Dr Pavel Bezecny, Consultant Medical Oncologist from Lancashire Teaching Hospitals NHS Trust, is the Chair of the Lancashire & South Cumbria Cancer of Unknown Primary (CUP) Network Site Specific Group (NSSG).

The role and purpose of the CUP NSSG is to improve the experience and outcomes of cancer care for patients with a diagnosis of Metastatic of Unknown Origin (MUO)/Cancer of Unknown Primary in the Lancashire & South Cumbria Cancer Network.

Definition of MUO, provisional CUP and confirmed CUP:

  • Malignancy of undefined primary origin (MUO) - Metastatic malignancy identified on the basis of a limited number of tests, without an obvious primary site, before comprehensive investigation or histology. This applies to any potential histological type.
  • Provisional carcinoma of unknown primary origin (provisional CUP) - Metastatic epithelial or neuro-endocrine malignancy identified on the basis of histology or cytology, with no primary site detected despite a selected initial screen of investigations, before possible review and possible further specialised investigations.
  • Confirmed carcinoma of unknown primary origin (confirmed CUP) - Metastatic epithelial or neuro-endocrine malignancy identified on the basis of final histology, with no primary site detected despite a selected initial screen of investigations, review, and further specialised investigations as appropriate.

The CUP NSSG is developing strategies and plans for service improvement and service development across the patient pathway, incorporating all aspects of care at appropriate stages of the patient's journey. The aim is to achieve the best possible outcomes and best quality of life for all patients with a diagnosis of MUO/CUP within the Network.

The CUP NSSG:

• Is the Network's primary source of clinical opinion on issues relating to CUP Services for the Network
• Is the Group with corporate responsibility for co-ordination and consistency across the Network for policy, practice guidelines, audit, research and service improvement relating to CUP Services.
• Will consult with the relevant cross-cutting Network groups on issues involving chemotherapy, cancer imaging, histopathology and laboratory investigation and specialist palliative care; and with the Head of Service on issues involving radiotherapy.

Members of the CUP NSSG will be responsible for feeding back information/decisions from the CUP NSSG to their clinical and managerial colleagues.