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- In trying to discover the primary site, there are two important considerations.
- 1. Some primary cancers are much more treatable than others. These include cancers of the
- breast, prostate, thyroid and ovary, lymphomas (including Hodgkin's disease), as well as
- germ cell tumors similar to those that develop in the testes. Great efforts are made to determine if one of these
- is the primary site. Not only is the prognosis much better with these types of cancer, but the treatment has to
- be specific for that cancer. The usual non-specific combination chemotherapy programs for CUPS have a low
- rate of response.
- 2. There are important clues your doctor can use to discover the primary site.
- • One clue is the location of the metastases. A woman with a tumor that develops in glands (adenocarcinoma)
- and is found in the lymph nodes of the armpit, for example, is more likely to have carcinoma of the breast. A
- woman who develops fluid in the abdomen (ascites) or has a tumor involving the lining of the abdominal
- cavity (peritoneum) should be suspected of having ovarian cancer.
- • The most common sites of CUPS are metastases to the lung, lymph nodes, bones and liver. When CUPS is
- found in the upper part of the body (above the diaphragm), the most common source is the lung. When it
- appears in the liver, the usual primary site is the gastrointestinal tract, including the pancreas.
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