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Below, week by week, is what OnCo's record of Endometrial cancer says about the first two months: the order is typical, the timing is yours to ask about. The gynaecological cancer where immunotherapy has had the biggest impact, guided by molecular classification. Sections appear only where the record has something to say. Orientation, not medical advice.
Staging tests establish exactly what and where the cancer is. Everything else follows from the answers.
Endometrial biopsy for postmenopausal bleeding; MRI for myometrial and cervical invasion; molecular classification (p53, MMR IHC, POLE sequencing) on the diagnostic specimen.
Ask which of these were tested and what the results were; see the report reader for what each value means.
These specialties appear in the standard of care for this cancer. In most centres they meet weekly as a tumour board to agree each plan; you can ask when yours was discussed and what was decided.
A second opinion from a centre that treats many similar cases is normal, not rude; the standard of care tells you what to compare it against.
Each row is a setting from the standard of care, in the order it usually arises. Not all will apply to you; your stage and biomarkers decide which do. The guideline grade, where recorded, says how strong the evidence is.
Universal MMR testing of tumours to identify Lynch syndrome; risk-reducing hysterectomy and salpingo-oophorectomy for Lynch carriers after childbearing; levonorgestrel IUD and weight management reduce risk; no screening for average-risk women.
Hysterectomy; adjuvant therapy by molecular class.
Minimally invasive total hysterectomy and bilateral salpingo-oophorectomy with sentinel lymph node mapping (FIRES, SENTOR); omentectomy for serous histology.
Observation (low risk, POLEmut) or vaginal brachytherapy (intermediate risk; PORTEC-2); molecular class may de-escalate (PORTEC-4a).
Chemoradiation plus carboplatin-paclitaxel (PORTEC-3) or chemotherapy alone (GOG-258); pembrolizumab or dostarlimab added for stage III-IV per RUBY/GY018 eligibility.
Chemotherapy + dostarlimab or pembrolizumab; lenvatinib-pembrolizumab; T-DXd if HER2+.
Progestin (oral or IUD) with re-biopsy every 3-6 months; hysterectomy after childbearing.
Carboplatin-paclitaxel plus dostarlimab (RUBY), pembrolizumab (NRG-GY018/KEYNOTE-868), or durvalumab (DUO-E; dMMR in the US), continued as maintenance up to 2-3 years.
Single-agent PD-1 blockade (dostarlimab GARNET, pembrolizumab) if immunotherapy-naive; otherwise chemotherapy or trials.
Trastuzumab with carboplatin-paclitaxel (randomised phase 2) or T-DXd for IHC 3+ after prior therapy.
Lenvatinib + pembrolizumab (KEYNOTE-775) if not previously given immunotherapy; T-DXd if HER2 IHC 3+; chemotherapy (doxorubicin, weekly paclitaxel); hormonal therapy for low-grade ER-positive disease.
Generated from this cancer's standard of care, biomarkers and open problems. Take the group that matches where you are. To tick, add your own and print, open the one-page appointment sheet.
Trials open now for this cancer in OnCo, largest phase first. Joining a trial is a decision like any other: ask what the comparison arm is, whether a placebo is used, and what happens if you leave. The cancer page searches ClinicalTrials.gov live for more.
Much of what helps in the first weeks is free if you know to ask: testing, helplines, rides and lodging, second opinions, trial travel.
Every term links to the glossary.