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Living with cancer· Appointment prep

Appointment sheet: Cancer of unknown primary (CUP)

One page to bring and write on: your details, the questions for Cancer of unknown primary (CUP) plus your own, the words you may hear, what to bring, the treatments the standard of care names, and room for the answers and agreed next steps. What you type stays in this browser. Print it or save it as a PDF. New to all this? Start with the first 60 days. Orientation, not medical advice.

Tick the questions to print

All of this cancer's questions start ticked. Untick what does not apply; ticks are kept in this browser. .

Your own questions

Shared with the prep pack, so questions you add there appear here too.

Print or save as PDF

Use (or Ctrl+P, Cmd+P on a Mac). To keep a copy, choose Save as PDF as the destination in the print dialog. Only the sheet prints; the controls stay on screen. Your typed notes print where you typed them; empty fields print as ruled lines to write on.

Appointment sheet

Cancer of unknown primary (CUP)

Prepared with OnCo (onco.cc/prep/cancer-of-unknown-primary/). Orientation, not medical advice; your team knows your case.

My details

Name
Date of appointment
Hospital and clinician
Who is coming with me

What I know, what is unclear, changes to discuss

Saved in this browser
What I know so far
What is unclear to me
Changes since last time

My questions

15 on the sheet
Newly diagnosed
  1. 1.What is my exact diagnosis, stage, and grade, and which tests established them?
  2. 2.Which biomarkers have been tested on my tumour (for example Immunohistochemistry panel, Comprehensive genomic profiling, MSI, TMB, PD-L1, Tissue-of-origin classifiers, AFP, hCG, PSA, CA-125), and what were the results?
  3. 3.Which subtype is my cancer, and does that change the recommended treatment?
  4. 4.Is germline (inherited) genetic testing recommended for me or my family?
Favourable subsets
  1. 5.For my situation (favourable subsets), which of the standard options do you recommend and why?
  2. 6.Am I a candidate for Carboplatin, Paclitaxel / nab-paclitaxel, and what side effects should I expect?
Unfavourable, first line
  1. 7.For my situation (unfavourable, first line), which of the standard options do you recommend and why?
  2. 8.Am I a candidate for Carboplatin, Paclitaxel / nab-paclitaxel, Gemcitabine + cisplatin, and what side effects should I expect?
Molecularly directed
  1. 9.For my situation (molecularly directed), which of the standard options do you recommend and why?
  2. 10.Am I a candidate for Pembrolizumab, Nivolumab, and what side effects should I expect?
Any stage
  1. 11.Are there clinical trials I could join, for example of Comprehensive genomic profiling, Liquid biopsy (ctDNA), DNA methylation profiling, Pembrolizumab?
  2. 12.Would a second opinion at a high-volume centre change anything, and can you help arrange it?
  3. 13.What supportive care (symptom control, nutrition, exercise, mental health, financial help) is available from the start?
  4. 14.I read that “Whether finding the primary matters, or only finding the target”. How does that affect my plan?
  5. 15.I read that “Median survival under a year for unfavourable CUP despite decades of trials”. How does that affect my plan?

The words I may hear

Tests and results to bring

Biomarker results to ask for: Immunohistochemistry panel (CK7/CK20, TTF-1, CDX2, GATA3, PAX8, NKX3.1, SOX10, p16), Comprehensive genomic profiling (targetable alterations in ~30%), MSI, TMB, PD-L1 (tumour-agnostic immunotherapy), Tissue-of-origin classifiers (gene expression, methylation), AFP, hCG (germ cell), PSA (men), CA-125, ctDNA.

Scans and tests linked to this cancer: Comprehensive genomic profiling, Histopathology & immunohistochemistry, Liquid biopsy (ctDNA), PET/CT, DNA methylation profiling.

Bring copies of scan reports, pathology and blood results, and a list of every medicine and supplement.

The treatments I may be offered

From the standard of care recorded for this cancer; which apply depends on your stage and biomarkers. Ask which the team recommends and why.

Answers and next steps

Saved in this browser
What I was told
Agreed next steps, dates and who to call