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About CUP
 

Diagnosis
and treatment

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support

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forward

Research
and resources

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• GP Diagnosis
• Help the doctor to achieve the correct diagnosis
• NHS benchmarks and treatment model
• Hospital Diagnosis
• Tests
• Special tests
• Classifications
• Treatment
• Chemotherapy
• Radiation therapy
• Hormone treatment
• Immunotherapy
• Palliative & Supportive care
• Prognosis

What you need
to know

General Practitioner - First Line Diagnosis

From the patient perspective, there is a danger that we learn to 'live with our symptoms'. We convince ourselves, from our interpretation of the data, that there is nothing really wrong; and that we do not want to bother our overworked GP.

Through their scientific expertise and experience GPs develop a "nose" for a presentation that may be cancer which requires further investigation but we should recognise that:

• Many of the Less Common Cancers such as CUP lead to only very vague and generalised symptoms which can easily be confused with other conditions.
• On average a GP will only see a few cases of cancer every year. He or she may never experience a Less Common Cancer such as CUP.
• The Algorithms, or Decision Trees, often used by doctors to make the correct diagnosis, work best when applied to people who have straight-forward presentations. They work less well for generic or non-specific symptoms. In a book, called How Doctors Think, published in 2007, Jerome Groopman suggests that doctors make up their minds too quickly (implying that when dealing with uncertainty they may settle on the first piece of data presented).

You may not know what it is, but you will know if there is something wrong with your body:

• Do not delay, book an appointment today. With regard to cancer, early and accurate diagnosis is critical.To use a military maxim: make sure that the enemy diversion you are ignoring is not the main offensive!
• Before seeing the doctor it may help reflect on the way both you and doctors think and behave to make the most of your time with the doctor.(See also "Help the doctor to achieve the correct diagnosis.")
  

Referral

If he or she is concerned about possible cancer, the GP will refer you to a specialist. The specialist you see first will depend on the symptoms you have (there are no CUP specialists). If you have mostly:

• Digestive tract, bowel or stomach symptoms - Gastroenterologist
• Chest/Lung symptoms - Respiratory specialist
• Enlarged lymph gland - You’ll often be seen by a surgeon first. If the gland is in the head and neck area you may be referred to a head and neck specialist or an ear nose and throat (ENT) specialist. If the enlarged gland is under your arm you may be referred to a breast specialist
• Symptoms of the vagina, cervix, womb or ovaries (female reproductive system) - Gynaecologist.  Women who have fluid collecting in the abdomen (ascites) are usually seen by a gynaecologist 
• Urinary or kidney symptoms; disorders of the male reproductive system - Urologist
• Symptoms to do with your blood cells -  Haematologist