How treatment for CUP is planned

A group of health professionals with expert knowledge in cancers of unknown primary will manage your treatment. This is called a multidisciplinary team (MDT). This team will include a doctor who specialises in chemotherapy and radiotherapy, called an oncologist.

The MDT will meet to discuss the results of the tests and to plan your treatment. You may be given a choice of treatment options, which your specialist will discuss with you. If you don't understand what you've been told, let the staff know so they can explain again.

Before you have any treatment, you will need to give permission (consent) for the hospital staff to start.

It may be a good idea to take someone with you when the treatment options are first explained. You may also find it useful to have a list of questions ready to make sure you get the information you need.

Multidisciplinary team (MDT)

Most hospitals have a multidisciplinary team of specialists who diagnose and treat people with MUO (malignancy of unknown primary origin) and CUP. They will meet to discuss and decide what the best treatment is for you.

A multidisciplinary team (MDT) or the CUP team may include:

  • a clinical oncologist who specialises in radiotherapy and chemotherapy and other drug treatments
  • a medical oncologist who specialises in chemotherapy and other drug treatments
  • a palliative care specialist who specialises in symptom control
  • a pathologist who advises on the type and extent of the cancer
  • a radiologist who helps to interpret x-rays and scans
  • a clinical nurse specialist (CNS) who gives information and support. You are usually given their contact details at your first meeting.

It may also include other professionals, such as a dietitian, physiotherapist, occupational therapist, counsellor or psychologist.

How does an MDT work?

How the team is organised will depend on where you live - they may be slightly different across the UK. Some MDTs discuss patients from different hospitals. Specialists may be on teams for a number of different types of cancer.

How often an MDT meets may also vary. This could mean that you have to wait a bit longer to get all the results of your scans and a treatment plan from your doctor. This can be frustrating and worrying - but the pooling of different types of expertise should mean the best possible decisions are made about your treatment and care.

If waiting for results is making you anxious, you may find it helpful to talk about how you’re feeling with a partner, your family or close friends. You can also talk things over with one of our cancer support specialists on 0808 808 00 00.

Benefits of an MDT

The National Institute for Health and Care Excellence (NICE) recommend that people with cancer should be managed by a multidisciplinary team. People cared for by an MDT are more likely to:

  • receive accurate diagnosis and staging
  • be offered a choice of treatments decided by a group of experts, rather than by one doctor
  • receive better coordination and continuity of care through all stages of the cancer
  • be treated in line with locally agreed policies and national guidelines
  • be offered appropriate and consistent information (because the person giving the information should be aware of the team’s strategy for your care)
  • have their psychological and social needs considered – communication between different team members is better where they have a formal working relationship.

Giving consent

Before you have any treatment, your doctor will explain its aims. They will usually ask you to sign a form saying that you give permission (consent) for the hospital staff to give you the treatment.

No medical treatment can be given without your consent.

Before you are asked to sign the form you should be given full information about:

  • the type and extent of the treatment
  • its advantages and disadvantages
  • any significant risks or side effects
  • any other treatments that may be available.

If you do not understand what you have been told, let the staff know straight away, so they can explain again. Some cancer treatments are complex, so it is not unusual to need repeated explanations.

It is a good idea to have a relative or friend with you when the treatment is explained, to help you remember the discussion.

You may also find it useful to write a list of questions before your appointment.

People sometimes feel that hospital staff are too busy to answer their questions, but it is important for you to know how the treatment is likely to affect you. The staff should be willing to make time for your questions.

You can always ask for more time if you feel that you can't make a decision when your treatment is first explained to you.

You are also free to choose not to have the treatment. The staff can explain what may happen if you do not have it. It is essential to tell a doctor or the nurse in charge, so they can record your decision in your medical notes. You do not have to give a reason for not wanting treatment, but it can help to let the staff know your concerns so they can give you the best advice.

Back to Making treatment decisions

Getting a second opinion

Your treatment will be planned using national guidelines, but you may still want another medical opinion.

Making a complaint

Talking to your healthcare team can make it easier to cope. If you find talking difficult, there are things you can do.