Questions to ask your doctor about your endometrial (uterine) cancer
(Use this PDF as a guide to help prepare for appointments and discussions with your healthcare team)
Understanding Molecular Subtypes of Endometrial Cancer:
If you or someone you love has been diagnosed with endometrial cancer, you may hear terms like molecular subtype, molecular classification, or tumor profiling and wonder what they really mean for you. Understanding the molecular subtype of endometrial cancer can feel overwhelming at first, but it plays an important role in helping guide treatment decisions and long-term care.
Many patients are never told which molecular category their endometrial cancer falls into, or realize they can ask about molecular testing. Yet knowing your tumor’s molecular profile can offer valuable insight into how the cancer behaves, which treatments may be most effective, and whether clinical trials could be an option.
To help make this information easier to understand, we recommend watching the short webinar below from SHARE Cancer Support. In just 14 minutes, Dr. Tashanna Myers, Division Chief of Gynecologic Oncology and Vice Chair of Academic Affairs for the Department of OB/GYN at Baystate Medical Center, explains the four molecular subtypes of endometrial cancer, why molecular classification matters, and how this knowledge can help you have more meaningful conversations with your healthcare team.
YouTube Webinar: In a Nutshell: Endometrial Cancer Molecular Subtypes
(Approximately 14 minutes)
Whether you are newly diagnosed, already in treatment, or supporting a loved one, this resource can help you better understand molecular subtypes of endometrial cancer and feel more confident asking your doctor questions about molecular testing, treatment options, and what comes next.
What kind of uterine cancer do you have, and what does it mean?
Not all endometrial or uterine cancers are the same. Understanding the type of cancer, along with its stage, grade, and molecular biomarkers, can help explain how the cancer behaves and which treatments may be most effective. These details are a crucial part of personalized endometrial cancer care and can inform treatment decisions, clinical trial eligibility, and follow-up planning.
You may want to ask your doctor about the following:
Cancer type (histology): This describes how the cancer cells look under a microscope. Common types of endometrial and uterine cancer include adenocarcinoma (endometrioid), serous, clear cell, uterine sarcoma, and less common subtypes such as carcinosarcoma.
Stage: The stage explains how far the cancer has spread, or if it is confined to the uterus.
Grade: The grade describes how different the cancer cells are from normal cells, which can indicate how quickly the cancer may grow.
Hormone receptor status: Some endometrial cancers are hormone-dependent. Ask if your tumor is:
Estrogen receptor (ER) positive or negative
Progesterone receptor (PR) positive or negative
HER2 status:
HER2 positive or negative, which may influence targeted treatment options, especially in certain aggressive subtypes.
What are the biomarkers for mismatch repair, and why do they matter?
Mismatch repair (MMR) biomarkers can help predict how well your endometrial or uterine cancer may respond to immunotherapy and guide treatment decisions. Understanding these markers can empower you to ask informed questions about testing and personalized care.
Common MMR and related biomarkers include:
dMMR / MSI-High (MSI-H): Indicates mismatch repair deficiency, often associated with better response to immunotherapy
pMMR / MSI-Stable (MSS): Indicates normal mismatch repair function
MLH1, MSH2, MSH6, PMS2: Genes tested to identify Lynch syndrome, an inherited cancer risk
PD-1 / PD-L1: Proteins that can indicate eligibility for certain immunotherapy treatments
p53, PIK3CA, PTEN, KRAS: Other molecular markers that may influence treatment choices
Knowing your MMR and molecular profile can help your healthcare team create a treatment plan tailored to your cancer’s unique characteristics.
What testing has been done, and what do the results mean?
Different types of testing can provide important information about your endometrial or uterine cancer and help guide treatment decisions. Understanding what testing has been done and what the results mean can help you ask informed questions and take an active role in your care.
Genetic testing (germline testing): Looks at genes inherited from your biological parents and can identify inherited cancer risks, such as Lynch syndrome.
Genomic testing (somatic testing, aka Next Generation Sequencing/NGS): Examines the tumor itself to identify cancer-specific mutations that may guide targeted treatment options, immunotherapy, or clinical trial eligibility.
What are your treatment options?
What will your surveillance be, and how often will you get scans?
Treatment for endometrial or uterine cancer depends on your cancer type, stage, grade, and molecular profile. Asking your doctor how these factors influence recommendations can help you make informed decisions and understand your care plan.
Your doctor may discuss treatment and surveillance options, including:
Imaging scans: CT, PET, PET/CT, or MRI to monitor the cancer
Blood-based tests:
ctDNA (circulating tumor DNA): Small fragments of DNA from cancer cells that are shed into the bloodstream can help detect recurrence before it appears on scans
cfDNA (cell-free DNA): DNA fragments from dying cells, which may or may not indicate cancer
CA-125 (Cancer Antigen 125): A protein tumor marker that can be released into the bloodstream and may be elevated in some gynecologic cancers, which can help monitor changes over time, but does not always indicate cancer
Understanding how these tests are used for monitoring and follow-up can help you feel more confident in your treatment plan and next steps.
Have questions or want to learn more?
We understand this can feel like a lot, and questions don’t always come all at once. Take this at your own pace. We’re here when you need us. Contact us anytime or subscribe to stay connected to trusted updates and resources.