Treatment Options for Carcinoma of Unknown Primary
Newly Diagnosed Carcinoma of Unknown Primary
Cervical (Neck) Lymph Nodes
Poorly Differentiated Carcinomas
Women with Peritoneal Cancer
Isolated Axillary Lymph Node Metastasis
Inguinal Lymph Node Metastasis
Melanoma in a Single Lymph Node Area
Multiple Involvement
Recurrent Carcinoma of Unknown Primary
Newly Diagnosed Carcinoma of Unknown Primary
Cervical (Neck) Lymph Nodes
Cancer found in cervical (neck) lymph nodes may have spread from a tumor in the head or neck. Treatment of cervical lymph node carcinoma of unknown primary (CUP) may include the following:
- Surgery to remove the tonsils.
- Radiation therapy alone. Intensity-modulated radiation therapy (IMRT) may be used.
- Radiation therapy followed by surgery to remove the lymph nodes.
- Surgery to remove the lymph nodes, with or without radiation therapy.
- A clinical trial of new types of treatment.
See the PDQ summary on Metastatic Squamous Neck Cancer with Occult Primary Treatment 1 for more information.
Poorly Differentiated CarcinomasCancer cells that are poorly differentiated look very different from normal cells. The type of cell they came from is not known. Treatment of poorly differentiated carcinoma of unknown primary, including tumors in the neuroendocrine system (the part of the brain that controls hormone -producing glands throughout the body) may include the following:
- Combination chemotherapy.
- A clinical trial of new types of treatment.
Treatment for women who have peritoneal (lining of the abdomen) carcinoma of unknown primary may be the same as for ovarian cancer. Treatment may include the following:
- Chemotherapy.
- A clinical trial of new types of treatment.
See the PDQ summary on Ovarian Epithelial Cancer Treatment 2 for more information.
Isolated Axillary Lymph Node MetastasisCancer found only in the axillary (armpit) lymph nodes may have spread from a tumor in the breast.
Treatment of axillary lymph node metastasis is usually:
- Surgery to remove the lymph nodes.
Treatment also may include one or more of the following:
- Surgery to remove the breast.
- Radiation therapy to the breast.
- Chemotherapy.
- A clinical trial of new types of treatment.
Cancer found only in the inguinal (groin) lymph nodes most likely began in the genital, anal, or rectal area. Treatment of inguinal lymph node metastasis may include the following:
- Surgery to remove the cancer and/or lymph nodes in the groin.
- Surgery to remove the cancer and/or lymph nodes in the groin, followed by radiation therapy or chemotherapy.
Treatment of melanoma that is found only in a single lymph node area is usually:
- Surgery to remove the lymph nodes.
See PDQ summary on Melanoma Treatment 3 for more information.
Multiple InvolvementThere is no standard treatment for carcinoma of unknown primary that is found in several different areas of the body. Treatment may include the following:
- Hormone therapy.
- Internal radiation therapy.
- Chemotherapy with one or more anticancer drugs.
- A clinical trial.
Treatment for recurrent carcinoma of unknown primary is usually within a clinical trial. Treatment depends on the following:
- The type of cancer.
- How the cancer was treated before.
- Where the cancer has come back in the body.
- The condition and wishes of the patient.
Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with recurrent carcinoma of unknown primary 4. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site 5.
Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with newly diagnosed carcinoma of unknown primary 6. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site 5.
Glossary Termsabdomen (AB-doh-men)The area of the body that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs.anal (AY-nul) Having to do with the anus. The anus is the opening of the rectum (last part of the large intestine) to the outside of the body.axillary (AK-sih-LAYR-ee) Pertaining to the armpit area, including the lymph nodes that are located there.axillary lymph node (AK-sih-LAYR-ee limf node) A lymph node in the armpit region that drains lymph from the breast and nearby areas.breast (brest) Glandular organ located on the chest. The breast is made up of connective tissue, fat, and breast tissue that contains the glands that can make milk. Also called mammary gland.cancer (KAN-ser) A term for diseases in which abnormal cells divide without control and can invade nearby tissues. Cancer cells can also spread to other parts of the body through the blood and lymph systems. There are several main types of cancer. Carcinoma is a cancer that begins in the skin or in tissues that line or cover internal organs. Sarcoma is a cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue. Leukemia is a cancer that starts in blood-forming tissue such as the bone marrow, and causes large numbers of abnormal blood cells to be produced and enter the blood. Lymphoma and multiple myeloma are cancers that begin in the cells of the immune system. Central nervous system cancers are cancers that begin in the tissues of the brain and spinal cord. Also called malignancy.carcinoma of unknown primary (KAR-sih-NOH-muh ... UN-none PRY-mayr-ee) A case in which cancer cells are found in the body, but the place where the cells first started growing (the origin or primary site) cannot be determined. Also called cancer of unknown primary origin and CUP.cell (sel) The individual unit that makes up the tissues of the body. All living things are made up of one or more cells.cervical (SER-vih-kul) Relating to the neck, or to the neck of any organ or structure. Cervical lymph nodes are located in the neck. Cervical cancer refers to cancer of the uterine cervix, which is the lower, narrow end (the “neck”) of the uterus.chemotherapy (KEE-moh-THAYR-uh-pee) Treatment with drugs that kill cancer cells.clinical trial (KLIH-nih-kul TRY-ul) A type of research study that tests how well new medical approaches work in people. These studies test new methods of screening, prevention, diagnosis, or treatment of a disease. Also called clinical study.combination chemotherapy (KOM-bih-NAY-shun KEE-moh-THAYR-uh-pee) Treatment using more than one anticancer drug.condition (kun-DIH-shun) In medicine, a health problem with certain characteristics or symptoms.differentiation (DIH-feh-REN-shee-AY-shun) In cancer, refers to how mature (developed) the cancer cells are in a tumor. Differentiated tumor cells resemble normal cells and tend to grow and spread at a slower rate than undifferentiated or poorly differentiated tumor cells, which lack the structure and function of normal cells and grow uncontrollably.drug (drug) Any substance, other than food, that is used to prevent, diagnose, treat or relieve symptoms of a disease or abnormal condition. Also refers to a substance that alters mood or body function, or that can be habit-forming or addictive, especially a narcotic.genital (JEH-nih-tul) Refers to the genitalia (external and internal sex organs and glands).gland (gland) An organ that makes one or more substances, such as hormones, digestive juices, sweat, tears, saliva, or milk. Endocrine glands release the substances directly into the bloodstream. Exocrine glands release the substances into a duct or opening to the inside or outside of the body.groin (groyn) The area where the thigh meets the abdomen.hormone (HOR-mone) One of many chemicals made by glands in the body. Hormones circulate in the bloodstream and control the actions of certain cells or organs. Some hormones can also be made in the laboratory.hormone therapy (HOR-mone THAYR-uh-pee) Treatment that adds, blocks, or removes hormones. For certain conditions (such as diabetes or menopause), hormones are given to adjust low hormone levels. To slow or stop the growth of certain cancers (such as prostate and breast cancer), synthetic hormones or other drugs may be given to block the body’s natural hormones. Sometimes surgery is needed to remove the gland that makes a certain hormone. Also called endocrine therapy, hormonal therapy, and hormone treatment.intensity-modulated radiation therapy (in-TEN-sih-tee-MAH-juh-LAY-tid RAY-dee-AY-shun THAYR-uh-pee) A type of 3-dimensional radiation therapy that uses computer-generated images to show the size and shape of the tumor. Thin beams of radiation of different intensities are aimed at the tumor from many angles. This type of radiation therapy reduces the damage to healthy tissue near the tumor. Also called IMRT.internal radiation therapy (in-TER-nul RAY-dee-AY-shun THAYR-uh-pee) A type of radiation therapy in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into or near a tumor. Also called brachytherapy, implant radiation therapy, and radiation brachytherapy.lymph node (limf node) A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Lymph nodes filter lymph (lymphatic fluid), and they store lymphocytes (white blood cells). They are located along lymphatic vessels. Also called lymph gland.melanoma (MEH-luh-NOH-muh) A form of cancer that begins in melanocytes (cells that make the pigment melanin). It may begin in a mole (skin melanoma), but can also begin in other pigmented tissues, such as in the eye or in the intestines.metastasis (meh-TAS-tuh-sis) The spread of cancer from one part of the body to another. A tumor formed by cells that have spread is called a “metastatic tumor” or a “metastasis.” The metastatic tumor contains cells that are like those in the original (primary) tumor. The plural form of metastasis is metastases (meh-TAS-tuh-SEEZ).neuroendocrine (NOOR-oh-EN-doh-krin) Having to do with the interactions between the nervous system and the endocrine system. Neuroendocrine describes certain cells that release hormones into the blood in response to stimulation of the nervous system.ovarian cancer (oh-VAYR-ee-un KAN-ser) Cancer that forms in tissues of the ovary (one of a pair of female reproductive glands in which the ova, or eggs, are formed). Most ovarian cancers are either ovarian epithelial carcinomas (cancer that begins in the cells on the surface of the ovary) or malignant germ cell tumors (cancer that begins in egg cells).PDQ PDQ is an online database developed and maintained by the National Cancer Institute. Designed to make the most current, credible, and accurate cancer information available to health professionals and the public, PDQ contains peer-reviewed summaries on cancer treatment, screening, prevention, genetics, complementary and alternative medicine, and supportive care; a registry of cancer clinical trials from around the world; and directories of physicians, professionals who provide genetics services, and organizations that provide cancer care. Most of this information, and more specific information about PDQ, can be found on the NCI's Web site at http://www.cancer.gov/cancertopics/pdq. Also called Physician Data Query.peritoneal (PAYR-ih-toh-NEE-ul) Having to do with the parietal peritoneum (the tissue that lines the abdominal wall and pelvic cavity) and visceral peritoneum (the tissue that covers most of the organs in the abdomen, including the intestines).radiation therapy (RAY-dee-AY-shun THAYR-uh-pee) The use of high-energy radiation from x-rays, gamma rays, neutrons, protons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body near cancer cells (internal radiation therapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that travels in the blood to tissues throughout the body. Also called irradiation and radiotherapy.rectal (REK-tul) By or having to do with the rectum. The rectum is the last several inches of the large intestine closest to the anus.recurrent cancer (ree-KER-ent KAN-ser) Cancer that has recurred (come back), usually after a period of time during which the cancer could not be detected. The cancer may come back to the same place as the original (primary) tumor or to another place in the body. Also called recurrence.standard therapy (... THAYR-uh-pee) Treatment that experts agree is appropriate, accepted, and widely used. Also called best practice, standard medical care, and standard of care.surgery (SER-juh-ree) A procedure to remove or repair a part of the body or to find out whether disease is present. An operation.tonsil (TON-sil) One of two small masses of lymphoid tissue on either side of the throat.tumor (TOO-mer) An abnormal mass of tissue that results when cells divide more than they should or do not die when they should. Tumors may be benign (not cancer), or malignant (cancer). Also called neoplasm. |
