Essential Endometrial Cancer Testing
What testing should endometrial cancer patients undergo after diagnosis? Dr. Hinchcliff explains the importance of determining cancer stage, histology, and performing biomarker testing, as these factors can guide more targeted treatments.
Dr. Emily Hinchcliff is a Gynecologic Oncologist at Northwestern Medicine. Learn more about Dr. Hinchcliff.
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Related Resources:
 What Questions Should Patients Ask About Endometrial Cancer Testing? |
Endometrial Cancer Biomarkers | Impact on Prognosis and Treatment |
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Transcript:
Katherine Banwell:
Dr. Hinchcliff, what testing should people with endometrial cancer undergo after diagnosis?
Dr. Emily Hinchcliff:
So, when I think about a cancer diagnosis, there are first two big buckets of things that are important to understand. One is the cancer stage, meaning where did the cancer start, and then, where has it potentially spread to. The other is the cancer histology, or what do the cells look like under the microscope. And in endometrial cancer, there are actually a variety of different subtypes of endometrial cancer that can be differentiated based on what they look like under the microscope. Once you have those as your framework, I think the next step is to better understand what’s called biomarker testing, or the genetics of your cancer.
Katherine Banwell:
Would you define biomarker testing? What does that mean?
Dr. Emily Hinchcliff:
Yeah. So, biomarker testing – while, under the microscope, we can determine what kind of cancer something is, we can’t tell what’s going on inside the cancer cells itself, and so, biomarker testing is an umbrella term for a variety of different tests that really try and assess what’s going on inside the cancer, what are the genetics making the cancer cells divide and grow abnormally, and also, what are the things that might be expressed or on the cancer cell surface that are potentially targets for us to leverage to treat the cancer better. So, what is unique to that cancer, either the patient’s own cancer individually or that cancer type in general, that we can use to our benefit to treat the cancer better.
Katherine Banwell:
What are the most common biomarkers associated with gynecologic cancers?
Dr. Emily Hinchcliff:
So, in endometrial cancer specifically, I think if there are a couple take-homes that I can emphasize to patients in this talk today, the first is it is essential to know your what’s called mismatch repair status. So, mismatch repair is one of the things that can happen inside a cancer cell, and when that goes awry, when that becomes abnormal, it means that the cancer has particular features that we can use to treat it better.
And so, the two categories of mismatch repair are you can be mismatch repair deficient, meaning there’s something abnormal in that machinery inside the cancer cell, or mismatch repair proficient, meaning that that machinery is still intact, and the reason for that being so important is that in endometrial cancer, if someone’s cancer is mismatch repair deficient, we can use a whole class of drugs called immunotherapy, or leveraging your own immune system using medicines to try and treat that cancer better.
So, I think knowing that about your cancer type is really essential in endometrial cancer. I think the other thing that is important to know is in endometrial cancer, some subsets will express a receptor – so basically, something on the cancer surface – called HER2, and if you are HER2-positive, that also can be a target for potential drugs. So, those are two really important biomarkers in endometrial cancer that I think it’s important that patients know that they have been tested, and then know what their results are.
