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<div class="pre-content"><div><div class="bk_prnt"><p class="small">NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.</p><p>PDQ Cancer Information Summaries [Internet]. Bethesda (MD): National Cancer Institute (US); 2002-. </p></div><div class="iconblock clearfix whole_rhythm no_top_margin bk_noprnt"><a class="img_link icnblk_img" title="Table of Contents Page" href="/books/n/pdqcis/"><img class="source-thumb" src="/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-pdqcis-lrg.png" alt="Cover of PDQ Cancer Information Summaries" height="100px" width="80px" /></a><div class="icnblk_cntnt eight_col"><h2>PDQ Cancer Information Summaries [Internet].</h2><a data-jig="ncbitoggler" href="#__NBK65797_dtls__">Show details</a><div style="display:none" class="ui-widget" id="__NBK65797_dtls__"><div>Bethesda (MD): <a href="http://www.cancer.gov/" ref="pagearea=page-banner&targetsite=external&targetcat=link&targettype=publisher">National Cancer Institute (US)</a>; 2002-.</div></div><div class="half_rhythm"></div><div class="bk_noprnt"><form method="get" action="/books/n/pdqcis/" id="bk_srch"><div class="bk_search"><label for="bk_term" class="offscreen_noflow">Search term</label><input type="text" title="Search this book" id="bk_term" name="term" value="" data-jig="ncbiclearbutton" /> <input type="submit" class="jig-ncbibutton" value="Search this book" submit="false" style="padding: 0.1em 0.4em;" /></div></form></div></div></div></div></div>
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<div class="main-content lit-style" itemscope="itemscope" itemtype="http://schema.org/CreativeWork"><div class="meta-content fm-sec"><h1 id="_NBK65797_"><span class="title" itemprop="name">Carcinoma of Unknown Primary Treatment (PDQ®)</span></h1><div class="subtitle whole_rhythm">Patient Version</div><p class="contrib-group"><span itemprop="author">PDQ Adult Treatment Editorial Board</span>.</p><p class="small">Published online: December 17, 2021.</p></div><div class="jig-ncbiinpagenav body-content whole_rhythm" data-jigconfig="allHeadingLevels: ['h2'],smoothScroll: false" itemprop="text"><div id="_abs_rndgid_" itemprop="description"><p id="CDR0000062729__201">This PDQ cancer information summary has current information about the treatment of carcinoma of unknown primary. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.</p><p id="CDR0000062729__202">Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary ("Date Last Modified") is the date of the most recent change. The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the PDQ Adult Treatment Editorial Board.</p></div><div id="CDR0000062729__1"><h2 id="_CDR0000062729__1_">General Information About Carcinoma of Unknown Primary</h2><div id="CDR0000062729__1.kp" class="box"><h4><span class="title">Key Points for This Section</span></h4><ul><li class="half_rhythm"><div><a href="#CDR0000062729__2">Carcinoma of unknown primary (CUP) is a rare disease in which malignant (cancer) cells are found in the body but the place the cancer began is not known.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062729__156">Sometimes the primary cancer is never found.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062729__161">The signs and symptoms of CUP are different, depending on where the cancer has spread in the body. </a></div></li><li class="half_rhythm"><div><a href="#CDR0000062729__5">Because the place where the cancer started is not known, many tests and procedures may be done to search for the primary cancer.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062729__169">If tests show there may be cancer, a biopsy is done.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062729__175">When the type of cancer cells or tissue removed is different from the type of cancer cells expected to be found, a diagnosis of CUP may be made.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062729__178">Tests and procedures used to find the primary cancer depend on where the cancer has spread.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062729__19">Certain factors affect prognosis (chance
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of recovery).</a></div></li></ul></div><div id="CDR0000062729__2"><h3>Carcinoma of unknown primary (CUP) is a rare disease in which malignant (cancer) cells are found in the body but the place the cancer began is not known.</h3><p id="CDR0000062729__140"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">Cancer</a> can form in any <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">tissue</a> of the body. The <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045847/" class="def">primary cancer</a> (the cancer that first formed) can spread to other parts of the body. This process is called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046710/" class="def">metastasis</a>. Cancer <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046476/" class="def">cells</a> usually look like the cells in the type of tissue in which the cancer began. For example, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000444971/" class="def">breast cancer</a> cells may spread to the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270740/" class="def">lung</a>. Because the cancer began in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000304766/" class="def">breast</a>, the cancer cells in the lung look like breast cancer cells.</p><p id="CDR0000062729__154">Sometimes doctors find where the cancer has spread but cannot find where in the body the cancer first began to grow. This type of cancer is called a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000527198/" class="def">cancer of unknown primary</a> (CUP) or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000458104/" class="def">occult primary tumor</a>.
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<div id="CDR0000062729__200" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=In%20cancer%20of%20unknown%20primary%2C%20cancer%20cells%20have%20spread%20in%20the%20body%20but%20the%20place%20where%20the%20primary%20cancer%20began%20is%20not%20known&p=BOOKS&id=576502_CDR0000770048.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65797/bin/CDR0000770048.jpg" alt="Cancer of unknown primary; drawing shows a primary tumor that has spread from an unknown site to other parts of the body (the lung and the brain). An inset shows cancer cells spreading from the primary cancer, through the blood and lymph systems, to another part of the body where a metastatic tumor has formed." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>In cancer of unknown primary, cancer cells have spread in the body but the place where the primary cancer began is not known.</p></div></div></p><p id="CDR0000062729__155">Tests are done to find where the primary cancer began and to get information about where the cancer has spread. When tests are able to find the primary cancer, the cancer is no longer a CUP and treatment is based on the type of primary cancer.</p></div><div id="CDR0000062729__156"><h3>Sometimes the primary cancer is never found.</h3><p id="CDR0000062729__158">The primary cancer (the cancer that first formed) may not be found for one of the following reasons:
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</p><ul id="CDR0000062729__159"><li class="half_rhythm"><div>The primary cancer is very small and grows slowly.
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</div></li><li class="half_rhythm"><div>The body’s <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046356/" class="def">immune system</a> killed the primary cancer.
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</div></li><li class="half_rhythm"><div>The primary cancer was removed during <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">surgery</a> for another <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651193/" class="def">condition</a> and doctors didn’t know cancer had formed. For example, a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046645/" class="def">uterus</a> with cancer may be removed during a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045718/" class="def">hysterectomy</a> to treat a serious <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045364/" class="def">infection</a>.</div></li></ul></div><div id="CDR0000062729__161"><h3>The signs and symptoms of CUP are different, depending on where the cancer has spread in the body. </h3><p id="CDR0000062729__163">Sometimes CUP does not cause any <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000750109/" class="def">signs</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045022/" class="def">symptoms</a>. Signs and symptoms may be caused by CUP or by other conditions. Check with your doctor if you have any of the following:</p><ul id="CDR0000062729__166"><li class="half_rhythm"><div>Lump or thickening in any part of the body.
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</div></li><li class="half_rhythm"><div>Pain that is in one part of the body and does not go away.
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</div></li><li class="half_rhythm"><div>A cough that does not go away or hoarseness in the voice.
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</div></li><li class="half_rhythm"><div>Change in <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046500/" class="def">bowel</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046501/" class="def">bladder</a> habits, such as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000407757/" class="def">constipation</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000306496/" class="def">diarrhea</a>, or frequent <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046642/" class="def">urination</a>.
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</div></li><li class="half_rhythm"><div>Unusual bleeding or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000443583/" class="def">discharge</a>.
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</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000450108/" class="def">Fever</a> for no known reason that does not go away.
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</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000801579/" class="def">Drenching night sweats</a>.</div></li><li class="half_rhythm"><div>Weight loss for no known reason or loss of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000454699/" class="def">appetite</a>.
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</div></li></ul></div><div id="CDR0000062729__5"><h3>Because the place where the cancer started is not known, many tests and procedures may be done to search for the primary cancer.</h3><p id="CDR0000062729__7">The following tests and procedures may be used:</p><ul id="CDR0000062729__167"><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270871/" class="def">Physical exam</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000798522/" class="def">health history</a></b>: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046641/" class="def">Urinalysis</a></b>: A test to check the color of urine and its contents, such as sugar, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046092/" class="def">protein</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270735/" class="def">blood</a>, and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044123/" class="def">bacteria</a>.</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000304685/" class="def">Blood chemistry studies</a></b>: A procedure in which a blood sample is checked to measure the amounts of certain substances released into the blood by <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000257523/" class="def">organs</a> and tissues in the body. An unusual (higher or lower than normal) amount of a substance can be a sign of disease.
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</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045107/" class="def">Complete blood count</a></b>: A procedure in which a sample of blood is drawn and checked for the following:
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<dl id="CDR0000062729__168" class="temp-labeled-list"><dt>-</dt><dd><p class="no_top_margin">The number of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046124/" class="def">red blood cells</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045993/" class="def">white blood cells</a>, and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045840/" class="def">platelets</a>.</p></dd><dt>-</dt><dd><p class="no_top_margin">The amount of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045108/" class="def">hemoglobin</a> (the protein that carries <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000538149/" class="def">oxygen</a>) in the red blood cells.</p></dd><dt>-</dt><dd><p class="no_top_margin"> The portion of the sample made up of red blood cells.</p></dd></dl></div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045050/" class="def">Fecal occult blood test</a></b>: A test to check <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046605/" class="def">stool</a> (solid waste) for blood that can only be seen with a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000638184/" class="def">microscope</a>. Small samples of stool are placed on special cards and returned to the doctor or laboratory for testing. Because some cancers bleed, blood in the stool may be a sign of cancer in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046462/" class="def">colon</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046555/" class="def">rectum</a>.
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</div></li></ul></div><div id="CDR0000062729__169"><h3>If tests show there may be cancer, a biopsy is done.</h3><p id="CDR0000062729__171">A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045164/" class="def">biopsy</a> is the removal of cells or tissues so they can be viewed under a microscope by a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046244/" class="def">pathologist</a>. The pathologist views the tissue under a microscope to look for cancer cells and to find out the type of cancer. The type of biopsy that is done depends on the part of the body being tested for cancer.
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One of the following types of biopsies may be used:
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</p><ul id="CDR0000062729__172"><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046411/" class="def">Excisional biopsy</a></b>: The removal of an entire lump of tissue.
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</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046698/" class="def">Incisional biopsy</a></b>: The removal of part of a lump or a sample of tissue.
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</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045657/" class="def">Core biopsy</a></b>: The removal of tissue using a wide needle.
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</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045691/" class="def">Fine-needle aspiration</a> (FNA) biopsy</b>: The removal tissue or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044669/" class="def">fluid</a> using a thin needle.
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</div></li></ul><p id="CDR0000062729__173">If cancer is found, one or more of the following <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046590/" class="def">laboratory tests</a> may be used to study the tissue samples and find out the type of cancer:</p><ul id="CDR0000062729__174"><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000386202/" class="def">Genetic analysis</a></b>: A laboratory test in which the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045671/" class="def">DNA</a> in a sample of cancer cells or tissue is studied to check for <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046063/" class="def">mutations</a> (changes) that may help predict the best treatment for carcinoma of unknown primary.</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044171/" class="def">Histologic</a> study</b>: A laboratory test in which stains are added to a sample of cancer cells or tissue and viewed under a microscope to look for certain changes in the cells. Certain changes in the cells are linked to certain types of cancer.
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</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000653117/" class="def">Immunohistochemistry</a></b>: A laboratory test that uses <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044918/" class="def">antibodies</a> to check for certain <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046086/" class="def">antigens</a> (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045776/" class="def">markers</a>) in a sample of a patient’s tissue. The antibodies are usually linked to an <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046081/" class="def">enzyme</a> or a fluorescent dye. After the antibodies bind to a specific antigen in the tissue sample, the enzyme or dye is activated, and the antigen can then be seen under a microscope. This type of test is used to help <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046450/" class="def">diagnose</a> cancer and to help tell one type of cancer from another type of cancer.
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</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000783668/" class="def">Reverse transcription–polymerase chain reaction</a> (RT–PCR) test</b>: A laboratory test in which the amount of a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046391/" class="def">genetic</a> substance called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000662001/" class="def">mRNA</a> made by a specific <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045693/" class="def">gene</a> is measured. An enzyme called reverse transcriptase is used to convert a specific piece of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046568/" class="def">RNA</a> into a matching piece of DNA, which can be amplified (made in large numbers) by another enzyme called DNA polymerase. The amplified DNA copies help tell whether a specific mRNA is being made by a gene. RT–PCR can be used to check the activation of certain genes that may indicate the presence of cancer cells. This test may be used to look for certain changes in a gene or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046470/" class="def">chromosome</a>, which may help diagnose cancer.
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</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270737/" class="def">Cytogenetic analysis</a></b>: A laboratory test in which the chromosomes of cells in a sample of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> tissue are counted and checked for any changes, such as broken, missing, rearranged, or extra chromosomes. Changes in certain chromosomes may be a sign of cancer. Cytogenetic analysis is used to help diagnose cancer, plan treatment, or find out how well treatment is working. Changes in certain chromosomes are linked to certain types of cancer.</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044052/" class="def">Light</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044025/" class="def">electron microscopy</a></b>: A laboratory test in which cells in a sample of tissue are viewed under regular and high-powered microscopes to look for certain changes in the cells.
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</div></li></ul></div><div id="CDR0000062729__175"><h3>When the type of cancer cells or tissue removed is different from the type of cancer cells expected to be found, a diagnosis of CUP may be made.</h3><p id="CDR0000062729__177">The cells in the body have a certain look that depends on the type of tissue they come from. For example, a sample of cancer tissue taken from the breast is expected to be made up of breast cells. However, if the sample of tissue is a different type of cell (not made up of breast cells), it is likely that the cells have spread to the breast from another part of the body. In order to plan treatment, doctors first try to find the primary cancer (the cancer that first formed).</p></div><div id="CDR0000062729__178"><h3>Tests and procedures used to find the primary cancer depend on where the cancer has spread.</h3><p id="CDR0000062729__180">In some cases, the part of the body where cancer cells are first found helps the doctor decide which <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045959/" class="def">diagnostic tests</a> will be most helpful. </p><ul id="CDR0000062729__181"><li class="half_rhythm"><div>When cancer is found above the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046451/" class="def">diaphragm</a> (the thin muscle under the lungs that helps with breathing), the primary cancer site is likely to be in the upper part of the body, such as in the lung or breast.
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</div></li><li class="half_rhythm"><div>When cancer is found below the diaphragm, the primary cancer site is likely to be in the lower part of the body, such as the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046254/" class="def">pancreas</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046312/" class="def">liver</a>, or other organ in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045070/" class="def">abdomen</a>.</div></li><li class="half_rhythm"><div>Some cancers commonly spread to certain areas of the body. For cancer found in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph nodes</a> in the neck, the primary cancer site is likely to be in the head or neck, because <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000257519/" class="def">head and neck cancers</a> often spread to the lymph nodes in the neck.
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</div></li></ul><p id="CDR0000062729__182">The following tests and procedures may be done to find where the cancer first began:</p><ul id="CDR0000062729__183"><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046033/" class="def">CT scan</a> (CAT scan)</b>: A procedure that makes a series of detailed pictures of areas inside the body, such as the chest or abdomen, taken from different angles. The pictures are made by a computer linked to an <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045944/" class="def">x-ray</a> machine. A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000409764/" class="def">dye</a> may be <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044678/" class="def">injected</a> into a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000476471/" class="def">vein</a> or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
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</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045788/" class="def">MRI</a> (magnetic resonance imaging)</b>: A procedure that uses a magnet, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651209/" class="def">radio waves</a>, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI).
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</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046140/" class="def">PET scan</a> (positron emission tomography scan)</b>: A procedure to find <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045772/" class="def">malignant</a> tumor cells in the body. A small amount of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046550/" class="def">radioactive</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044033/" class="def">glucose</a> (sugar) is injected into a vein. The PET <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000386220/" class="def">scanner</a> rotates around the body and makes a picture of where glucose is being used in the body. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do.
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</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045775/" class="def">Mammogram</a></b>: An x-ray of the breast.
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</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045678/" class="def">Endoscopy</a></b>: A procedure to look at organs and tissues inside the body to check for <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044636/" class="def">abnormal</a> areas. An <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046428/" class="def">endoscope</a> is inserted through an <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046353/" class="def">incision</a> (cut) in the skin or opening in the body, such as the mouth. An endoscope is a thin, tube-like instrument with a light and a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000572035/" class="def">lens</a> for viewing. It may also have a tool to remove tissue or lymph node samples, which are checked under a microscope for signs of disease. For example, a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045648/" class="def">colonoscopy</a> may be done.
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</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000732562/" class="def">Tumor marker test</a></b>: A procedure in which a sample of blood, urine, or tissue is checked to measure the amounts of certain substances made by organs, tissues, or tumor cells in the body. Certain substances are linked to specific types of cancer when found in increased levels in the body. These are called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046636/" class="def">tumor markers</a>. The blood may be checked for the levels of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046490/" class="def">CA-125</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000721308/" class="def">CgA</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046208/" class="def">alpha-fetoprotein</a> (AFP), <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000354453/" class="def">beta human chorionic gonadotropin</a> (beta-hCG), or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046540/" class="def">prostate-specific antigen (PSA)</a>.
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</div></li></ul><p id="CDR0000062729__184">Sometimes, none of the tests can find the primary cancer site. In these cases, treatment may be based on what the doctor thinks is the most likely type of cancer. </p></div><div id="CDR0000062729__19"><h3>Certain factors affect prognosis (chance
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of recovery).</h3><p id="CDR0000062729__21">The <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045849/" class="def">prognosis</a> depends on the following: </p><ul id="CDR0000062729__130"><li class="half_rhythm"><div>Where the cancer began in the body and where it has spread.</div></li><li class="half_rhythm"><div>The number of organs with cancer in them.</div></li><li class="half_rhythm"><div>The way the tumor cells look when viewed under a microscope.</div></li><li class="half_rhythm"><div>Whether the patient is male or female.</div></li><li class="half_rhythm"><div>Whether the cancer has just been diagnosed or has <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046556/" class="def">recurred</a> (come back).</div></li></ul><p id="CDR0000062729__135">For most patients with CUP, current treatments do not <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000318813/" class="def">cure</a> the cancer. Patients may want to take part in one of the many <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trials</a> being done to improve treatment. Clinical trials for CUP are taking place in many parts of the country. Information about clinical trials is available from the <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI website</a>.</p></div></div><div id="CDR0000062729__23"><h2 id="_CDR0000062729__23_">Stages of Carcinoma of Unknown Primary</h2><div id="CDR0000062729__23.kp" class="box"><h4><span class="title">Key Points for This Section</span></h4><ul><li class="half_rhythm"><div><a href="#CDR0000062729__24">There is no standard staging system for carcinoma of unknown primary (CUP).</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062729__28">The information that is known about the cancer is used to plan treatment.</a></div></li></ul></div><div id="CDR0000062729__24"><h3>There is no standard staging system for carcinoma of unknown primary (CUP).</h3><p id="CDR0000062729__209">The extent or spread of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> is usually described as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045885/" class="def">stages</a>. The stage of the cancer is usually used to plan treatment. However, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000527198/" class="def">carcinoma of unknown primary</a> (CUP) has already spread to other parts of the body when it is found. There is no standard <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000689095/" class="def">staging system</a> for CUP.</p><p id="CDR0000062729__210">Sometimes CUP <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046556/" class="def">recurs</a> (comes back) after treatment.</p></div><div id="CDR0000062729__28"><h3>The information that is known about the cancer is used to plan treatment.</h3><p id="CDR0000062729__32"> Doctors use the following types of information to plan treatment:</p><ul id="CDR0000062729__185"><li class="half_rhythm"><div>The place in the body where the cancer is found, such as the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045829/" class="def">peritoneum</a> or the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044102/" class="def">cervical</a> (neck), <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046511/" class="def">axillary</a> (armpit), or inguinal (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046375/" class="def">groin</a>) <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph nodes</a>.
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</div></li><li class="half_rhythm"><div>The type of cancer <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046476/" class="def">cell</a>, such as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045135/" class="def">melanoma</a>.
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</div></li><li class="half_rhythm"><div>Whether the cancer cell is poorly <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046445/" class="def">differentiated</a> (looks very different from normal cells when viewed under a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000638184/" class="def">microscope</a>).</div></li><li class="half_rhythm"><div>
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The <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000750109/" class="def">signs</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045022/" class="def">symptoms</a> caused by the cancer.
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</div></li><li class="half_rhythm"><div>The results of tests and procedures.
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</div></li><li class="half_rhythm"><div>Whether the cancer is newly <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046450/" class="def">diagnosed</a> or has <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046556/" class="def">recurred</a> (come back).
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</div></li></ul></div></div><div id="CDR0000062729__62"><h2 id="_CDR0000062729__62_">Treatment Option Overview</h2><div id="CDR0000062729__62.kp" class="box"><h4><span class="title">Key Points for This Section</span></h4><ul><li class="half_rhythm"><div><a href="#CDR0000062729__63">There are different types of treatment for patients with carcinoma of unknown primary (CUP). </a></div></li><li class="half_rhythm"><div><a href="#CDR0000062729__67">Four types of standard treatment are used:</a></div><ul><li class="half_rhythm"><div><a href="#CDR0000062729__69">Surgery </a></div></li><li class="half_rhythm"><div><a href="#CDR0000062729__73">Radiation therapy
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</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062729__76">Chemotherapy </a></div></li><li class="half_rhythm"><div><a href="#CDR0000062729__79">Hormone therapy
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</a></div></li></ul></li><li class="half_rhythm"><div><a href="#CDR0000062729__82">New types of treatment are being tested in clinical trials.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062729__206">Treatment for carcinoma of unknown primary may cause side effects.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062729__143">Patients may want to think about taking part in a clinical trial.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062729__145">Patients can enter clinical trials before, during, or after starting their cancer treatment.</a></div></li></ul></div><div id="CDR0000062729__63"><h3>There are different types of treatment for patients with carcinoma of unknown primary (CUP). </h3><p id="CDR0000062729__65">Different types of treatment are available for patients with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000527199/" class="def">CUP</a>. Some treatments are <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044930/" class="def">standard</a> (the currently used treatment), and some are being tested in <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trials</a>. A treatment clinical trial is a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651211/" class="def">research study</a> meant to help improve current treatments or obtain information on new treatments for patients with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a>. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.</p></div><div id="CDR0000062729__67"><h3>Four types of standard treatment are used:</h3><div id="CDR0000062729__69"><h4>Surgery </h4><p id="CDR0000062729__71"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">Surgery</a> is a common treatment for CUP. A doctor may remove the cancer and some of the healthy <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">tissue</a> around it.</p><p id="CDR0000062729__124">After the doctor removes all the cancer that can be seen at the time of the surgery, some patients may be given <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045214/" class="def">chemotherapy</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">radiation therapy</a> after surgery to kill any cancer <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046476/" class="def">cells</a> that are left. Treatment given after the surgery, to lower the risk that cancer will come back, is called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045587/" class="def">adjuvant therapy</a>.</p></div><div id="CDR0000062729__73"><h4>Radiation therapy
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</h4><p id="CDR0000062729__75">Radiation therapy is a cancer treatment that uses high-energy <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045944/" class="def">x-rays</a> or other types of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045072/" class="def">radiation</a> to kill cancer cells or keep them from growing. There are two types of radiation therapy:</p><ul id="CDR0000062729__203"><li class="half_rhythm"><div>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046686/" class="def">External radiation therapy</a> uses a machine outside the body to send radiation toward the area of the body with cancer. Certain ways of giving radiation therapy can help keep radiation from damaging nearby healthy tissue. This type of radiation therapy may include the following:<dl id="CDR0000062729__204" class="temp-labeled-list"><dt>-</dt><dd><p class="no_top_margin"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000335073/" class="def">Intensity-modulated radiation therapy</a> (IMRT): IMRT is a type of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045582/" class="def">3-dimensional</a> (3-D) radiation therapy that uses a computer to make pictures of the size and shape of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a>. Thin beams of radiation of different intensities (strengths) are aimed at the tumor from many angles. This type of external radiation therapy causes less damage to nearby healthy tissue and is less likely to cause dry mouth, trouble swallowing, and damage to the skin.</p></dd></dl></div></li><li class="half_rhythm"><div>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046345/" class="def">Internal radiation therapy</a> uses a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046550/" class="def">radioactive</a> substance sealed in needles, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000257219/" class="def">seeds</a>, wires, or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045637/" class="def">catheters</a> that are placed directly into or near the cancer.</div></li></ul><p id="CDR0000062729__205">The way the radiation therapy is given depends on the type and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045885/" class="def">stage</a> of the cancer being treated. External and internal radiation therapy are used to treat carcinoma of unknown primary.</p></div><div id="CDR0000062729__76"><h4>Chemotherapy </h4><p id="CDR0000062729__131">Chemotherapy is a cancer treatment that uses <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000348921/" class="def">drugs</a> to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044678/" class="def">injected</a> into a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000476471/" class="def">vein</a> or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000301626/" class="def">systemic chemotherapy</a>). When chemotherapy is placed directly into the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046483/" class="def">cerebrospinal fluid</a>, an <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000257523/" class="def">organ</a>, or a body <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000463703/" class="def">cavity</a> such as the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045070/" class="def">abdomen</a>, the drugs mainly affect cancer cells in those areas (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046559/" class="def">regional chemotherapy</a>). <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045650/" class="def">Combination chemotherapy</a> is the use of two or more anticancer drugs.</p></div><div id="CDR0000062729__79"><h4>Hormone therapy
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</h4><p id="CDR0000062729__132"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045110/" class="def">Hormone therapy</a> is a cancer treatment that removes <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045713/" class="def">hormones</a> or blocks their action and stops cancer cells from growing. Hormones are substances made by <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046386/" class="def">glands</a> in the body and circulated in the bloodstream. Some hormones can cause certain cancers to grow. If tests show that the cancer cells have places where hormones can attach (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044958/" class="def">receptors</a>), drugs, surgery, or radiation therapy are used to reduce the production of hormones or block them from working.</p></div></div><div id="CDR0000062729__82"><h3>New types of treatment are being tested in clinical trials.</h3><p id="CDR0000062729__85">Information about clinical trials is available from the
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<a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI website</a>.</p></div><div id="CDR0000062729__206"><h3>Treatment for carcinoma of unknown primary may cause side effects.</h3><p id="CDR0000062729__206_md_73">For information about <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046580/" class="def">side effects</a> caused by treatment for cancer, visit our <a href="https://www.cancer.gov/about-cancer/treatment/side-effects" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Side Effects</a> page.</p></div><div id="CDR0000062729__143"><h3>Patients may want to think about taking part in a clinical trial.</h3><p id="CDR0000062729__143_md_23">For some patients, taking part in a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trial</a> may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044930/" class="def">standard treatment</a>.</p><p id="CDR0000062729__143_md_24">Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment.</p><p id="CDR0000062729__143_md_25">Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward.</p></div><div id="CDR0000062729__145"><h3>Patients can enter clinical trials before, during, or after starting their cancer treatment.</h3><p id="CDR0000062729__145_md_29">Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring (coming back) or reduce the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046580/" class="def">side effects</a> of cancer treatment.</p><p id="CDR0000062729__145_md_30">Clinical trials are taking place in many parts of the country. Information about clinical trials supported by NCI can be found on NCI’s <a href="https://www.cancer.gov/research/participate/clinical-trials-search" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">clinical trials search</a> webpage. Clinical trials supported by other organizations can be found on the <a href="https://clinicaltrials.gov/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">ClinicalTrials.gov</a> website.</p></div></div><div id="CDR0000062729__86"><h2 id="_CDR0000062729__86_">Treatment of Newly Diagnosed Carcinoma of Unknown Primary</h2><div id="CDR0000062729__87"><h3>Cervical (Neck) Lymph Nodes</h3><p id="CDR0000062729__211">For information about the treatments listed below, see the <a href="#CDR0000062729__67">Treatment Option Overview</a> section.</p><p id="CDR0000062729__88"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">Cancer</a> found in <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044102/" class="def">cervical</a> (neck) <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph nodes</a> may have spread from a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> in the head or neck. Treatment of cervical lymph node <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000527198/" class="def">carcinoma of unknown primary</a> (CUP) may include the following:</p><ul id="CDR0000062729__89"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">Surgery</a> to remove the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046618/" class="def">tonsils</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">Radiation therapy</a> alone. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000335073/" class="def">Intensity-modulated radiation therapy</a> (IMRT) may be used.</div></li><li class="half_rhythm"><div>Radiation therapy followed by surgery to remove the lymph nodes.</div></li><li class="half_rhythm"><div>Surgery to remove the lymph nodes, with or without radiation therapy.</div></li><li class="half_rhythm"><div>A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trial</a> of new types of treatment.</div></li></ul><p id="CDR0000062729__90">See the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044271/" class="def">PDQ</a> summary on <a href="/books/n/pdqcis/CDR0000258020/">Metastatic Squamous Neck Cancer with Occult Primary Treatment</a> for more information.</p></div><div id="CDR0000062729__91"><h3>Poorly Differentiated Carcinomas</h3><p id="CDR0000062729__212">For information about the treatments listed below, see the <a href="#CDR0000062729__67">Treatment Option Overview</a> section.</p><p id="CDR0000062729__186"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">Cancer</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046476/" class="def">cells</a> that are poorly <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046445/" class="def">differentiated</a> look very different from normal cells. The type of cell they came from is not known. Treatment of poorly differentiated <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000527198/" class="def">carcinoma of unknown primary</a>, including <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumors</a> in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045803/" class="def">neuroendocrine</a> system (the part of the brain that controls <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045713/" class="def">hormone</a>-producing <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046386/" class="def">glands</a> throughout the body) may include the following:</p><ul id="CDR0000062729__187"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045650/" class="def">Combination chemotherapy</a>.</div></li><li class="half_rhythm"><div>A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trial</a> of new types of treatment.</div></li></ul></div><div id="CDR0000062729__97"><h3>Women with Peritoneal Cancer</h3><p id="CDR0000062729__213">For information about the treatments listed below, see the <a href="#CDR0000062729__67">Treatment Option Overview</a> section.</p><p id="CDR0000062729__188">Treatment for women who have <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044993/" class="def">peritoneal</a> (lining of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045070/" class="def">abdomen</a>) <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000527198/" class="def">carcinoma of unknown primary</a> may be the same as for <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000445074/" class="def">ovarian cancer</a>. Treatment may include the following:</p><ul id="CDR0000062729__189"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045214/" class="def">Chemotherapy</a>.</div></li><li class="half_rhythm"><div>A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trial</a> of new types of treatment.</div></li></ul><p id="CDR0000062729__100">See the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044271/" class="def">PDQ</a> summary on <a href="/books/n/pdqcis/CDR0000062963/">Ovarian Epithelial, Fallopian Tube, and Primary Peritoneal Cancer Treatment</a> for more information.</p></div><div id="CDR0000062729__101"><h3>Isolated Axillary Lymph Node Metastasis</h3><p id="CDR0000062729__214">For information about the treatments listed below, see the <a href="#CDR0000062729__67">Treatment Option Overview</a> section.</p><p id="CDR0000062729__190"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">Cancer</a> found only in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045607/" class="def">axillary (armpit) lymph nodes</a> may have spread from a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000304766/" class="def">breast</a>.</p><p id="CDR0000062729__191">Treatment of axillary lymph node <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046710/" class="def">metastasis</a> is usually:</p><ul id="CDR0000062729__103"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">Surgery</a> to remove the lymph nodes.</div></li></ul><p id="CDR0000062729__126">Treatment also may include one or more of the following:</p><ul id="CDR0000062729__192"><li class="half_rhythm"><div>Surgery to remove the breast.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">Radiation therapy</a> to the breast.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045214/" class="def">Chemotherapy</a>.</div></li><li class="half_rhythm"><div>A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trial</a> of new types of treatment.</div></li></ul></div><div id="CDR0000062729__104"><h3>Inguinal Lymph Node Metastasis</h3><p id="CDR0000062729__215">For information about the treatments listed below, see the <a href="#CDR0000062729__67">Treatment Option Overview</a> section.</p><p id="CDR0000062729__193"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">Cancer</a> found only in the inguinal (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046375/" class="def">groin</a>) <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph nodes</a> most likely began in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000476624/" class="def">genital</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044185/" class="def">anal</a>, or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044083/" class="def">rectal</a> area. Treatment of inguinal lymph node <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046710/" class="def">metastasis</a> may include the following:</p><ul id="CDR0000062729__106"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">Surgery</a> to remove the cancer and/or lymph nodes in the groin.</div></li><li class="half_rhythm"><div>Surgery to remove the cancer and/or lymph nodes in the groin, followed by <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">radiation therapy</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045214/" class="def">chemotherapy</a>.</div></li></ul></div><div id="CDR0000062729__107"><h3>Melanoma in a Single Lymph Node Area</h3><p id="CDR0000062729__216">For information about the treatments listed below, see the <a href="#CDR0000062729__67">Treatment Option Overview</a> section.</p><p id="CDR0000062729__194">Treatment of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045135/" class="def">melanoma</a> that is found only in a single <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph node</a> area is usually:</p><ul id="CDR0000062729__195"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">Surgery</a> to remove the lymph nodes.</div></li></ul><p id="CDR0000062729__110">See <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044271/" class="def">PDQ</a> summary on <a href="/books/n/pdqcis/CDR0000062713/">Melanoma Treatment</a> for more information.</p></div><div id="CDR0000062729__111"><h3>Multiple Involvement</h3><p id="CDR0000062729__217">For information about the treatments listed below, see the <a href="#CDR0000062729__67">Treatment Option Overview</a> section.</p><p id="CDR0000062729__196">There is no <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044930/" class="def">standard treatment</a> for <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000527198/" class="def">carcinoma of unknown primary</a> that is found in several different areas of the body. Treatment may include the following: </p><ul id="CDR0000062729__113"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045110/" class="def">Hormone therapy</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046345/" class="def">Internal radiation therapy</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045214/" class="def">Chemotherapy</a> with one or more anticancer <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000348921/" class="def">drugs</a>.</div></li><li class="half_rhythm"><div>A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trial</a>.</div></li></ul><p id="CDR0000062729__TrialSearch_86_19">Use our <a href="https://www.cancer.gov/research/participate/clinical-trials-search" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">clinical trial search</a> to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. <a href="https://www.cancer.gov/research/participate/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">General information</a> about clinical trials is also available.</p></div></div><div id="CDR0000062729__118"><h2 id="_CDR0000062729__118_">Treatment of Recurrent Carcinoma of Unknown Primary</h2><p id="CDR0000062729__208">For information about the treatments listed below, see the <a href="#CDR0000062729__67">Treatment Option Overview</a> section.</p><p id="CDR0000062729__197">Treatment for <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045862/" class="def">recurrent</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000527198/" class="def">carcinoma of unknown primary</a> is usually within a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trial</a>. Treatment depends on the following:</p><ul id="CDR0000062729__198"><li class="half_rhythm"><div> The type of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a>.</div></li><li class="half_rhythm"><div>How the cancer was treated before.</div></li><li class="half_rhythm"><div>Where the cancer has come back in the body.</div></li><li class="half_rhythm"><div>The <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651193/" class="def">condition</a> and wishes of the patient.</div></li></ul><p id="CDR0000062729__TrialSearch_118_19">Use our <a href="https://www.cancer.gov/research/participate/clinical-trials-search" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">clinical trial search</a> to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. <a href="https://www.cancer.gov/research/participate/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">General information</a> about clinical trials is also available.</p></div><div id="CDR0000062729__149"><h2 id="_CDR0000062729__149_">To Learn More About Carcinoma of Unknown Primary</h2><p id="CDR0000062729__150">For more information from the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044266/" class="def">National Cancer Institute</a> about <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000527198/" class="def">carcinoma of unknown primary</a>, see the following: </p><ul id="CDR0000062729__151"><li class="half_rhythm"><div>
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<a href="https://www.cancer.gov/types/unknown-primary" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Carcinoma of Unknown Primary Home Page</a>
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</div></li><li class="half_rhythm"><div>
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<a href="https://www.cancer.gov/types/metastatic-cancer" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Metastatic Cancer</a>
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</div></li></ul><p id="CDR0000062729__149_md_40">For general cancer information and other resources from the National Cancer Institute, visit:</p><ul id="CDR0000062729__149_md_41"><li class="half_rhythm"><div>
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<a href="https://www.cancer.gov/about-cancer" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">About Cancer</a>
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</div></li><li class="half_rhythm"><div>
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<a href="https://www.cancer.gov/about-cancer/diagnosis-staging/staging" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Cancer Staging</a>
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</div></li><li class="half_rhythm"><div>
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<a href="https://www.cancer.gov/publications/patient-education/chemo-and-you" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Chemotherapy and You: Support for People With Cancer</a>
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</div></li><li class="half_rhythm"><div>
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<a href="https://www.cancer.gov/publications/patient-education/radiation-therapy-and-you" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Radiation Therapy and You: Support for People With Cancer</a>
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</div></li><li class="half_rhythm"><div>
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<a href="https://www.cancer.gov/about-cancer/coping" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Coping with Cancer</a>
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</div></li><li class="half_rhythm"><div>
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<a href="https://www.cancer.gov/about-cancer/coping/questions" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Questions to Ask Your Doctor about Cancer</a>
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</div></li><li class="half_rhythm"><div>
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<a href="https://cancercontrol.cancer.gov/ocs/resources/survivors.html" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">For Survivors, Caregivers, and Advocates</a>
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</div></li></ul></div><div id="CDR0000062729__AboutThis_1"><h2 id="_CDR0000062729__AboutThis_1_">About This PDQ Summary</h2><div id="CDR0000062729__AboutThis_2"><h3>About PDQ</h3><p id="CDR0000062729__AboutThis_3">Physician Data Query (PDQ) is the National Cancer Institute's (NCI's) comprehensive cancer information database. The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries come in two versions. The health professional versions have detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions have cancer information that is accurate and up to date and most versions are also available in <a href="https://www.cancer.gov/espanol/publicaciones/pdq" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Spanish</a>.</p><p id="CDR0000062729__AboutThis_4">PDQ is a service of the NCI. The NCI is part of the National Institutes of Health (NIH). NIH is the federal government’s center of biomedical research. The PDQ summaries are based on an independent review of the medical literature. They are not policy statements of the NCI or the NIH.</p></div><div id="CDR0000062729__AboutThis_5"><h3>Purpose of This Summary</h3><p id="CDR0000062729__AboutThis_6">This PDQ cancer information summary has current information about the treatment of carcinoma of unknown primary. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.</p></div><div id="CDR0000062729__AboutThis_7"><h3>Reviewers and Updates</h3><p id="CDR0000062729__AboutThis_8">Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary ("Updated") is the date of the most recent change.
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</p><p id="CDR0000062729__AboutThis_9">The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the <a href="https://www.cancer.gov/publications/pdq/editorial-boards/adult-treatment" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">PDQ Adult Treatment Editorial Board</a>.
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</p></div><div id="CDR0000062729__AboutThis_10"><h3>Clinical Trial Information</h3><p id="CDR0000062729__AboutThis_11">A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about the effects of a new treatment and how well it works. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard." Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.
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</p><p id="CDR0000062729__AboutThis_12">Clinical trials can be found online at <a href="https://www.cancer.gov/research/participate/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI's website</a>. For more information, call the <a href="https://www.cancer.gov/contact/contact-center" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Cancer Information Service</a> (CIS), NCI's contact center, at 1-800-4-CANCER (1-800-422-6237).
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</p></div><div id="CDR0000062729__AboutThis_13"><h3>Permission to Use This Summary</h3><p id="CDR0000062729__AboutThis_14">PDQ is a registered trademark. The content of PDQ documents can be used freely as text. It cannot be identified as an NCI PDQ cancer information summary unless the whole summary is shown and it is updated regularly. However, a user would be allowed to write a sentence such as “NCI’s PDQ cancer information summary about breast cancer prevention states the risks in the following way: [include excerpt from the summary].”
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</p><p id="CDR0000062729__AboutThis_15">The best way to cite this PDQ summary is:</p><p id="CDR0000062729__AboutThis_21">PDQ® Adult Treatment Editorial Board. PDQ Carcinoma of Unknown Primary Treatment. Bethesda, MD: National Cancer Institute. Updated <MM/DD/YYYY>. Available at: <a href="https://www.cancer.gov/types/unknown-primary/patient/unknown-primary-treatment-pdq" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://www.cancer.gov/types/unknown-primary/patient/unknown-primary-treatment-pdq</a>. Accessed <MM/DD/YYYY>. [PMID: 26389238]</p><p id="CDR0000062729__AboutThis_16">Images in this summary are used with permission of the author(s), artist, and/or publisher for use in the PDQ summaries only. If you want to use an image from a PDQ summary and you are not using the whole summary, you must get permission from the owner. It cannot be given by the National Cancer Institute. Information about using the images in this summary, along with many other images related to cancer can be found in <a href="https://visualsonline.cancer.gov/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Visuals Online</a>. Visuals Online is a collection of more than 3,000 scientific images.
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</p></div><div id="CDR0000062729__AboutThis_17"><h3>Disclaimer</h3><p id="CDR0000062729__AboutThis_18">The information in these summaries should not be used to make decisions about insurance reimbursement. More information on insurance coverage is available on Cancer.gov on the <a href="https://www.cancer.gov/about-cancer/managing-care" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Managing Cancer Care</a> page.</p></div><div id="CDR0000062729__AboutThis_19"><h3>Contact Us</h3><p id="CDR0000062729__AboutThis_20">More information about contacting us or receiving help with the Cancer.gov website can be found on our <a href="https://www.cancer.gov/contact" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Contact Us for Help</a> page. Questions can also be submitted to Cancer.gov through the website’s <a href="https://www.cancer.gov/contact/email-us" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">E-mail Us</a>.</p></div></div></div></div>
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<div xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Views</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="PDF_download" id="Shutter"></a></div><div class="portlet_content"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><a href="/books/NBK65797/?report=reader">PubReader</a></li><li><a href="/books/NBK65797/?report=printable">Print View</a></li><li><a data-jig="ncbidialog" href="#_ncbi_dlg_citbx_NBK65797" data-jigconfig="width:400,modal:true">Cite this Page</a><div id="_ncbi_dlg_citbx_NBK65797" style="display:none" title="Cite this Page"><div class="bk_tt">PDQ Adult Treatment Editorial Board. Carcinoma of Unknown Primary Treatment (PDQ®): Patient Version. 2021 Dec 17. 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2015</li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>In this Page</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="page-toc" id="Shutter"></a></div><div class="portlet_content"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><a href="#CDR0000062729__1" ref="log$=inpage&link_id=inpage">General Information About Carcinoma of Unknown Primary</a></li><li><a href="#CDR0000062729__23" ref="log$=inpage&link_id=inpage">Stages of Carcinoma of Unknown Primary</a></li><li><a href="#CDR0000062729__62" ref="log$=inpage&link_id=inpage">Treatment Option Overview</a></li><li><a href="#CDR0000062729__86" ref="log$=inpage&link_id=inpage">Treatment of Newly Diagnosed Carcinoma of Unknown Primary</a></li><li><a href="#CDR0000062729__118" ref="log$=inpage&link_id=inpage">Treatment 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