The Primary
Cancer is caused by a number of changes (mutations) in the genes in our body that control cell growth or regulate the detection and repair of DNA damage. Often there is more than one gene involved in cancer development.
Cancer is the result of accumulated mutations to a person's DNA. The mutations that can lead to cancer may be inherited or acquired. Multiple events have to occur to cells before cancer occurs (which is why few children get cancer, unless it is through inherited damage, and those over 60 are more likely to get cancer).
Mutations may result through a loss of activity in Tumour Supressor Genes (the brakes), or enhanced activity by Oncogenes (accelerators), that regulate the way our cells work. So, whilst we may have a genetic predisposition to a particular cancer it needs further "hits" to turn this into cancer. The damage or additional damage can be caused by a wide variety of factors such as: lifestyle (diet, drink, smoking, sunbathing etc.), radiation exposure, stress, viral infection, chemicals.
The point of origin in the body, where the genes have caused cells to grow uncontrollably and form a tumour, is known as the Primary Site. In most cases the primary site is obvious and quickly diagnosed.
Strictly speaking one might say that CUP exists from the point someone knows they have cancer until they know for certain the site of the primary. But our concern is with CUP where there has been cancer spread but it is impossible to tell from initial tests (X-rays, blood tests, scans etc.) where the cancer began in the body - and cancer treatment is directed presently at the anatomical starting point or primary.
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Cancer is the result of accumulated mutations to a person's DNA.
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