Often discovered at an advanced age, occult cancer is very bad prognosis.
Occult cancers represent around 2% of all cancers, or 6000 new cases per year in France. “”In practice, oncologists doctors almost never use the term “occult cancer”, we prefer the official term of “unknown primitive cancer” or cpi“, Restores Dr. Marie Viala, an oncologist doctor at the Regional Cancer Institute (Montpellier).
What is an occult cancer?
Occult cancer designates a type of cancer that has spread to other parts of the body (metastases), without the doctors knowing where it was born. “”We do not know if its origin is bronchial, mammary, orl, digestive … We only see metastases and the biopsy that we will achieve on these metastases just tells us that it is cancer. Our colleagues anatomopathologists cannot determine its origin“, Explains the oncologist doctor. In this type of cancer, the primitive tumor has not developed (it is said that it has” involved “). On the other hand, it sent secondary tumor cells (metastases) to different organs by a mechanism that can today be explained. Occult cancer is therefore always detected at the metastasic stage.
What are the symptoms?
Symptoms are generally the same as those observed in people with known type cancer: weight loss, loss of appetite or significant fatigue. To this can be added other more specific symptoms depending on the affected organs: the appearance of lymph nodes in the neck, the arm or groin larger than normal, breathing difficulties (breathlessness, cough …), swelling of the abdomen, bone pain, anemia, headache …
How do you take care of an occult cancer?
The treatment varies depending on the characteristics of the disease. Most often, we will set up chemotherapy with two somewhat standard protocols when you do not have a track on the origin of primitive cancer: either the association “Carboplatine + Paclitaxel (taxol)”, or the association “Cisplatine or carboplatin + gemcitabine”. As a second intention, we will test chemotherapy that we have not yet tested. On the third line, you can move towards rather digestive chemotherapy, with an association of Folfox. Beyond the third line, we are a little devoid of therapeutic options. With current techniques, we try as much as possible to approach the primitive origin. “”There are therapeutic tests in which we try to orient ourselves with molecular biology, that is to say that we study the genome of the tumor to find out if this tumor has special mutations which sometimes can be at the origin of the tumor process. This can give us primitive cancer orientation ideas, which will allow us to adapt the treatment and improve the prognosis“. The location of metastases also gives large clues to the original fabric of primitive cancer. If for example, we have cervical lymph node metastases, we will rather get closer to ENT cancer.
What are the chances of survival?
Because they are discovered late and often at an advanced age, these cancers are bad prognosis. The probability of survival of patients with unknown primitive cancer is around 20% to 1 year. “”About half of the observed deaths occur within 3 months of the diagnosis“, Specifies the European Society of Medical Oncology (ESMO).
“”These cancers are fortunately increasingly rare because with current techniques, we arrive – as we said with this famous set of tracks – to support this diagnosis. There are also patients for whom life expectancy exceeds 5 years or even remission is possible “is to reassure our expert.
