Cancer with Unknown Primary Site (CUP) is defined as a condition
in which cancer cells are found in the body, but the primary site
where the cancer start in the first place cannot be determined.
Symptoms of CUP
Symptoms
is completely depending to the type of secondary cancer and some
symptoms of the primary cancer, but in this case, it is not. The general
symptoms include
1. Unintentional weight loss
Weight loss of over 10% unintentionally.
2. Loss of appetite
A general symptoms for patient with cancer
3. Fatigue and tiredness
Due to above symptoms
4. Anemia and bone pain.
If cancer affects the production of cells in the bone marrow
4. Etc.
Causes and risk factors
As mentioned above, it is totally depended to type of secondary cancer, but the general causes and rick factors can be
1. Age
Due
to wear and tear over life long activity, the elder body is no longer
function at its optimal stage, and susceptible more of diseases,
including cancers. Elder people account to high percentage of cancers
than younger age groups.
2. Smoking
Cigarette contains high amount of carcinogens, which can lead to many types of cancer
3. Sunlight
Ultraviolet can caused damage to skin, causing skin cancer
4. Ionizing radiation
One of the causes of thyroid cancer
5. Certain chemicals and other substances
Chemicals and substances can cause mutation of DNA in the cells, causing cancers
6. Some viruses and bacteria
Certain viruses and bacteria can weakened the immune system, leading to the risk of cancer development
7. Hormones
Over productions of certain hormones such as estrogen can lead to increased risk of cancer.
8. Family history
Increased risk of cancer if a person has a family history of cancer
9. Excessive drinking
Heavy drinkers are at risk of liver cancer
1o. Obesity
Fat cells can interfere with production of certain hormones
11. Gene defects
Risk of cancer increased with certain gene defects, such as mutation of BRCA1 and BRCA2 in breast cancer
12. Etc
Where is the primary cancer site
1.
If lymph nodes in the neck and biopsy indicates it is cancer, the
primary site may be found in the mouth,throat pharynx, thyroid or upper
part of the airway.
2. Lymph nodes in the armpit
The primary cancer may be located in the breast in women and small cells ling cancer in men.
3. A shallow of chest X ray
The primary cancer may be located in the lung or bowel or pancreas.
4. Fluid in the abdomen
The primary cancer may be located in cervix, ovary, endometrium in women and bowel in men.
5. Lymph nodes in the groin
The primary cancer may be located cervix, endometrium vulva, ovary, pelvic in women and bowel in both men and women
6. Abnormality of liver scan
The primary cancer may be located bowel, breast, lung.
7. Generalize cancer
Some primary cancers can causes cancer anywhere in the body, including lymphomas, melanomas, etc.
8. Etc.
Diagnosis and tests
Types
of diagnosis are depended to your symptoms, family history, medical
history, past occupation, lifestyle, how the cancer has spread and and
experience of your doctor after the careful physical exam.
1. Blood test
Blood test
The blood is to determine the levels of markers, protein of the primary cancer if it can be found.
2. Chest X ray
Check X ray is to check the lung if the secondary tumor is in the chest.
3. CT Scan (computerized tomography)
A
CT scan generates a large series of two-dimensional X-ray images
taken around a single axis of rotation, to create a three-dimensional
picture of the inside of the body in details.The pictures are
viewed by your doctor to see the extent of the tumors abnormalities,
such as spreading of cancer to the nearby structure and lymph
nodes.
4. MRI scan (magnetic resonance imaging)
MRI
(magnetic resonance imaging) is one of many advanced technology
used to visualize internal structures cross sectional imaging of
your body used effectively in providing the better details of the
metastasis of cancer in the lymph nodes and surrounding areas.
5. UltrasoundUltrasound
allows your doctor to visualize and assess the size and to check for
any abnormality and surrounding area with image taken from the test.
6. Positron emission tomography (PET scan)
Positron
emission tomography (PET scan) is a type of nuclear medicine imaging
with the uses of small amounts of short-lived radioactive material,
either injected into a vein, swallowed or inhaled as a gas which will
appear in the area of the body being examined, where it gives off
energy in the form of gamma rays detected by a camera of positron
emission tomography that produces a three-dimensional image or picture
of functional processes of the organs in the body, such as the lungs,
brain, liver, or other organs.
7. EndoscopeEndoscopy
is thin, tube-like instrument with camera and light at the end to
view your stomach by passing it through your mouth and esophagus to
the stomach. spray anesthesia is
applied to the throat area.
8. Mammogram
mammogram
is a low-dose x-ray of the breast tissue to screen and detect any
breast tissue abnormally and any sign of tumor. mammograms can detect
between 85 to 90 percent of all abnormalities, including breast cancer,
cysts, fibroadenomas, tumors, etc. even before you can feel a lump.
9. Barium x-rays
In
this test, you require to drink a white liquid which will show up on
the X ray to check for structural and motility abnormalities of the
stomach.
10. Bone scan
It is a nuclear scanning test, beside
mostly used in identifying new areas of bone growth and damage to the
bones breakdown, it can also evaluates the metastasis (spread) of
cancer in the bone..
11. Others such as Urine tests, faecal occult blood (FOB), etc.
Preventions
A. How to avoid
Since there are no primary cancer is found, how to avoid has become more general
1. Avoid certain chemical agents
Chemicals and certain substances can increase the risk of cancer.
2. Lose weight
Increased risk of certain certain for obese men and women
3. Smoking
Cigarette contain cancer causing carcinogens.
4. Alcohol
Excessive alcohol drinking has been proven to be one of major risk of certain cancers.
5. HIV infection
Researchers found that men infected with the human immunodeficiency virus (HIV) are at higher risk of certain cancers.
6. Diet
Exposure
to certain chemical carcinogens in the foods of first 20 years of
life or over a prolonged period of time may increase the risk of
certain cancers.
7. Using non-steroidal anti-inflammatory drugs
In
experimental and epidemiologic (nonrandomized) studies, along with
randomized clinical trials, have shown that NSAIDs may have a
prophylactic effect against certain cancers.
8. Eating organic healthy foods are always helpful in preventing long-term stomach inflammation.
9. Eat less red meat and fat
In
an Red-meat lovers may have a greater likelihood of developing
certain cancers of the throat and stomach than people who limit their
intake of steaks and hamburgers, a new study suggests.
10. Exposure to radiation
Researchers found that high doses of radiation caused increase the risk of soft-tissue sarcomas in some patients.
11. Etc.
B. Diet
1. Green tea
In
some clinical studies researchers suggested that the polyphenols in
green tea, may play an important role in the prevention of cancer
by killing cancerous cells and stopping their progression.
2. Garlic
An
analysis of several case-controlled studies in Europe suggests an
inverse association between garlic consumption and risk of common
cancers.
3. Cruciferous vegetables
Cruciferous vegetables
such as cauliflower, broccoli, cabbage, etc. beside contain high
amount of antioxidants, but also phytonutrients that have been shown
to help prevent the onset and halt the progression of certain cancers.
4. Soy
In
laboratory studies, saponins have shown the ability to inhibit the
reproduction of cancer cells and slow the growth of tumors in several
different tissues.
5. Carrot
Carrot contains high amount of
beta carotene which has shown to induce appotosis of cancer cells. In
study of Cell Cycle Regulation and Induction of Apoptosis by
β-carotene, researchers found that in vivo study warrants further
confirmation that β-carotene acts as apoptosis agent in cancer cells
particularly leukemia cells but not normal cells.
6. Etc.
C. Nutritional supplements
1. Free radicals scavengers
Vitamin
A, C, E are free radical scavengers enhanced the immune system
against the forming of free radicals and prevent the alternation of
cell DNA cause of abnormal cell growth. For more information of
how antioxidants help to treat cancer, click here
2. Selenium
Research
showed that selenium has a protective effect on various stages of
cancer, including both the early and later stages of the disease. In a
study in large groups of people, researchers found that in areas of
the world where selenium levels in the soil are high, death rates
from cancer are significantly lower than in areas where selenium
levels are low.
3. Beta -carotene
In some laboratory,
animal, and human studies, researchers found that vitamin A, certain
retinoids may also inhibit cancer development.
4. Lycopene
Many studies showed that antioxidant lycopene in tomato inhibits cancer cell growth and exhibit apoptosis, causing cell death.
5. Phytochemicals
Phytochemicals
are under active research for possible benefits immune system, and
as anti-cancer agents. Flavonoids found abundant in berry, inhibit
caner cell in vitro study.
6. Etc.
Treatments
A. In conventional medicine
The
objective of the treatment is to cure. If the above diagnosis and tests
detect the primary cancer site then standard treatment to such type of
cancer will be applied. Unfortunately, if the primary cancer can not be
found after all diagnosis have been exhausted, curing has become
impossible. Treatment now relies on the specific symptoms and where the
secondary cancer first appeared.
1. Radiotherapy
a. Radiation may
be used to kill any cancer cell remaining in the body locally. By
using high-energy x-rays or other types of radiation, radiation
therapy kills the cancer cells and keep them from growing or
regrowing.
b. Side effects
b.1. Fatigue
b.2. Chest pain
b.3. Heart problem
b.4. Short of breath
b.5. Skin discoloration or pinkness, irritation.
b.6. Etc.
2. Chemotherapy
a.
Chemotherapy is most use to treat with advance stage of cancer
combined with radio therapy, as it has spread to a distant parts of the
body by using drugs taken by mouth or injected into a vein or muscle
of the patient to stop the growth of or to kill cancer cells. In
sarcoma soft tissue, chemo is recommended to shrink the tumor if
surgery is not possible in the place
b. Side effects
b.1. Nausea
b.2. Vomiting
b.3. Hair loss
b.4. Fatigue
b.5. Anemia
b.6. Mouth sores taste and smell changes
b.7. Infection
b.8. Etc.
CUP does not respond well to chemotherapy in general.
3. Etc.
B. Herbal medicine
1. Celandine
Celandine
is a herbaceous perennial plant, genus Chelidonium, belonging to
the family Papaveraceae, native to Europe and western Asia and
introduced widely in North America.
In a study of Ukrain (Ukrain
is an anticancer drug based on the extract of the plant)– a new
cancer cure? A systematic review of randomised clinical trials,
researcher suggested, according to the data from randomised
clinical trials that Ukrain to have potential as an anticancer
drug. However, numerous caveats prevent a positive conclusion, and
independent rigorous studies are urgently needed.
2. Devil's Claw
The extract of Harpagophytum procumbens, commonly known as devil's claw,
In
vitro studies, researchers found that cat's claw demonstrated
anticancer effects against several cancer cell lines and has been
reported to be effective in the treatment of lymphoma cancer,
according to a study conducted by K. S. Wilson, M.D., which was
published in the journal "Current Oncology" in August 2009.
3. Fenugreek
Fenugreek is used both as a herb (the leaves) and as a spice (the seed), genus Trigonella, belonging to family Fabaceae. Vitro studies have shown that fenugreek exhibits chemopreventive properties against certain cancers.
4. CurcuminIn
a study conducted by S. Uddin and colleagues at the Department
of Human Cancer Genomic Research at King Faisal Specialist
Hospital and Research Center in Saudi Arabia, researchers found
that Curcumin in turmeric may inhibit the proliferation of
lymphoma cancer by modulating cell cycling and inducing
apoptosis.
5. Asparagus Cochinchinensis
In vitro studies
researchers found that curcumin acts as a weak phytoestrogen, exhibits
neuroprotective, antiproliferative and preventative effects against
cancer.
6. Etc.
C. Traditional Chinese medicine
1. Pu Kong Yin (Dandelion Root)
In
a study of the efficacy of dandelion root extract in inducing
apoptosis in drug-resistant human melanoma cells, researchers found
that treatment with this common, yet potent extract of natural
compounds has proven novel in specifically inducing apoptosis in
chemoresistant melanoma, without toxicity to healthy cells.
2. Gan Cao
Gan
Cao is also known as Licorice root. In-vitro, researchers found
that saponins in Gan Cao stimulate the immune system and inhibit
Epstein-Barr virus expression and possess anti-cancer activities.
3. Bai Hua She She Cao
The
Sanjiv Kumar YADAV, Shao Chin LEE(Yong Loo Lin School of Medicine,
National University of Singapore researcher results showed that the
ethanol extract from Bai Hua She She Cao effectively evokes cancer
cell apoptosis, possibly through burst-mediated caspase activation.
4. Huang Qi
In
study of Astragalus-Based Chinese Herbs and Platinum-Based
Chemotherapy for Advanced Non–Small-Cell Lung Cancer: Meta-Analysis
of Randomized Trials, researchers found that astragalus may
increase effectiveness of platinum-based chemotherapy when
combined with chemotherapy. These results
require confirmation with rigorously controlled trials.
According
to the American Cancer Society, the substances, licochalcone-A,
licocoumarone and glabridin, which are present in licorice root,
may prevent mutations in the DNA and kill existing cancer.
5. Ling Zhi
Ling
Zhi one of many herbs, has been used over thousands of year in
treating abnormal cells growth in traditional Chinese and herbal
medicine. In a study , researcher found that cancer cells responded to
the herb much in the same way as they would react to chemotherapy
drugs. Yet unlike chemotherapy drugs, which can also be toxic to
healthy cells, herbal extracts were more deadly to cancer cells than
to normal cells, indicating that they have some ability to
specifically target cancer.
6. Etc.
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