Follow-up after treatment for cancer of unknown primary

Follow-up after treatment is an important part of cancer care. Follow-up for cancer of unknown primary (CUP) is often shared among the cancer specialists (called oncologists) and your family doctor. Your healthcare team will work with you to decide on follow-up care to meet your needs.

Don’t wait until your next scheduled appointment to report any new symptoms and symptoms that don’t go away. Tell your healthcare team if you have:

  • new pain or pain that gets worse
  • any new lump or swelling
  • a cough or difficulty breathing

Because CUP is an advanced cancer when it is diagnosed, you may be referred to a palliative care team. Palliative care provides physical, emotional, social and spiritual support for people with cancer and their families. Palliative care is given to relieve symptoms, control the cancer, if possible, and improve your quality of life.

Schedule for follow-up visits

CUP includes different types of cancer that are treated differently, so there isn’t a standard schedule for follow-up visits. How often follow-up is done depends on how the CUP responded to treatment, how likely it is to spread to other parts of the body and how likely it is to come back.

People with certain types of CUP may need to see their healthcare team more often than people with other types of CUP. People receiving palliative care are followed as often as needed.

During follow-up visits

During a follow-up visit, your healthcare team will usually ask questions about the side effects of treatment and how you’re coping. They may also ask about pain and how well your pain medicines are working.

Your doctor may do a physical exam, including:

  • checking your surgical scar
  • feeling the lymph nodes

There are no standard tests used to follow-up with CUP. Your healthcare team may order different tests depending on the symptoms you have or if your symptoms are getting worse.

If a recurrence is found, your healthcare team will assess you to determine the best treatment options.

Questions to ask about follow-up

To make the decisions that are right for you, ask your healthcare team questions about follow-up.

Expert review and references

  • Fizazi K, Greco FA, Pavlidis N, et al . Cancers of unknown primary site: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annals of Oncology. Oxford University Press; 2011.
  • Greco FA & Hainsworth JD . Cancer of unknown primary site. DeVita VT Jr, Lawrence TS, & Rosenberg SA. Cancer: Principles & Practice of Oncology. 10th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2015: 113:1720-1737.
  • National Cancer Institute. Carcinoma of Unknown Primary Treatment (PDQ®) Health Professional Version. 2015.
  • National Comprehensive Cancer Network. Occult Primary (Cancer of Unknown Primary [CUP]) (Version 3.2014).