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If a cancer has spread throughout your body before it is discovered, it may be difficult to determine exactly where it started. When this happens, your cancer is considered a cancer of uncertain or unknown primary (also known as CUP). Even after the most thorough clinical workup, accurate identification of the primary cancer site may not be possible.

The urgency of identifying the primary tumor site

One example of a cancer of unknown primary would be a person with an enlarged lymph node on the side of their neck. When the lymph node is removed, it is found to contain cancer. But the appearance of the cancer under the microscope does not look like a cancer that starts in lymph nodes. At that point it might be called “cancer of unknown primary” (or CUP). Often, though, its appearance might suggest that the cancer started in the mouth, throat, or voice box (larynx). During a thorough exam of this area, a small cancer of the pharynx might be found. From then on, the patient is said to have pharyngeal cancer rather than cancer of unknown primary and will receive treatment that is appropriate for that cancer.

However, many times even after further examination and conventional laboratory tests, physicians still cannot identify the original source of the cancer. In these cases, CancerTYPE ID can help physicians quickly and accurately determine the original cancer source to ensure patients receive the most appropriate therapy.

CancerTYPE ID^® helps in selecting the right therapy

CancerTYPE ID provides information that guides physicians in identification of the primary cancer site. This molecular diagnostic test is able to classify 54 different tumor types and can be used on small biopsy specimens.^1,2 When used in the early diagnostic workup of a needle biopsy sample, CancerTYPE ID can lead to a quicker and more complete diagnosis and, ultimately, more appropriate treatment.

Types of cancer classifications

The following list does not include all types of cancers, but merely names the most common ones so that you can better understand when your physician team discusses your treatment needs. All cancers are named according to their appearance under the microscope.

• Well Differentiated cancer has cells that closely resemble normal cells of the organ where they start.
• Poorly Differentiated cancer has cells with very little similarity to normal cells. In general, cancers of unknown primary tend to be poorly differentiated.
• Squamous cell cancers are formed by flat cells normally found on the surface of the skin or the linings of the mouth, throat, or vagina.
• Adenocarcinomas are cancers that develop from gland cells. Gland cells are found in many organs of the body, including some that are not usually thought of as glands. For example, almost all cancers from the intestinal tract are adenocarcinomas. About 40% of lung cancers are adenocarcinomas. Adenocarcinomas can also develop in many other organs.
• Lymphoma develops from cells of the immune system found in lymph nodes and several other organs.
• Melanomas develop from cells that produce the skin’s tan or brown color.
• Sarcomas develop from connective tissue cells that are usually present in tendons, ligaments, muscle, fat, and related tissues.
• Germ cell tumors, mostly seen in men, typically begin in the testes (testicles) or parts of the body where the testes developed in the fetus.

For more information about cancer of unknown primary or CUP, visit The Cancer of Unknown Primary Foundation.

References:
1. Ma, et al. Molecular Classification of Human Cancers Using a 92-Gene Real Time Quantitative Polymerase Chain Reaction Assay. Archives of Pathology and Laboratory Medicine, 130: 465-473, 2006.
2. Data on file.  Technical Report 021510, bioTheranostics.