Treatments for squamous cell carcinoma of unknown primary

The following are treatment options for squamous cell carcinoma of unknown primary (CUP). Squamous cell CUP is most often found in lymph nodes in the neck (called cervical lymph nodes) or in the groin (called inguinal lymph nodes). Your healthcare team will suggest treatments based on where the cancer is found and your needs. They will work with you to develop a treatment plan.

Surgery

Doctors usually offer surgery to remove the lymph nodes that have cancer (called lymph node dissection). Neck dissection is used to remove lymph nodes in the neck. Inguinal lymph node dissection is used to remove lymph nodes in the groin.

Find out more about neck dissection and inguinal lymph node dissection.

Radiation therapy

You may be offered external beam radiation therapy for squamous cell CUP found in lymph nodes in the neck or groin. Radiation therapy may be given after surgery to lower the chance that the cancer will come back, or recur.

In some cases, external beam radiation therapy may be used as the main treatment instead of surgery if doctors don’t think they can remove all of the cancerous lymph nodes with a lymph node dissection.

Chemotherapy

Chemotherapy may be offered for squamous cell CUP. The combinations of chemotherapy drugs offered may include:

  • paclitaxel (Taxol) and either carboplatin (Paraplatin, Paraplatin AQ) or cisplatin (Platinol AQ)
  • cisplatin and gemcitabine (Gemzar)
  • docetaxel (Taxotere) and either carboplatin or cisplatin
  • docetaxel, cisplatin and 5-flurouracil (Adrucil, 5-FU)
  • cisplatin and 5-flurouracil
  • oxaliplatin (Eloxatin), leucovorin (folinic acid) and 5-flurouracil

Chemoradiation

Chemoradiation combines chemotherapy with radiation therapy. The 2 treatments are given during the same time period. It may be offered for squamous cell CUP in lymph nodes in the neck. It may be given before or after a neck lymph node dissection.

If you can’t have or don’t want cancer treatment

You may want to consider a type of care to make you feel better rather than treat the cancer itself. This may be because the cancer treatments don’t work anymore, they’re not likely to improve your condition or they may cause side effects that are hard to cope with. There may also be other reasons why you can’t have or don’t want cancer treatment.

Talk to your healthcare team. They can help you choose care and treatment for advanced cancer.

Clinical trials

You may be asked if you want to join a clinical trial for cancer of unknown primary. Find out more about clinical trials.

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.
  • Kim KW, Krajewski, KM, Jagannathan JP, et al . Cancer of unknown primary sites: what radiologists need to know and what oncologists want to know. AJR: American Journal of Roentgenology. The American Roentgen Ray Society; 2013.
  • 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). http://www.nccn.org/professionals/physician_gls/pdf/occult.pdf.