Carcinoma of unknown primary

Diagnosis

The diagnosis of carcinoma of unknown primary requires assessment of signs and symptoms, evaluating the patient’s medical history, current medications, vitamins, supplements, or other therapies, and performing a physical examination. The physical exam often entails inspecting the affected area or looking for tumors, swollen lymph nodes, or anything odd.

Several tests and procedures may be required, such as:

• Imaging tests: Scans provide detailed images of the inside of the body. CT, MRI, PET, mammogram, and X-ray are the type of scans that may be necessary.
• Biopsy: A biopsy will be performed if the lump is discovered or if the symptoms or initial test indicates possible cancer. A biopsy involves the removal of cells or tissue from the body for lab testing to see whether they are malignant and where they came from. The procedure involves inserting a needle through the skin or during surgery.
• Tests to look for the original cancer: Tests may aid the healthcare provider in locating the original tumor where the cancer began. If the primary tumor is discovered, one will no longer be diagnosed with carcinoma of unknown primary. If initial tests reveal cancer cells that originated elsewhere in the body, one may be subjected to additional testing to determine the location of the cancer cells’ origin or primary tumor.

Tests may include:

• • Physical examination: A thorough examination for symptoms of cancer will be performed.
  • Imaging studies: The tests, such as CT and positron emission tomography (PET), can indicate details of abnormal areas, how far cancer has gone, and where the cancer may have begun.
  • Blood tests: These tests detect higher- or lower-than-normal quantities of chemicals released into the bloodstream by the tissues and organs in the body. They can monitor organ function which can provide the doctor with information about whether cancer has affected the organs, such as the liver and kidneys.

A tumor marker test may check for chemicals produced by types of cancer which may provide further information for the diagnosis. Tumor markers are chemicals secreted into the bloodstream by some malignancies. Tumor markers include prostate-specific antigen (PSA) for prostate cancer, alpha-fetoprotein (AFP) for liver cancer, and CA-125 for ovarian cancer.

• • Endoscopy: Using an endoscope, the organs and tissues may be examined. An endoscope is a narrow, tube-like device that has a light and a lens for seeing as well as a tool for removing tissue samples. The scope may be passed through the mouth and into the lungs, esophagus, stomach, liver, or small intestine. The scope can be put into the anus to inspect the colon and rectum.
  • Advanced lab testing: A pathologist may employ several types of high-powered microscopes as well as dyes, stains, or chemicals to magnify cell features and detect changes in cell DNA. Certain cell alterations or features have been connected to different types of cancer. This extensive test can provide more information for the diagnosis.

Treatment

Since carcinoma of unknown primary has already spread and the primary cancer site might not be identified, the treatment will depend on what is known and what is regarded to be the most likely type of cancer. The treatment strategy is tailored to the patients’ specific clinical circumstances as well as their personal preferences.

Common treatment options include:

• Chemotherapy: Chemotherapy is recommended if cancer is suspected in more than one location. One or more medications to kill cancer cells are used for this type of treatment. It can be administered through a vein, or consumed orally.
• Radiation therapy: If cancer is deemed to be localized, radiation therapy is utilized. It can also help with reducing symptoms, such as discomfort caused by a growing malignancy. Radiation therapy kills cancer cells by delivering high-energy beams from sources such as X-rays and protons. External radiation often involves the use of radiation beams directed towards the cancer, while internal radiation uses radioactive seeds, wires, needles, or catheters implanted in or near the malignancy.
• Surgery: This method is utilized if the cancer is deemed to be localized such as a lymph node or the liver. The doctor will remove the malignancy as well as a little amount of good tissue surrounding it. To eliminate any leftover cancer cells, radiation or chemotherapy may be used.
• Palliative care: This is often recommended in conjunction with more severe therapies like surgery, chemotherapy, or radiation therapy. This treatment focuses on relieving pain and other symptoms of cancer. Additional support to the existing treatment is provided by specialized professionals in collaboration with the patients, their doctors, and families.