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Cancer of unknown primary

Multiple sites of metastasis for cup cancers

of Unknown

According to the National Cancer Institute, this diagnosis is given to between 2 and 4 percent of all those newly diagnosed with cancer.

Cancer of unknown primary (CUP) is attributed when the disease has metastasized, but the place where the cancer began cannot be determined. Since many cancers are named after the place of origin, the designation of CUP is given in these cases.

It’s suspected that the original (primary) tumor may be small or have shrunk without discovery.

It is also possible that the original tumor was unknowingly removed, such as during a hysterectomy or the removal of a mole. CUP is most often found in the lymph nodes, liver, lungs, pancreas or bone, but can be found in other sites, as well.

Recently, advances in diagnostic capabilities have dramatically improved, thus enabling physicians to ultimately identify cancers originally determined to be cancer of unknown primary.

Sometimes, the type of cells found within the metastasis can help determine the hidden primary site. 


Chemotherapy is the most common treatment option for cancer of unknown primary.

But, since conventional treatment plans are based on protocols developed for known primaries, the typical treatment plan for a CUP diagnosis depends heavily on the size, location of the tumor found, where it has spread and the patient’s general health.

While most oncologists will use existing protocol guidelines to treat these unknown tumor types, at Nagourney Cancer Institute your personalized cancer therapy plan will be developed based on chemo and targeted therapies that have shown, in the lab, to kill your tumor cells.

Our EVA-PCD functional profiling assay uses a sample of your tumor to create a functional profile of your cancer. Based on the results, treatment recommendations are developed for you without needing to define the primary site of your cancer.

At Nagourney Cancer Institute, our philosophy is that "it is less important to know where a tumor came from than it is to know how to treat it."

Cancer treatment
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Nagourney Cancer Institute
750 E. 29th Street
Long Beach, California 90806

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