Cancer of unknown primary (CUP)

Planning treatment

Cancer of unknown primary (CUP)

Planning treatment

Your specialist works with a multidisciplinary team (MDT) to recommend the best treatment options for you. Our Canrefer website has information about MDTs in NSW.

It is important to understand your treatment options. The specialist will explain these to you, and together you will agree on a treatment plan.

What you need to know

CUP treatment options

The best treatment for your cancer of unknown primary (CUP) depends on several things:

  • the type of cells found in the cancer
  • the location and extent of the cancer in the body
  • your general health
  • your own choices and preferences.

Your specialist will explain the options to you.

Types of cancer treatment - CUP

Possible treatments for cancer of unknown primary (CUP) can include:

  • chemotherapy
  • radiotherapy (radiation therapy)
  • surgery
  • hormonal therapy
  • palliative care
  • targeted therapy – may be available in clinical trials
  • immunotherapy – may be available in clinical trials.

People with CUP may have a one or more types of treatment.  Not all treatments are suitable for every type of CUP. Some people may also take part in clinical trials which test new cancer care options.

Treatment for different CUP subtypes

Cancer of unknown primary (CUP) is an advanced cancer.

For most people, CUP cannot be cured. Instead, treatment is used to control the cancer, extend life and manage the symptoms caused by the cancer. This is known as “palliative treatment”.

Treatment for specific CUP subtypes

In some people with CUP, the type of cancer cells found and the location of the secondary cancer in the body are similar to a known cancer type. These people can be treated as though they have that cancer type.

Several specific CUP subtypes are recognised, which can be treated as advanced cancers of the following types:

  • bowel cancer
  • breast cancer
  • germ cell tumour
  • head and neck cancer
  • neuroendocrine tumour
  • ovarian cancer
  • prostate cancer.

Treatment for non-specific CUP subtypes

People with CUP that is not similar to a known cancer type, are described as having non-specific CUP.

Their treatment options are based on:

  • their ECOG performance status, which is used to assess how well someone is likely to cope with cancer treatments
  • the levels of a chemical in the blood called lactate dehydrogenase (LDH).

The main type of treatment for non-specific CUP subtypes is chemotherapy.

Ask your doctor about the treatment they recommend and where you can find more information

What to ask or talk about

Understanding your treatment options

Your specialist should explain:

  • what they think is the best treatment for you
  • how helpful they expect it to be
  • where you can have your treatment
  • any side effects you may get
  • whether there is a clinical trial you could take part in
  • any costs involved with treatment.

This will help you to make an informed decision about what treatment to have.

Making treatment decisions

Some key points to remember when making treatment decisions:

  • Make sure you have all the information you need to make your decision, including what costs will be involved.
  • Ask the specialist to explain more clearly if you don’t understand the choices.
  • Don’t be rushed into decisions.
  • Take time to think about your choices and discuss them with your doctors and your family or friends.
  • If you are not happy with the choices you are offered, you can ask to see another specialist for a second opinion.‚Äč


Use our checklists to find helpful tips or questions to ask.

Next steps

Treatment plan

Once you and your specialist have agreed on your treatment, a treatment plan will be made. 

The treatment plan gives details of:

  • the different treatments you will have
  • the order you will have them in
  • where you will have each treatment
  • what each treatment will involve
  • how long the treatment will take. 

Starting treatment

Before you start treatment, make sure you know:

  • the date and time of your first treatment
  • where you need to go
  • if you need any tests beforehand
  • whether there is anything you should do to prepare
  • when you next need to see your specialist.

Where to get help

There are people you can talk to for more information or support.

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