Tests for CUP in specific areas of the body

Your doctor may arrange for you to have more detailed tests in certain areas of the body. You may have an endoscopy. An endoscope is a thin tube with a camera and small instrument attached to it. It is used to look inside the body and take biopsies of any abnormal areas. Before an endoscopy, you may be given some medicine to help you relax and make you sleepy.

There are many different types of endoscopy. Doctors can use these to look at different areas of the body such as the:

  • back of the mouth, throat and voicebox
  • lungs
  • oesophagus and stomach
  • bladder
  • tummy (abdomen) and pelvis
  • bowel.

If your doctor thinks the cancer may have started in another area, they will use other tests.

Waiting for test results can be a difficult time. You may want to talk to someone close to you, your specialist nurse or one of our cancer support specialists.

More specific tests

More specific investigations may be helpful for some people. If the doctor thinks the cancer might have started in a specific area of the body, they will carry out more detailed tests of that area.

Your blood, urine and stool (faeces) may also be tested. These tests can help the doctors know which might be the best area of the body to scan.


An endoscopy is a test that looks inside the body. An endoscope is a thin, flexible tube with a camera on the end. It also has a small instrument that allows your doctors to take biopsies of any abnormal areas. Before the test, you may be given a sedative to help you relax and make you feel sleepy.

There are many different types of endoscopy.


The endoscope is passed up your nose and up over the back of your throat (nasendoscopy) or through the mouth and down your throat (laryngoscopy). This is so your doctor or nurse can look closely at the back of your mouth and larynx (voicebox).


An endoscope called a bronchoscope is used to examine the inside of the lung airways. They may give you a mild sedative to help you relax. Your doctor or nurse will spray a local anaesthetic on the back of your throat to numb it. They will then gently pass the bronchoscope into your nose or mouth and down into the lung airways. The test may be slightly uncomfortable but it only takes a few minutes.

Upper gastro-intestinal endoscopy

You’ll be asked to lie on your side on a couch. Your doctor or nurse may use a spray to numb the back of your throat or sedative to help you relax.

Your doctor or nurse will ask you to swallow the first part of the endoscope. They will then gently ease it further down the gullet (oesophagus), into the stomach and the first part of the small bowel (duodenum).


A doctor or nurse uses an endoscope to look at the inside of the bladder.


This procedure allows the doctor to look inside the tummy (abdomen) and pelvis. It is done under a general anaesthetic and you need a short stay in hospital.


This is like an endoscopy but the tip of the endoscope has an ultrasound probe on it. It uses sound waves to build up a picture of the area.


You will be asked to lie curled up on your left side while a tube is gently passed into the back passage. Your doctor or nurse can then examine the full length of the large bowel (colon). This can be uncomfortable and you may feel bloated afterwards for a few days.

If just the lower part of the bowel is examined, the procedure is called a sigmoidoscopy. If just the rectum is examined, it is called a proctoscopy.

A colonoscopy
A colonoscopy

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I was a bit nervous about the colonoscopy, but it wasn’t bad. They give you a mild sedative which helps and all I felt was a bit of discomfort.


Video-assisted thoracoscopic surgery (VATS)

This is a small operation that uses keyhole surgery. A small cut, less than 2.5cm (an inch), is made between the ribs so that an endoscope can be put inside. This is to examine the surface of the lungs and take biopsies. You will have a general anaesthetic for this test. VATS may be done when a biopsy can’t be taken through the skin.


A mammogram is a low-dose x-ray of the breast. It may be done if a woman has symptoms that suggest breast cancer, such as cancer in the lymph nodes of the armpit. A radiographer will position you so your breast is against the x-ray machine and gently compressed with a flat, clear, plastic plate. Two mammograms (from different angles) are taken of each breast.

Most women find having a mammogram uncomfortable or a bit painful, but the test doesn’t take long.

Blood tests

These are done to check:

  • how organs such as your liver and kidneys are working
  • the number of different blood cells you are producing (your full blood count).

A low number of red blood cells (anaemia) may mean that there’s some bleeding inside your body. This could possibly be from a cancer in the bowel or stomach.

If the number of the different blood cells is abnormal, it may mean that a cancer is affecting the bone marrow. The bone marrow is where blood cells are made.

Tumour markers

Some cancers produce chemicals that can be measured in the blood called tumour markers. These can also be raised in conditions other than cancer, so they aren’t always reliable.

Your specialist may use different tumour markers to help them make a diagnosis or to see how the cancer is responding to the treatment:

  • PSA (prostate specific antigen) to check for prostate cancer.
  • Human chorionic gonadotrophin (HCG) to check for germ cell tumours – a rare type of cancer that can start in the testicles or ovaries.
  • Alpha-fetoprotein (AFP) to check for some types of germ cell tumour and some types of primary liver cancer.
  • CA125 to check for ovarian cancer.
  • CA15-3 to check for breast cancer.
  • CA19-9 to check for cancer in the pancreas or bile ducts.
  • Carcinoembryonic antigen (CEA) to check for bowel cancer.
  • Chromogranin A (CgA) to check for neuroendocrine cancers – rare cancers affecting the neuroendocrine system that produces the body’s hormones.

Urine tests (urine cytology)

Samples of your urine can be tested for abnormal cells and to see how well your kidneys or bladder are working. Rare cancers, such as neuroendocrine cancers, produce extra hormones that can be measured in the urine. You may need to collect your urine for 24 hours for this test.

FOB (faecal occult blood) test

A small sample of your stool (faeces) can be tested to detect tiny amounts of hidden blood in your bowel motions. Occult blood means blood that is not visible to the eye.

Waiting for test results

Waiting for test results can be a difficult time. It may take from a few days to a couple of weeks for the results of your tests to be ready. You may find it helpful to talk with your partner, family or a close friend. Your specialist nurse or one of the organisations listed on our database, can also provide support. You can also talk things over with one of our cancer support specialists on 0808 808 00 00.

Back to Diagnosing

Being diagnosed with CUP

If your GP thinks you may have cancer, they will refer you to hospital for more tests. You may be referred to a specialist CUP team.

Tests and scans for CUP

Having further tests may help doctors find out more about where the cancer first started.