
Unknown Primary Carcinoma Questions Answers What role does the pathlogic
review play in diagnosing a primary tumor? Many authors have acknowledged
the importance of pathologic review in identifying the underlying primary
malignacy. From a...
Found at: http://www.mdanderson.org/~genonc/qseven.html
General Oncology - Unknown Primary Tumors
Department of Clinical Investigation Section of General Oncology The
Section of General Oncology is engaged in patient care, research, and
education with respect to suspected unknown primary tumors. Unknown Primary
Carcinoma (UPC) is defined as the.
Found at: http://www.mdanderson.org/~genonc/homepage.html
General Oncology - Unknown Primary Tumors
Department of Clinical Investigation Section of General Oncology The
Section of General Oncology is engaged in patient care, research, and
education with respect to suspected unknown primary tumors. Unknown Primary
Carcinoma (UPC) is defined as the.
Found at: http://www.mdacc.tmc.edu/~genonc/homepage.html
Unknown Primary Carcinoma - Question Four
Unknown Primary Carcinoma Questions Answers How extensive should the
diagnostic evaluation be? The goal of an effective diagnostic strategy for
suspected UPCs must be to accurately identify patients with treatable
underlying primary malignancies..
Found at: http://www.mdanderson.org/~genonc/qfour.html
References for Carcinoma of unknown primary; Section 1
References for Carcinoma of unknown primary: Section 1 McCredie M, Coates
M, Churches T, et al.: Cancer incidence in New South Wales, Australia.
European Journal of Cancer 27(7): 928-931, 1991. Muir C: Cancer of unknown
primary site. Cancer 75(1)..
Found at: http://cure.acor.org/nci/cancernet/references/103331_1.ht
UPT Articles
.> University of Texas, M.D. Anderson Cancer Center Department of Clinical
Investigation Section of General Oncology Faculty articles on the topic of
Unknown Primary Tumors Lenzi R, Hess HR, Abbruzzese MC, Raber MN, Ordonez
N, Abbruzzese JL: Poorly.
Found at: http://www.mdanderson.org/~genonc/articles.html
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