When is genomic tumour profiling recommended for cancer of unknown primary?

Cancer of unknown primary means cancer has been found, but the organ where it began remains unclear after clinical assessment, scans and examination of tissue. A tumour profile studies molecular changes in the cancer cells and may provide clues about tumour biology or a treatment target.

The result is one part of decision-making. It is reviewed with the biopsy findings, imaging, symptoms, general health and treatments already considered. A profile cannot always identify the original site, and a suggested treatment match may still need careful discussion.

Ask the oncology team whether profiling is appropriate after the pathology and imaging review is complete, particularly when the diagnosis remains uncertain or a molecular result could open a treatment option. Confirm whether stored biopsy tissue is adequate and whether another sample would add useful information.

Request a clear explanation of what the test is looking for, how the result will be interpreted, and whether treatment decisions can proceed while the report is pending. Keep copies of pathology and imaging summaries for appointments.

Do not wait for profiling to report a new or worsening problem. Tell the cancer team about increasing pain, persistent vomiting, new confusion, jaundice, fever or worsening breathlessness; severe breathlessness, collapse or uncontrolled pain requires urgent emergency assessment.

Ask which standard investigations have been completed, what decision the profile may change, whether the sample is adequate, when results are expected, and what options exist if no useful target is found.