This guideline covers diagnosing and managing secondary cancers in people aged 18 and over when the site of the primary cancer is unknown. This includes people who have had treatment for cancer before. It aims to improve quality of life by offering advice on tests for identifying the site of the primary cancer and options for managing the person’s condition when this cannot be found.
This guideline covers carcinomas only and does not cover, for example, lymphoma, melanoma and sarcoma. For other NICE guidelines on cancer, see the cancer topic page.
This guideline includes recommendations on:
- organisation of services and support
- factors influencing management decisions
- managing specific presentations
- systemic treatment
Who is it for?
- Healthcare professionals
- Commissioners and providers
- Adults with cancer of unknown primary origin, their families and carers
Is this guideline up to date?
We checked this guideline in February 2014. We identified no major studies that will affect the recommendations in the next 3 to 5 years.
Next review: February 2019
Guideline development process
This guideline was previously called metastatic malignant disease of unknown primary origin: diagnosis and management of metastatic malignant disease of unknown primary origin.
The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or service users. The application of the recommendations in this guideline is not mandatory and the guideline does not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or their carer or guardian.
Local commissioners and/or providers have a responsibility to enable the guideline to be applied when individual health professionals and their patients or service users wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with compliance with those duties.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.