Unknown Primary


Carcinoma of Unknown Primary (CUP)

This can affect about 5% of all cancers.

By definition these cancers represent cancers that have spread and an initial primary site of cancer is undetectable using conventional tests.

Patients can present with a wide spectrum of symptoms and treatment can vary dependent on site, type and distribution of cancer.

Although there are recognised treatment modalities for these cancers further research is required to develop a better understanding of this complex disease.


Dr Gerard Andrade

Consultant Clinical Oncologist



Why is the primary hidden ?

'What, Why and How' are fairly typical reactions to CUP diagnosis, you are not alone if you have never heard of cancer of unknown primary before. It seems incomprehensible in our scientific age that a Primary is invisible. There are 4 main possibilities for the invisibility:


  • Size of a grain of rice or smaller. The primary may be very small – too small to be picked-up by present day tests including ultrasound, CT scans, MRI and PET.
  • Fallen on stony ground. The primary may have been successfully attacked by the body’s immune system as it tries to get a toehold and has migrated through the body to find sanctuary in a place where it can thrive and confuse the immune system.
  • Self healing. The primary might have “self healed” or been pushed out of the body if, for example, it was hanging perilously to part of the digestive system. This does not necessarily stop it from manifesting itself as a secondary.
  • Hidden. The secondaries, if growing close to the primary, may make it difficult to distinguish from a larger cancer mass.

    The above information is courtesy of CUP Foundation- Jo's Friends. To find out more information please visit www.cupfoundjo.org




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