Testing plays a vital role in shaping an effective endometrial cancer treatment and care plan. Gynecologic oncology expert Dr. Joshua Cohen explains the importance of identifying key biomarkers, reviews how test results influence treatment options, and discusses why shared decision-making between patients and their healthcare team leads to better outcomes.
Dr. Joshua G. Cohen is a board-certified gynecologic oncologist and Medical Director of the Gynecologic Cancer Program at the City of Hope Orange County. Learn more about Dr. Cohen.
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Transcript
Katherine:
Dr. Cohen, why is it so important to endometrial cancer patients advocate for essential testing?
Dr. Josh Cohen:
The diagnosis is key, and we talk about how to manage patients based on that diagnosis. We also do certain molecular signatures, which I think we’ll talk about in a little bit. But you really want that diagnosis to be the best possible information because the way we approach endometrial cancer treatment may include chemotherapy, it may include immunotherapy, which is a latest and greatest advance in the treatment for endometrial cancer. It could include radiation.
But all of these things are extremely dependent upon the diagnosis and the stage of the cancer and, essentially, any tumor markers or molecular signatures that we may send to further evaluate what type of cancer you have.
Katherine:
What is shared decision-making, and why is it important in endometrial cancer care?
Dr. Josh Cohen:
Yeah. I think endometrial cancer’s a field that’s vastly expanded in treatment in the last five years with the use of immunotherapy, the use of targeted agents. We’re doing molecular testing at a much higher level now where we’re checking for something called HER2. We’re checking for something called mismatched repair deficiency. We’re checking P53 status. And all of these are important because in a shared decision-making approach, there may not be one way to treat your cancer.
A shared decision-making approach means there are side effects to all treatments and you, as the patient, have to hear these side effects and the benefits and then work with your medical team to pick something you feel comfortable with. No one lives in a vacuum and cancer doesn’t either.
Someone who has poorly controlled diabetes and rheumatoid arthritis may have a different side effect profile for certain treatments than someone who’s otherwise healthy and doesn’t have an immune therapy condition already, like rheumatoid arthritis, when we’re talking about using your immune system to attack cancer cells.
Katherine:
Do you have anything you want to add?
Dr. Josh Cohen:
As a patient, advocate for yourself. Ask questions. It’s okay to ask questions. It’s okay to ask for direct information about your healthcare. Gather that source information. It’s okay to get a second opinion. I will say ChatGPT’s not bad, Dr. Google has some relevance, but you’re still better off getting a second opinion if you have the ability to and you want more information. It’s okay to do that. It’s okay as a family member to ask those tough questions and communicate. What I tell my patients, I love questions, but I also can’t help if I don’t know.
If you’re not feeling well, if you’re having a side effect, let us know about it so we can intervene because if you’re silent and you don’t mention it, it’s hard for us to make a difference. It’s a relationship. We all go into this to do the best possible job we can to make the biggest difference we can for our patients, and we want to hear from you if you have concerns. So, advocate, communicate, ask questions.