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Below, week by week, is what OnCo's record of Cancer of unknown primary, favourable subsets says about the first two months: the order is typical, the timing is yours to ask about. Favourable subsets of cancer of unknown primary are the roughly one in five cases where the pattern of spread, the microscope appearance or blood markers point strongly to a particular cancer even though no primary can be found. They are treated as that cancer would be, for example breast cancer for a woman with cancer only in armpit nodes, and many are curable or controllable for years. Sections appear only where the record has something to say. Orientation, not medical advice.
Staging tests establish exactly what and where the cancer is. Everything else follows from the answers.
Histology with directed immunohistochemistry, CT of chest, abdomen and pelvis, sex-specific examinations and tumour markers, PET-CT for cervical node squamous carcinoma and single-site disease.
Ask which of these were tested and what the results were; see the report reader for what each value means.
These specialties appear in the standard of care for this cancer. In most centres they meet weekly as a tumour board to agree each plan; you can ask when yours was discussed and what was decided.
A second opinion from a centre that treats many similar cases is normal, not rude; the standard of care tells you what to compare it against.
Each row is a setting from the standard of care, in the order it usually arises. Not all will apply to you; your stage and biomarkers decide which do. The guideline grade, where recorded, says how strong the evidence is.
Treat as node-positive breast cancer: axillary dissection, breast radiotherapy or mastectomy, systemic therapy by receptor status.
Treat as advanced ovarian cancer: cytoreductive surgery and carboplatin-paclitaxel with maintenance as indicated.
Treat as head and neck cancer: HPV and EBV testing, neck dissection or chemoradiotherapy with cisplatin.
Treat as extragonadal germ cell tumour with cisplatin-based combination chemotherapy.
Platinum-etoposide as for extrapulmonary neuroendocrine carcinoma; somatostatin analogues and radioligand therapy for well-differentiated tumours.
Resection or stereotactic radiotherapy with curative intent.
Generated from this cancer's standard of care, biomarkers and open problems. Take the group that matches where you are. To tick, add your own and print, open the one-page appointment sheet.
Much of what helps in the first weeks is free if you know to ask: testing, helplines, rides and lodging, second opinions, trial travel.
Every term links to the glossary.