Cancer of Unknown Primary: Treatment Choices

March 21, 2017

Cancer of Unknown Primary: Treatment Choices

Woman talking with a female doctor

Learning about your treatment options

Because a cancer of unknown primary (CUP) can be any one of many types of cancers, there is not one way to treat it. The treatment your healthcare provider recommends depends on where the cancer most likely started. It also depends on the size and location of the tumor or tumors, the results of your lab and imaging tests, and the stage or extent of the cancer. Your healthcare provider also takes your age and general health into account when suggesting treatment.

Today there are more ways than ever before to find the origin of CUP. These include genetic analysis. The closer your healthcare provider can get to finding where the cancer came from (called the primary site), the higher the chance that your treatment will work.

It’s normal to have questions and concerns about treatment. Learn all you can about the cancer and your treatment choices. That way, you’ll be able to help make decisions about your care.

Your healthcare provider is the best person to answer questions about treatment. Ask him or her following:

  • What the choices are

  • How well they can work

  • What the risks and side effects may be

  • How you may need to change your normal activities

  • The goal of treatment

Sometimes, even if a cure isn’t possible, treatment may improve your quality of life. It may also help you live longer. You may want to consider both the possible side effects and benefits of treatment.

It’s more important to make an informed choice rather than a quick one.It may take two or three weeks to get results from some tests. Make sure you receive all of the information before making your decision. It will also help you learn what to expect from treatment and your cancer care team.

Types of treatment for CUP

Treatment is only started after a long search for a primary cancer. This includes many tests. These can include imaging, blood, and other tests. You may have a new test that analyzes genetic mutations in the cancer to look for a likely primary cancer. 

When a primary cancer can’t be found, you’ll have treatment for CUP. It may be local, systemic, or a combination of both. Local treatments remove, destroy, or control cancer cells in one area. Radiation and surgery are local treatments. Systemic treatments are used to destroy or control cancer cells throughout your entire body. Chemotherapy and hormone therapy are systemic treatments.

You may get just one type of treatment or a combination of treatments.


The goals of chemotherapy are to shrink or slow the growth of the cancer. It’s also done to reduce the chance that the cancer will spread. This may ease symptoms, extend your life, or cure the cancer in some cases.

Radiation therapy

The goal of radiation is to kill cancer cells. It does this by using strong beams of energy. Radiation can be used to kill a cancer in one area of the body. It can also be used to ease the symptoms of cancer. There are two kinds of radiation — external and internal. For external radiation, a machine delivers radiation from outside of the body. For internal radiation, a healthcare provider places a radioactive source (often in tiny pellets) in or near the cancer. This kills the cells.

Hormone therapy

This treatment stops the hormones in the body from allowing certain types of cancer cells to grow. Stopping the hormones can be done one of two ways. You may have surgery or radiation. This is done to take out or destroy organs that make hormones. These include the ovaries or testicles. Or, your healthcare provider may give medicines that change the way hormones work.


The goal of surgery is to remove cancerous growths from your body.

Clinical trials for new treatments

Experts are finding new ways to treat cancer. These methods are tested in clinical trials. Before starting treatment, ask your healthcare team if there are any clinical trials you should consider.

Working with your healthcare provider for a treatment plan

Work with your healthcare team to make a treatment plan. It may take time to choose the best plan.

Ask your healthcare provider how much time you can take to explore your options. It can be tough to decide on a treatment. You may want a second opinion first. A second opinion can give peace of mind. It can also help you make sure you’re making the best choices for treatment. You may also want to talk with your family and friends.


March 21, 2017

Reviewed By:  

Gersten, Todd, MD,Stump-Sutliff, Kim, RN, MSN, AOCNS