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Patients that are diagnosed with a CUP-Syndrome are diagnosed at a metastatic stage, and a primary tumor cannot be identified. CUP-Syndrome stands for cancer of unknown primary origin, which means that the primary tumor cannot be found because it regressed or is just too small to be found. 

Signs and symptoms of the disease are wide and a CUP usually is diagnosed due to masses or swellings that are found somewhere in the body. Usually a CUP develops rapidly, thus a comprehensive physical examination, as well as imaging diagnostics are crucial when abnormalities are found, in order to determine whether it is a cancerous disease. 

In case of a suspicion of a cancerous disease, usually a PET-CT-Scan is performed, which helps to see whether tumor masses are located. If a mass has been confirmed, it should be biopsied in order to perform a histopathological analysis. With this analysis, antibodies and protein markers are used to determine the expression pattern of the cancer surface cells. Often, this analysis is helpful to determine the primary origin of the CUP, as it may highlights the antigens that are similar to the cancer that it grew from. 

Once this has been done, the patient is evaluated for a therapeutic protocol which is mostly consistent of chemotherapy and/or a radiotherapy. What most patients do not know is, that when the first examination (histopathological analysis) on the biopsy has been performed, the tissue is kept and stored at the histopathology department of the hospital, where the biopsy has been performed. This stored tissue material can be used for further thorough (genetic) tissue analyses and in-depth sequencing. It is known that tumors show the accumulation of several genetic modifications, thus providing cancer cells with the selective growth advantage to initiate expansion. Now, sophisticated high-throughput technologies enable the identification of these mutated genes in cancers that can lead to a potent targeted therapy. The most modern method nowadays is the usage of immunotherapies in CUP-syndrome patients that are mainly used within a combined concept. 

A combined concept is mostly consistent of a chemotherapy, whether it is of systemic or metronomic nature, radiotherapy, if feasible, and immunotherapy, that is determined according to the outcome of the in-depth analysis of the biopsy. With a combined concept one tries to achieve the best possible tumor burden reduction, to determine for a less intense maintenance therapy. A precision-based therapy protocol is evaluated for each individual case, on the basis of the medical history, general condition and diagnostic constellations. 

Thus, it is crucial to perform a thorough broad-spectrum screening so that every patient has a chance to explore all possibilities of a targeted treatment, may it be in a private setting or a clinical trial elsewhere. So it is most important to first find a laboratory that looks for all markers and mutations, and second, to find an oncologist who is willing to work with you in the best (and targeted) way possible. 

Step 1 : Contact us 

Important: Our oncological team is happy to talk to you by phone to get a deeper understanding about your specific case, enabling to provide you with a provisional treatment plan and cost estimate. Our oncologists will provide you all the details on medications, therapeutics and treatments including underlying mechanism and side effects. After a physical examination and an in-depth discussion with you on-site, the definite treatment plan will be discussed. Please understand that complex medical processes as mentioned above can only be explained through a thorough consultation on-site.

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