Treatment to control symptoms of CUP

Treatment to control symptoms is also called palliative treatment or supportive care. Doctors often use palliative treatment for people with cancer of unknown primary (CUP). Palliative treatment aims to control symptoms and improve quality of life.

Palliative treatment

Palliative treatment includes medicines to help with symptoms such as:

• pain
• sickness
• breathlessness

Palliative treatment is not limited to painkillers and anti sickness drugs. Cancer treatments such as surgery or radiotherapy can also help control the cancer and relieve symptoms. If you are well enough to have them, cancer treatments can help you live longer and improve your quality of life.

For example, you may have an operation to relieve a blocked bowel caused by cancer. The surgeon removes as much of the cancer as possible. This can help relieve severe sickness and help you feel better. 

Palliative care team

A palliative care team or symptom control team is usually involved in your care. They are often part of the team of professionals (multidisciplinary team or MDT) who care for people with CUP.

They can help manage your symptoms and improve your quality of life. They also support you and your family.

These teams work in hospitals, in the community and hospices. They work together with your cancer specialist and GP. Palliative care nurses may also visit you at home.

Treatments you might have

You might have a number of treatments depending on your symptoms. Treatments you might have include:

• steroids
• bisphosphonates
• painkillers
• anti sickness medicines
• blood transfusions

You might have one or more of these treatments. 

Steroids

You often have steroids as part of chemotherapy treatment. They can also help you feel better by controlling symptoms such as swelling. Sometimes swelling around a tumour causes pain. So reducing the swelling can reduce the pain.

Steroids can also increase your appetite and generally help you feel better.

Steroids can make some people feel agitated and have problems sleeping. Ask your doctor if you can take all your steroid tablets in the morning if you're having problems sleeping. Don't do this without checking with your doctor first.

Bisphosphonates

Drugs called bisphosphonates might help to relieve pain and reduce bone damage if cancer has spread to your bones. You have bisphosphonates either as tablets or injections.

Painkillers

Pain is usually well controlled for most people. There are different ways of controlling pain, and there are different types of painkillers. Let your doctor or nurse know if you have any pain. You might need to try a different dose or type of painkiller.

Doctors might also use treatments such as chemotherapy or radiotherapy to help shrink a cancer and relieve pain. This can take a little while before you feel the benefit of treatment. And you need to be well enough to have the cancer treatment.

Anti sickness medicines

You may feel or be sick for different reasons. It might be due to the cancer itself or as a side effect of some treatments.

Your doctor or nurse can give you medicines to help. There are different types of anti sickness drugs. You might need to try different types or doses to find the best one for you.

Common types of anti sickness drugs include metoclopramide and ondansetron.

Blood transfusions

People with cancer often become anaemic. This means you don't have enough red blood cells to carry oxygen around your body.

Anaemia can make you feel tired and breathless. Blood transfusions are the best way to quickly top up your red blood cells. You have the blood cells as a drip into a vein. This can take a few hours, depending on how many bags of blood you need.

You have a blood transfusion at the hospital. You might be able to go home the same day or the next day.

Coping

No one can say for how long the treatment will keep the cancer and its symptoms under control. And this can be very hard to deal with. Your doctor and specialist nurse will help you and support you with this.