About Cancer

There are many different types of cancer with unique characteristics, but they all involve the same underlying process. 

Cancer begins when healthy cells become damaged or ‘mutated’ and begin to multiply uncontrollably, often leading to the formation of a tumour. It can occur in various parts of the body, and some types will grow and spread more rapidly than others Oncologists are doctors who are experts that specialise in detecting cancer and treating it. They work alongside a range of other healthcare professionals to offer comprehensive care plans tailored to each individual’s needs.

Carcinoma of Unknown Primary (CUP)

Cancers begin in one place but may spread to other parts of your body in a process known as metastasis. The original location is known as the ‘primary’ cancer, and treatment is usually based around this. Carcinomas are a form of cancer that involve a particular cell type called epithelial cells, and they often metastasise to other locations. Sometimes it can be difficult to know where a carcinoma began, as it may only be detected after it has spread. This is known as Carcinoma of Unknown Primary (CUP).

At the PPU, we have developed an advanced pathway for diagnosing and investigating patients who have had a scan that demonstrates metastatic disease – without an obvious primary cancer being detected. The speed of diagnosis is crucial to ensure patients are referred to the correct team to start treatment as soon as possible. Imaging scans such as CT or MRI that suggest cancer are rapidly seen to by our oncology team who will arrange an assessment as soon as possible.

They will usually take a small sample of cells (biopsy) to determine the diagnosis of a tumour and type of cells it is composed of. If the tumour cells are of a different type to the surrounding healthy cells, (indicating that they have spread from elsewhere), CUP can be diagnosed and the speedy search for the primary carcinoma will begin.

The region of in the body in which the tumour is found can help to guide further investigations. Cancers often spread in a particular pattern, and this can be used to trace them back to the primary location. We are committed to investing in innovative technologies, and advanced imaging scans such as PET (positron emission tomography) can map out the location of cancer cells. Blood tests for tumour markers (chemicals that are linked to specific types of tumours) can also help to identify the primary carcinoma. Sometimes, however, the primary carcinoma cannot be found, so treatment will begin based on what type of cancer is most likely.