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Treatment of Cancer of Unknown Primary (CUP)

Due to the difficulties associated with the organization of treatment in Turkey, Switzerland, South Korea and India, we are not currently processing requests to these regions.

If you are interested in treatment in Germany, please leave a request and our specialists will contact you as soon as possible.

 

Cost for treatment

Cancer of unknown primary (CUP) diagnosis
 from  3315
Cancer rehabilitation
 from  951

Vivantes Neukölln Hospital Berlin

10/10
location_onGermany, Berlin

Department of Hematology, Oncology and Palliative Medicine

The Vivantes Neukölln Hospital is the maximum care hospital and one of the largest healthcare facilities in Berlin.  There are more than 20 specialized departments and centers, including pediatric departments. In total, the hospital has 1,200 beds. The hospital uses innovative technologies and the latest treatments, as
Cancer of unknown primary (CUP) diagnosis
9878

Medias Cancer Clinic Burghausen

10/10
location_onGermany, Burghausen

Department of Oncology and Surgical Oncology

The Medias Cancer Clinic Burghausen positions itself as a private highly specialised medical facility with international leadership in cancer treatment. The key areas of specialization of the clinic include regional chemotherapy, surgical oncology, hyperthermia, immunotherapy and pain therapy. The ultimate value of each emp
Cancer of unknown primary (CUP) diagnosis
11624

University Hospital Ulm

8.7/10
location_onGermany, Ulm

Department of Hematology, Oncology, Palliative Care, Rheumatology and Infectology

The University Hospital Ulm started its activities 35 years ago and during this time it has become one of the most prestigious medical institutions in Europe. The hospital is famous for its numerous discoveries and the world-class achievements in medicine and pharmaceuticals. The medical facility has 29 specialized departments a
Cancer of unknown primary (CUP) diagnosis
11085

MediClin Robert Janker Clinic

9.5/10
location_onGermany, Bonn

Department of Oncology and Palliative Care

The MediClin Robert Janker Clinic is a progressive medical facility, which has all the very latest diagnostic and treatment methods for the recovery of health of patients who suffer from cancers. The clinic was founded by renowned radiologist and surgeon Robert Janker. Today, its history has more than 80 years of successful clin
Cancer of unknown primary (CUP) diagnosis
11215

University Hospital Freiburg

9.7/10
location_onGermany, Freibung

Department of Hematology and Oncology

The University Hospital Freiburg is famous for its rich history and is one of the oldest and most prestigious medical facilities in Germany (one of the three best medical institutions in the country). The hospital was based on the Faculty of Medicine of the Albert Ludwig University of Freiburg, which celebrated its 550th anniver
Cancer of unknown primary (CUP) diagnosis
11656

University Hospital Frankfurt am Main

10/10
location_onGermany, Frankfurt am Main

Cancer Center

According to the reputable Focus magazine, the University Hospital Frankfurt am Main ranks among the top German medical facilities! The hospital was founded in 1914 and today is a well-known German medical facility, which combines rich traditions and scientific innovations. A medical team of more than 6,500 employees cares about
Cancer of unknown primary (CUP) diagnosis
10549

University Hospital Heidelberg

9.8/10
location_onGermany, Heidelberg

Department of Hematology, Oncology, Adult and Pediatric Rheumatology

According to the Focus magazine, the University Hospital Heidelberg ranks among the top five hospitals in Germany! The hospital is one of the most advanced and reputable medical institutions not only in Germany, but throughout Europe. There are more than 43 specialized departments and 13 medical institutes, which cover all field
Cancer of unknown primary (CUP) diagnosis
0

University Hospital Würzburg

9.2/10
location_onGermany, Würzburg

Department of Gastroenterology, Hematology, Oncology, Hepatology, Infectology, Rheumatology and Clinical Immunology

According to the Focus magazine in 2019, the University Hospital Würzburg ranks among the top national German hospitals! The hospital is one of the oldest medical facilities in Germany. The centuries-old traditions of first-class treatment are combined with the very latest achievements of modern evidence-based medicine and
Cancer of unknown primary (CUP) diagnosis
10125

University Hospital RWTH Aachen

8.7/10
location_onGermany, Aachen

Department of Oncology and Hematology

According to the prestigious Focus magazine, the University Hospital RWTH Aachen ranks among the top German hospitals! As a maximum care university medical facility, the hospital guarantees patients first-class medical services combined with a respectful and human attitude. The hospital integrates all the modern options for the
Cancer of unknown primary (CUP) diagnosis
11455

University Hospital Carl Gustav Carus Dresden

9.1/10
location_onGermany, Dresden

Department of Oncology

According to the prestigious Focus magazine, the University Hospital Carl Gustav Carus Dresden is among the top three hospitals in Germany! The hospital is the embodiment of the standards of modern high-quality medicine. Since the hospital positions itself as a maximum care medical facility, it represents all medical fields. The
Cancer of unknown primary (CUP) diagnosis
13415

University Hospital Erlangen

9.1/10
location_onGermany, Erlangen

Department of Hematology and Oncology

According to the Focus magazine, University Hospital Erlangen ranks among the best medical facilities in Germany! The hospital is one of the leading healthcare facilities in Bavaria and offers top-class medical care distinguished by the close intertwining of clinical activities with research and training of medical students. The
Cancer of unknown primary (CUP) diagnosis
10922

University Hospital Halle (Saale)

9.6/10
location_onGermany, Halle

Department of Hematology and Oncology

According to the prestigious Focus magazine, the University Hospital Halle (Saale) ranks among the top German medical facilities! The history of the hospital has more than 300 years, and during this time it managed to earn an excellent reputation not only in Germany, but throughout the world. The hospital positions itself as a s
Cancer of unknown primary (CUP) diagnosis
10021

University Hospital Hamburg-Eppendorf

9.2/10
location_onGermany, Hamburg

Department of Hematology, Oncology and Pulmonology

According to the Focus magazine, the University Hospital Hamburg-Eppendorf ranks among the top ten hospitals in Germany! Since its foundation in 1889, the hospital has taken a leading position in the European medical arena and still occupies it until today. A highly competent medical team of more than 11,000 employees takes care
Cancer of unknown primary (CUP) diagnosis
9783

Charite University Hospital Berlin

9/10
location_onGermany, Berlin

Charité Comprehensive Cancer Center

According to the authoritative Focus magazine, the Charite University Hospital Berlin occupies the first place in the rating of the top German medical facilities! The hospital is one of the largest and leading university medical complexes in Europe. The hospital in Germany provides modern diagnostics and treatment of patients, a
Cancer of unknown primary (CUP) diagnosis
9951

University Hospital Bonn

9.2/10
location_onGermany, Bonn

Department of Oncology, Hematology, Rheumatology and Immunoncology

According to the authoritative Focus magazine, the University Hospital Bonn ranks among the top ten medical facilities in Germany! The hospital was opened on January 1, 2001, although in fact it inherits the medical facility, which operated at the Faculty of Medicine of the University of Bonn. The hospital in Germany combin
Cancer of unknown primary (CUP) diagnosis
11728

University Hospital Giessen UKGM

9.5/10
location_onGermany, Giessen

Department of Oncology, Hematology and Palliative Care

The University Hospital Giessen UKGM positions itself as an ultramodern medical facility with outstanding quality of medical care. The hospital presents almost all areas of medicine, ranging from ophthalmology to traumatology and dentistry. The priorities of the hospital’s activities include surgery, neurosurgery, oncology
Cancer of unknown primary (CUP) diagnosis
9761
| from Booking Health GmbH

Content

  1. Overview
  2. Can cancer of unknown primary be treated?
  3. Types of cancer of unknown primary
  4. Diagnosis of cancer of unknown primary
  5. Symptoms
  6. Treatment
  7. Prognosis
  8. Best hospitals to undergo treatment of cancer of unknown primary
  9. The cost of treatment of cancer of unknown primary (CUP)
  10. How to undergo treatment of cancer of unknown primary abroad?

 

Cancer of unknown primary (CUP) is a disease manifested by metastatic tumors, while the primary focus cannot be revealed either based on the medical history of the patient or according to clinical examination data.

Overview

 

Sometimes the localization of the primary malignant focus is unknown. In such cases, it is called cancer of unknown primary (CUP).

Since this type of cancer metastasizes at the first stages, by the time the patient seeks medical help, the metastatic process usually spreads beyond one organ.

Cancer of unknown primary includes cases of oncological disease manifested by metastatic tumors, while the primary tumor is not revealed. The primary focus can be found with the help of additional examinations, and then the diagnosis is changed, and the treatment tactic is adjusted accordingly.

Can cancer of unknown primary be treated?

 

The primary localization of a malignant tumor is one of the main clinical criteria in establishing the treatment tactic. Cancer of unknown primary (CUP) is difficult to diagnose, but it is still possible.

Nevertheless, even if the origin of cancer is unknown, treatment still can be successful. According to statistics, the mortality rate of patients with cancer of unknown primary has decreased by 42% over the last ten years.

And even when it’s unknown where cancer has originated, professionals do their best to identify the tumor origin, which will help them choose the best treatment option.

Types of cancer of unknown primary

 

Following cancer types can be diagnosed without identification of a primary localization:

  • Well and moderately differentiated adenocarcinomas
  • Poorly differentiated carcinomas (including poorly differentiated adenocarcinomas)
  • Squamous cell carcinomas
  • Neuroendocrine tumors

Depending on the metastases spreading, patients are divided into few groups:

  • Patients with metastases in the lymph nodes (single or multiple within one lymph collector) – cervical, axillary, inguinal, and retroperitoneal
  • Patients with metastases in organs and tissues (single or multiple) – bones, lungs, liver, soft tissues, and brain
  • Patients with metastases in several lymph nodes, concomitant involvement of lymph nodes and/or organs

Symptoms

 

Symptoms of cancer of unknown primary (CUP) are nonspecific and depend on the localization of metastases and the spreading of the tumor process. However, depending on the localization of metastases, symptoms of cancer of unknown primary may vary.

For example, if metastases of primary cancer unknown (CUP) are found in the lungs, symptoms such as cough and shortness of breath are noticed. With metastases in the bones, pain in the bones or fracture of bones can develop. With metastases in the liver, pain in the abdomen, nausea, jaundice, or ascites may develop. With metastases in the lymph nodes, swollen lymph nodes are noticed.

General symptoms of cancer of unknown primary include:

  • Weight loss
  • Fatigue
  • Anemia
  • Loss of appetite

Diagnosis of cancer of unknown primary

 

Clinical examination of patients with cancer of unknown primary is complicated. The diagnostic algorithm in patients with metastatic sites without an identified primary tumor involves several stages, including:

  • Preliminary assessment of the general health condition
  • Assessment of the spreading of metastatic process
  • Harvesting material for histological examination
  • Search for the primary focus

A preliminary assessment is carried out based on a physical examination of the patient. It should be noted that the general health condition of the patient is an important factor in the choice of diagnostic tactics. Obviously, it makes no sense for a patient in a serious health condition to conduct a full examination. Even if it is possible to identify the primary tumor, the patient won’t undergo intense treatments. In this situation, a diagnostic program that includes only the first three stages is more suitable. In especially severe cases, the administration of symptomatic therapy should be discussed without examination.

After clinical analysis of chest X-ray data, ultrasound scan of the abdominal cavity, retroperitoneal region and small pelvis, and computed tomography, the localization of metastases is estimated. The use of computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET, PET-CT) allows professionals to identify additional metastatic sites, specifying the spreading of metastases, and determining the localization of the primary focus.

An important stage of the clinical examination is a histological study of the tissue harvested during puncture or biopsy. Histological examination is significant, it should be performed as early as possible. The data obtained makes it possible to confirm the malignancy of the process, to determine the tissue type from which the tumor has developed, to assess the degree of malignancy of cancer cells, and sometimes to assume the localization of the primary tumor, which greatly facilitates the search for the primary focus and reduces the number of diagnostic procedures.

Treatment

 

Since the primary focus remains unknown, any treatment carried out is hardly radical. Therefore, the choice of treatment tactic in people with cancer of unknown primary (CUP) is an issue that should be managed on an individual basis in each specific case. The therapeutic tactics are determined, first of all, taking into account the general health condition of the patient, the localization of metastases, the spreading of the tumor process, the type of the metastatic tumor, and the assumed localization of the primary focus.

Recently, researches have been carried out to develop therapeutic tactics that are not based on the localization of cancer of unknown primary, but are based on the biological characteristics of the tumor. This will make it possible to make the treatment more individualized and use targeted therapy more often. It has been proven that the average life expectancy of people who received targeted treatment is significantly higher than that of those whose treatments were limited to symptomatic therapy. The best five-year survival rates were observed in people with isolated metastases in the inguinal, axillary, and cervical lymph nodes who received targeted treatments.

The surgical method of treatment in patients with cancer of unknown primary is not radical. It can be used in case of involvement of the lymph nodes that can be removed or in isolated organ damage. Lymphadenectomy (lymph node removal) or removal of metastases with organ resection is possible. Also, surgical intervention may be performed with a symptom managing purpose.

Radiation therapy can be indicated for patients with isolated metastatic areas in the lymph nodes or organs with potential sensitivity to radiation. It is also possible to use radiation therapy as the symptomatic treatment option.

Since cancer of unknown primary (CUP) suggests a disseminated process or presence of distant metastatic, systemic drug therapy is considered to be the main method of treatment.

Treatment is personalized and based on all available clinical and histological data. The cellular characteristics of the tumor and its potential susceptibility to certain drugs are of decisive importance. If certain mutations are identified in the tumor, targeted therapy can be used. In cases of distant metastases, the combination of chemotherapy with surgical and radiation methods can lead to the achievement of significantly better results.

Prognosis

 

The prognosis in patients with metastases in cancer of unknown primary is not always unfavorable.

The survival rate is higher in patients with isolated metastases compared to the group of patients with multiple metastases in the lymph nodes and concomitant damage of the other organs. 

The best five-year survival rates were observed in patients with isolated metastases in the inguinal, axillary, and cervical lymph nodes who received specialized treatment. Women with metastases in the axillary lymph nodes and the pronounced expression of estrogen and progesterone receptors have the most favorable prognosis.

Depending on the histological type of the tumor, the best five-year survival rates are observed in the group of patients with metastases of squamous cell carcinoma. An unfavorable prognostic factor is the localization of metastases in the brain and liver.

Patients with cancer of unknown primary should undergo clinical and laboratory or instrumental follow-up every 3-6 months. With monitoring the dynamics of the disease, it is possible to identify the primary tumor, which will allow more targeted treatment.

Best hospitals to undergo treatment of cancer of unknown primary in

 

The following hospitals show the best success rates in the treatment of cancer of unknown primary (CUP):

  1. Vivantes Neukolln Hospital Berlin, Germany
  2. MediClin Robert Janker Clinic, Germany
  3. Medias Cancer Clinic Burghausen, Germany
  4. Memorial Sisli Hospital Istanbul, Turkey
  5. Memorial Bahcelievler Hospital Istanbul, Turkey

You can find more information about the hospitals and the services they provide on the Booking Health website.

The cost of treatment of cancer of unknown primary (CUP)

 

The prices in hospitals that are listed on Booking Health are relatively low. However, the cost of treatment may differ depending on the hospital, the peculiarities of the disease in each case, and the complexity of its treatment.

For example, the cost of diagnostics of cancer of unknown primary in Germany starts at 9,227 EUR, while the cost of diagnostics of cancer of unknown primary in Turkey starts at 5,306 EUR.

Besides the actual cost of treatment, you might want to consider the prices for possible additional procedures and follow-up care. Therefore, the ultimate cost of treatment may differ from the initial price.

To find out more information on the overall cost of treatment, you may leave the request on the Booking Health website.

How to undergo treatment of cancer of unknown primary abroad?

 

Medical tourism company Booking Health will help you arrange treatment of cancer of unknown primary, so you will not need to take care about cancer treatment organization.

Booking Health offers the following services:

  • Negotiation with the chosen healthcare facility
  • Help in receiving a medical visa
  • Translation of medical reports
  • Booking the tickets and hotels
  • Interpreting services
  • Services of personal medical coordinator

And this is not even a full list. With Booking Health, you receive the treatment in the best hospitals in the world, where it is carried out by professionals in the field of oncology, internal medicine, etc.

If you have any questions, you may leave a request on the Booking Health website, and our manager will assist you.

Authors: Dr. Nadezhda Ivanisova, Dr. Sergey Pashchenko

To check for the Cancer of Unknown Primary (CUP) you can submit a request on BookingHealth and our managers will find the best hospital that is specialized in Cancer of Unknown Primary (CUP) to fulfill your needs



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