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The National Institute for Health and Clinical Excellence (NICE) has recommended measures to combat what it calls the 'inequality in care received by patients with cancer of unknown primary' (CUP).

CUP, advanced cancer that has spread from an unknown primary location, affects 10,000 people a year in England and Wales. Professor Peter Littlejohns, NICE clinical and public health director, said it is a neglected area.

He said the patients miss out on medical and other benefits that are given to patients with a specific type of cancer because of lack of information, understanding and specialised services.

One of the new measures is that specialist teams at local, regional and national levels will focus on improving the care and treatment of patients with CUP.

Hospitals with a cancer centre or unit will be expected to set up specialist CUP teams to support and manage patient care until they can be referred to the most appropriate consultant, referred for palliative care or diagnosed with confirmed CUP.

Under the guidelines, inpatients should be seen by a CUP team member by the end of the next working day after referral, while outpatients should be seen within two weeks.

Each patient should be allocated a CUP specialist nurse or key worker and decision aids should be developed to help patients and carers make informed decisions about diagnostic tests and treatments.

The guidance also provides advice for those involved in the diagnosis and care of patients with CUP.

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