CUP syndrome – causes, symptoms & therapy

The CUP syndrome is present when a malignant tumor is found, but this turns out to be a secondary tumor, a so-called metastasis, and the actual origin of this metastasis has not yet been found or cannot be found.

This may be due to the fact that the original tumor may have dissolved or it is so small and inconspicuous that it cannot be made visible with conventional examination methods and is, so to speak, hidden.

causes

The causes of a CUP syndrome can have different causes. The primary tumor was not found because it is either no longer there or, more commonly, the metastasis(es) has grown faster than the primary tumor itself, which means that these are also found first. The primary tumor may have been destroyed by the immune system , but it may be powerless against metastasis itself, which is often more malignant than the tumor itself.CUP also develops when the primary tumor is very small in size and has not previously caused any problems. Even if the metastasis(es) is/are known and assigned to a specific tumor group, the primary tumor is still not found in many cases.

symptoms and course

Typical symptoms of CUP syndrome:

• headache

• dizziness

• nausea

• visual disturbances

• Cough

• shortness of breath

The symptoms of a CUP syndrome are not specific but diverse, since it depends on where the metastasis occurs. Some patients have had no problems at all and are suddenly confronted with the cancer diagnosis, where they also learn that the disease is already at an advanced stage, which offers different prognosis depending on the initial situation.

The most common metastases affect the lungs, liver, brain or bones. Secondary tumors can also appear in other areas of the body. While metastasis often causes more problems as it spreads to the brain or lungs than to the liver and bones, these forms of cancer are usually detected more quickly. However, since these sensitive organs are quickly affected by the disease, the prognosis is often no better, it depends on the localization and the extent of the disease that has already occurred.

The most common symptoms of a brain metastasis are headaches, dizziness, nausea and loss of vision, such as blurred vision. In the case of a metastasis in the lungs, the main symptoms are shortness of breath, sputum production and often a severe cough. Bone metastases usually cause severe general pain and movement problems as the disease progresses. Liver metastases are usually characterized by a high increase in all laboratory parameters relevant to the liver and jaundice .

Diagnose

The diagnosis of CUP syndrome includes the determination of laboratory values ​​by taking blood and imaging techniques, such as magnetic resonance imaging (MRI), ultrasound or X -rays of the lungs and tissue removal, the so-called biopsy. In addition, of course, the intensive search for the primary tumor is still a priority in the diagnosis.

If the underlying disease remains undetected in the body, it can lead to ongoing complications, especially the further formation of metastases. Ultimately, what is important is the cooperation of different specialists, especially oncologists, who deal with the disease and combine different examination methods.

complications

Unfortunately, in most cases, the patient dies as a result of the CUP syndrome. Death is brought about by the spread of the tumor to the various organs of the body. In most cases, treatment is no longer possible and is made more difficult due to the non-localization of the tumor. The metastases themselves cause various symptoms in the patient. In most cases, these are headaches and nausea. Pain can continue to appear in other regions of the body and thus greatly reduce the quality of life.

In the further course of the CUP syndrome, movement restrictions and failure of various organs occur. For most patients, CUP reduces life expectancy to about another year after diagnosis. The main aim of the treatment is to reduce the symptoms and pain, a causal treatment is not possible. The relatives can also suffer from severe psychological problems and depression as a result of the CUP syndrome .

treatment and therapy

The treatment of CUP syndrome is not always easy and is initially aimed at the cancer diagnosis found. It deals with the removal or reduction of metastases. Conventional procedures such as surgery, radiation and chemotherapy are used here. In some cases, hormone treatment is also an option. These therapies are often combined.

The forms of treatment are very individual, since the CUP syndrome is not a uniform cancer. Treatment must be tailored and tailored to the individual patient. Since the use of certain medications and interventions in many cases has strong side effects, it is essential to keep these to a minimum for those affected and to ensure adequate pain therapy.The complex situation and the therapies are psychologically very stressful, so that the patient should be offered psychotherapeutic help. Doctors and nursing staff must closely monitor the condition of the person being treated and adjust and realign the therapy procedures accordingly.

Whether treatment for CUP syndrome has lasting success depends on the circumstances of the individual patient and the ultimate diagnosis. It depends on the type of cancer, the spread and whether or not the primary tumor exists. The prognosis is often poor because complete therapy is not always possible. However, there are also cases with healing of the CUP syndrome after successful therapy.

prevention

In principle, it is not possible to prevent CUP syndrome, since it is not a specific disease but rather a disease state. After successful treatment, close monitoring of blood values ​​and, if necessary, other examination procedures is essential for the person concerned, since a relapse or a new formation can always occur.