Cancer is named from the place it originates. This makes a difference on what type of treatments will be effective. Being diagnosed with cancer of the unknown primary (CUP) means that cancer has been found in the body but the place of origin is unknown.

If later, the place of origin is found then the type of cancer diagnosis changes from an unknown primary to the specific organ or body area that the disease first began.

Some cases of cancer of the unknown primary are unfortunately never found. Physicians will then decide on the best course of treatment based on two factors: The way the cells look under the microscope and which organs are currently involved.

Statistics and Prognosis:

The exact number of cases of this disease is not known. It may be about 2% to 5% of all cancers in the United States. It is found more often among men than among women. The average age of people with this cancer is about 60 years.

This is a very dangerous cancer. Only half of patients will live 9 to 12 months after their cancer is found. There are several reasons why this cancer is so serious. First, most of these are fast-spreading cancers. Second, because the exact type is not known, it is harder for doctors to know what treatment is best. Also, the cancer is often widespread, making it harder to cure.

In recent years, microscopic and other diagnostic techniques have improved dramatically. For this reason, doctors can now determine the primary site in about four out of five cases.

The doctor who read my mammogram and ultrasound results today is the same doctor who detected in my recent MRI something of unknown significance. Today, the unknown remains. But the significance is not so significant.

This doctor saw an unusual pattern of tissue in my right breast when she viewed my Friday MRI results, some sort of enhancement she didn't see in the left breast or on the MRI I had a year ago. But today's mammogram looked good and today's ultrasound did too. So I guess if three different imaging tests don't turn up anything truly suspicious and there doesn't appear to be anything to biopsy, then all is well. For now.

All that must be determined now is when I will report back for more screening to chart the state of the dense breast tissue that keeps me on my toes.

Another bullet dodged. Another day in the life of a worried breast cancer girl.

A doctor found something suspicious when she read the results of the breast MRI I had on Friday. What she found is of unknown significance. This means something caught her attention. She just isn't sure what it is.

This doctor does know that whatever it is inside my right breast appears to be a low-risk something. But still, there's a concern looming in the air -- for her and for me.

I spoke with my oncologist about this concern, and he told me anything suspicious must be pursued by further testing. I'm thankful for that. He also said he expects that nothing actually significant will come of this. But if it does, it will have been caught early.

On Friday, I will report for further testing -- a mammogram and an ultrasound -- and then I will learn more about this unknown something that inhabits my breast, this something that takes me back more than two whole years when another something turned out to be what I feared more than anything. Breast cancer.

This e-mail just arrived in my inbox. It's one of those chain things -- you know, the read this and forward it to 11 people or all your plumbing will blow up messages. And while I don't tend to pass on to friends and family these types of scare tactics, I realize that the words that follow are definitely worth a read.

So I've extracted all warning and threats from the message I received, and I've pared it down to a very funny piece of prose I believe will strike a chord with women everywhere who know how very important -- and how very painful and humiliating -- the dreaded mammogram can be.

And so here it is, in all it's glory. Read it, absorb it, love it, and pass it on. Or don't pass it on. I'll be OK with your decision either way. Promise.

Go Get Your Mammies Grammed

For years and years they told me,
Be careful of your breasts.
Don't ever squeeze or bruise them.
And give them monthly tests.
So I heeded all their warnings,
And protected them by law.
Guarded them very carefully,
And I always wore my bra.
After 30 years of astute care,
My gyno, Dr Pruitt,
Said I should get a Mammogram
"OK," I said, "let's do it."
"Stand up here real close" she said,
(She got my boob in line),
"And tell me when it hurts," she said,
"Ah yes! Right there, that's fine."
She stepped upon a pedal,
I could not believe my eyes!
A plastic plate came slamming down,
My hooters in a vise!
My skin was stretched and mangled,
From underneath my chin.
My poor boob was being squashed,
To Swedish Pancake thin.
Excruciating pain I felt,
Within it's viselike grip.
A prisoner in this vicious thing,
My poor defenseless tit!
"Take a deep breath," she said to me,
Who does she think she's kidding?!?
My chest is mashed in her machine,
And woozy I am getting.
"There, that's good," I heard her say,
(The room was slowly swaying.)
"Now, let's have a go at the other one."
Have mercy, I was praying.
It squeezed me from both up and down,
It squeezed me from both sides.
I'll bet SHE'S never had this done,
To HER tender little hide.
Next time that they make me do this,
I will request a blindfold.
I have no wish to see again,
My knockers getting steam rolled.
If I had no problem when I came in,
I surely have one now.
If there had been a cyst in there,
It would have gone "ker-pow!"
This machine was created by a man,
Of this, I have no doubt.
I'd like to stick his balls in there,
And, see how THEY come out!

Author Unknown

Cancer of the unknown primary is when cancer is found somewhere in the body but the pathologist is unable to tell where the cells originated from. The cancer cells are so poorly differentiated that they do not resemble any cells of the body. It can be very difficult to find the right treatment because doctors usually use the type of cancer as the main starting point to choose chemotherapy or treatments that are known to be effective. Other problems arise with this type of diagnoses. Many physicians do not have much to go on to treat this disease or know if the patient is likely to survive.

French researchers have developed a prognostic model for cancer of the unknown primary. The findings were published in the December 1st issue of Cancer. Low serum albumin levels and elevated serum lactate dehydrogenase (LDH) in the blood of patients had the worse prognosis overall. This prognostic model can show who has the most powerful adverse prognostic factors.

Even with this information though, it doesn't seem to have anything to do with treatment. They can tell who has a better or worse prognosis but what then?

Previous posts on the topic:

Cancer of the unknown primary

Testicular cancer, cancer in one or both of the testicles, usually occurs in young men and will strike about 8,250 of these men this year. About 370 men will die.

A man's lifetime risk of developing this cancer -- that typically shows up in only one testicle -- is 1 in 300, securing it as one of the less common cancers in the United States. The chances of dying from testicular cancer are 1 in 5,000, making it one of the most curable forms of cancer. Yet it is still the most common form of cancer in men ages 15-34. It is also a cancer commonly characterized by denial and embarrassment. As a result, it is one of the least mentioned cancers.

An announcement last Wednesday revealed an overall decline in cancer death rates -- probably due to reduced exposure to tobacco, early detection, and better treatment. But the announcement also revealed a surprising jump in cases of thyroid cancer for women.

Between the years 1981 and 1993, incidence rates among women climbed 2.2 percent each year. Between the years 1993 and 2000, they rose 4.6 percent per year. And between 2000 and 2003, there was a 9.1 percent increase each year. This could be a result of better diagnosis but scientists are wondering if there is an unknown risk factor contributing to this startling finding. And it will take at least two more years to determine whether this is a random fluctuation or a true trend. The rate of thyroid cancer in men has also increased but not as much as for women.

The silver lining in this cancer cloud is that trends -- such as those showing increases in cancer incidences and death rates -- often fuel the fight against cancer because researchers are alerted to look for causes which ultimately results in better detection and better prevention.

Lori was diagnosed with metastatic adenocarcinoma of unknown primary in November 2002 on her twenty seventh birthday. Lori blogs too sexy for my hair. She writes about her experiences with cancer and also how it wrecks havoc on her mental state.

I know what its like to be diagnosed with cancer on your birthday but I really can't imagine not knowing what kind of cancer I have.

Cancer of an unknown primary basically means that they can't tell what part of the body it originated. When a pathologist looks at cancer cells under the microscope they can usually tell if it's a breast cell that is cancerous or lung cell etc. Sometimes the cancer cells don't resemble any normal cells of the body. They are too primitive to identify.

I'm not sure how they begin to treat an unknown primary since there are different chemotherapy drugs given depending on where the cancer originated. Do the doctors just guess and try different regimens?

Lori keeps her sense of humor even though she struggles with the side effects of chemotherapy on a constant basis. She refers to her cancer as ad-duh-no-carcinoma.

Lori is one tough chic!

I am always a bit nervous before I head out for a check-up with my oncologists. I have two of them -- a medical oncologist who delivered my chemotherapy and a radiation oncologist who delivered my radiation therapy. Today I see my radiation oncologist and she will examine my breasts and manipulate my breasts and feel my underarms and check for lymphedema -- swelling in the arm due to removed lymph nodes -- and she will ultimately determine whether or not I have anything to worry about at this time. It's been just over one year since my last radiation treatment and six months since I saw this doctor for a follow-up.

So I am a little apprehensive about what I might hear -- because it's always possible that something does not feel right, that something is questionable, that something has returned. I am mostly confident that I am okay but there is still an unknown that lies ahead of me. An unknown that in a matter of a few hours will be known. And I will either learn that I am in fact okay. Or I will begin another spiral into the what-if-it's-cancer scenario. Only time will tell.