You will be seen at the Victoria Hospital you can find useful information by clicking on these links

Travel and car parking

Facilities and amenities

Once we have received a referral, your Clinical Nurse Specialist (CNS) will be in touch to provide guidance on what we do next. We will assess what investigations are necessary and help go through the different options to allow you to make an informed decision. We have a clinic on a Friday morning at the Victoria Hospital and we might see you there to talk through options. At the first clinic we will ask you about your general health, medical history and current symptoms. We will give you as much or as little information about your cancer as you wish and will answer your questions openly and honestly. Please tell us if there is anything you do not want to talk about. It can also be helpful to write down any questions you may have and bring these with you to the clinic. You are welcome to bring family members or friends with you.

Thinking about your answers to the following questions can help you when we talk to you about your care:

• What do you know about your illness at the moment?
• What really matters to you when you think about your health?
• What matters to you the most when thinking about the future?

At your first appointment we will go over all your scans and test results with you to ensure you have all the information you need. We may discuss the need for further investigations. We will talk through what we do next and that might include treatment like chemotherapy or radiotherapy. It might be focusing on symptom control, what we call best supportive care. 

At your first appointment to see the specialist doctor, you will be asked about what is concerning you about the signs and symptoms you are experiencing.

This appointment is a chance for you to ask any questions you may have so it is helpful to bring them written down and also to bring someone with you to help support you.

Asking your healthcare professional the right questions will help you decide the tests and treatments that are right for you. We therefore encourage you to ask the BRAN questions at your appointment.

What are the Benefits?

What are the Risks?

What are the Alternatives?

What if I do Nothing?

At this meeting we discuss all the scans and investigations that have happened with the team of experts from your speciality. They then work together to decide on what we do next. Generally after this meeting we will arrange an appointment to see you in clinic to discuss everything.

Investigations

We often examine you and do tests to try and find out where the cancer started. Sometimes we will do a biopsy which is where we take a bit of the cancer out and look at it with a microscope. This is normally done as a day case.

If the primary cancer cannot be found after these tests we say this is a cancer of unknown primary (CUP). Although we may not be able to tell you where your cancer started we can learn enough about your cancer from these tests. This means we are still able to talk to you about what this means for you, how best to manage your cancer and any possible treatment options.

Sometimes we need to have more information and we might arrange for you to have more tests. We will make sure this is the right thing for you. It can take a few days or up to a few weeks for test results to be ready. We know that waiting for results can be a worrying time so we will let you know as soon as results are available.

We will meet again in clinic once we have all the information to discuss with you the best way to manage your cancer and your symptoms.

Chemo or radiotherapy?

Depending on the type of cancer and your general health we may talk to you about chemotherapy (cancer drug treatment) or radiotherapy (X-ray treatment) to try to slow down the cancer growth or to help you feel better. We will give you information about the possible benefits and downsides of any treatment and will talk to you about possible side effects. You should take time to decide if these treatments are the right choice for you.

Best supportive care

Sometimes we do not think that chemotherapy or radiotherapy will help you. Instead, Best Supportive Care focuses on quality of life and aims to help you live as well and as comfortable as possible, rather than curing the cancer. Best Supportive Care can:

• Help with symptoms such as breathlessness, pain, sickness or problems eating
• Help you and the people you care about come to terms with the diagnosis and what it means
• Help you talk about the future and plan ahead. This can be hard to do but can help you feel more prepared and in control
• Support you to manage at home

Best Supportive Care is usually provided by a combination of people, including: GPs and District Nurses, Cancer Specialist Nurses and Specialist Palliative Care.

Research

We may also talk to you about any relevant clinical trials or research projects.

Cancer of Unknown Primary Clinic

We have a CUP clinic on a Friday morning at the Victoria Hospital. At this clinic you might see the Consultant or the CNS. We would recommend bringing someone with you as it can be difficult to remember everything that is discussed. The CNS will generally call you a couple of days after your clinic to check if you have any questions or if there is anything you are unsure of.

If we find your primary cancer then we may refer you to that specialist team to take over your care. Your Advanced Clinical Nurse Specialist however will maintain contact with you until you get to know and are comfortable with your new specialist team.

This is where you will find information about how you can help yourself before surgery.

Preparing for surgery

Prehabilitation

Prehabilitation Sessions: Available at Maggies Centre Fife:

Thursdays 14.00-16.00 (pre-booked by the specialist nursing team)

We would recommend bringing someone with you to your Friday CUP clinic as it can be difficult to remember everything that is discussed.

• Think about arranging transport, time off work or childcare for the day of your appointments.
• Make sure you know where you are going.
• Bring a pen and paper to take notes.
• Try to bring a friend or family member with you.
• Allow extra time in case it takes longer than expected.
• Make sure your mobile phone is charged.
• Don’t be afraid to ask questions

You can read more about CUP and cancer on these websites, or please ask us for an information booklet

Fife Carers Centre

Fife Young Carers

Macmillian Cancer 

Cancer Research UK

CUP Foundation

Mywishes.co.uk

Penny Brohn

Yes to Life

Circle of Comfort charity

The Maggie’s Centre is next to the Victoria hospital and is a great place to get support and guidance. You can just drop in and meet the team. They are open Monday to Friday.

The most effective way to feedback about your patient experience is to use the Care Opinion website.  Care Opinion allows you to truthfully share your experience with us and with others.  This site is moderated and your comments will be both seen and reviewed. 

Tell us your story on Care Opinion