When the doctor is clueless about cancer

Just when you didn’t think much about cancer could get any scarier — there’s something called cancer of unknown primary (CUP)

If that sounds confusing, well, it’s because it is.

The “primary site” is the place in the body where a cancer first starts to grow. From there it can spread — or metastasize — to other parts of your body via the blood stream or the lymphatic vessels, like your lymph nodes.

In cases of CUP, the primary site can be hard to pin point, compounding anyone’s fear and anxiety when they hear they have cancer, and here’s why…

You probably already know that cancers are identified based on where they first start to grow. For example, lung cancer that metastasizes to the liver is still lung cancer (not liver cancer).

An example of a CUP is an enlarging lymph node over several weeks to months. It can be biopsied or removed, and the tissue examined under a microscope. It may be seen to be cancer of nearby tissue (mouth, throat, or larynx). Or, until the primary site is determined, it is called carcinoma of unknown primary, and even the best of doctors will struggle to determine your treatment strategy…

A needle in a haystack

When a primary site cannot be determined, it’s hard to determine treatment, especially mainstream medical treatment such as surgery, chemotherapy, radiation or biological/hormonal therapy.

Why? Because mainstream medicine treatment depends largely on what cancer it is and where it started. Without knowing this, the oncologist will have difficulty knowing the correct approach.

First he’s going to examine you, partially based on any health issues or complaints you might present…

You probably know that cancers grow in silence until they eventually push on nearby organs, blood vessels, nerves, or other organ structures enough to cause discomfort or affect bodily processes.

Cancer can cause symptoms early on (e.g. if growing in the brain) or later (e.g. if growing in the intestinal tract or pancreas) in which case it has already grown to an advanced stage. Obviously, it is best to investigate cancer signs and symptoms as early as possible.

Possible symptoms that should be pursued include:

  • Skin growth that bleeds easily, is non-tender, and is getting larger over weeks
  • Enlarging, non-tender, firm lumps anywhere or lymph nodes (these are in the neck, armpit, or groin)
  • Abdominal mass or feeling of fullness that remains over many week, although this will mean it has been growing awhile
  • Shortness of breath
  • Bone pain
  • Persistent unexplained weight loss despite normal appetite and eating
  • Fatigue, weakness, dizziness, fevers, or poor appetite that persists

In addition, there are many diagnostic tests available to help discover what kind, location and extent of cancer: physical examination; imaging such as x-ray, ultrasound, CT (computed tomography), MRI (magnetic resonance imaging), PET (positron emission tomography), or Somatostatin receptor scintigraphy (SRS); endoscopy; blood tests; biopsied tissue pathology evaluation; and newer genetic mapping.

Standard treatments

Sometimes you are left with just knowing a cancer tissue type as determined by the pathologist. In most cases of CUP, tissue types are found to be: adenocarcinoma (~ 60% of CUP), poorly-differentiated carcinoma (~ 20-30% of CUP), squamous cell carcinoma (~ 5-10% of CUP), and a couple of rarer types.

One main treatment for CUP is to use empiric chemotherapy (a combination of chemotherapy drugs together), the standard of care. This is dangerous in my opinion, and not just because it gives you fatigue, higher infection risk, nausea, vomiting, hair loss, no appetite, and/or diarrhea…

Only ~ 5% of CUP cases are cured using empiric chemotherapy. Even though there is tumor shrinkage in 35-40% of these patients, only about 20-25% lives for more than 2 years after diagnosis. That’s also why your oncologist will encourage you to join a clinical trial using an experimental new cancer-killer with hopes of a better outcome than with chemo.

And you may have recently read about research that revealed chemotherapy can actually promote the spread of certain cancers. In the latest study, they saw this occur with breast cancer.

But, perhaps worse, is that these treatments will weaken your immune system, including your own natural tumor suppression functions…

Your cancer repair mechanisms

Over the past 20+ years of animal cancer research, it is now understood that cancer is continuously occurring in all of us.

Moreover, it is only due to your own innate mechanisms to suppress tumor growth (by destroying cancer cells before they take hold of their own blood supply) that you remain cancer free.

In fact, it is well established that we all have a large group of tumor suppressor molecules that control cell division, promote apoptosis (programmed cell death), and suppress metastasis (spread of cancer).  Therefore, it is only when your tumor suppression functions fail that cancerous cells grow out of control.

Instead of using chemotherapy or radiation to blast one cancer type while also degrading your natural ability to heal, you can strengthen your innate healing ability through various methods. In my follow up article on this topic coming next week, I’d like to discuss these methods and where you can find them.

To your long-term health and to feeling good,

Michael Cutler, M.D.

Editor’s note: When it comes to cancer, your best bet is to know all of your options. Dr. Michael Cutler lists more natural ways to avoid and beat cancer, including the best minerals, herbs, supplements, foods and proven therapies allowed in other countries — but denied to you by American mainstream medicine — all in his comprehensive cancer guide, Surviving Cancer! To get your copy today — plus 3 FREE reports — click here!


  1. Unknown Primary: Treatment Options — American Society of Clinical Oncology (ASCO)
  2. Cancer Immunoediting: Integrating Immunity’s Roles in Cancer Suppression and Promotion — American Association for the Advancement of Science
  3. Functional Mechanisms for Human Tumor Suppressors — Journal of Cancer


Dr. Michael Cutler

By Dr. Michael Cutler

Dr. Michael Cutler is a graduate of Tulane University School of Medicine and is a board-certified family physician with more than 20 years of experience. He serves as a medical liaison to alternative and traditional practicing physicians. His practice focuses on an integrative solution to health problems. Dr. Cutler is a sought-after speaker and lecturer on experiencing optimum health through natural medicines and founder of the original Easy Health Options™ newsletter — an advisory on natural healing therapies and nutrients. His current practice is San Diego Integrative Medicine, near San Diego, California.