Ask an expert: What are the symptoms of endometrial cancer?

Written in association with: Dr Natalia Povolotskaya
Published:
Edited by: Carlota Pano

In the UK, more than 9,000 people are diagnosed each year with endometrial cancer of the reproductive system.

 

Here, Dr Natalia Povolotskaya, leading consultant gynaecologist and cancer surgeon, provides an expert insight into endometrial cancer, including risk factors, symptoms, and treatment.

 

 

What is endometrial cancer?

 

Endometrial cancer refers to cancer of the womb (uterus). It is the commonest gynaecological cancer.

 

The majority of patients with endometrial cancer are women who have gone through the menopause. Despite this, endometrial cancer may also develop in a small number of young women who are in their 30s or even late 20s.

 

What are the early warning signs of endometrial cancer?

 

Up to 90 per cent of patients will present with postmenopausal bleeding, which is vaginal bleeding after the menopause. However, only 1 out of 10 patients with postmenopausal bleeding will be diagnosed with cancerThis is not always endometrial cancer; it can be other gynaecological or non-gynaecological cancers. The other 9 out of 10 patients will have a benign explanation for their symptoms.

 

Young patients with endometrial cancer will present with heavy menstrual bleeding and/or unscheduled vaginal bleeding.

 

In addition to vaginal bleeding, some patients with endometrial cancer will present with recurrent vaginal dischargeRecurrent watery discharge is a concern.

 

In the later stages of endometrial cancer, patients will frequently experience pain.

 

What are the most common risk factors for endometrial cancer?

 

The main risk factor for endometrial cancer is obesity. The other risk factors are diabetespolycystic ovary syndromesome ovarian tumourstamoxifen use, and oestrogen-only hormone replacement therapy.

 

As well as this, endometrial cancer can also be genetically-linked in patients with a family history of Lynch syndrome, an inherited condition that increases the risk for various cancers. These include bowel and ovarian cancer. In this case, risk reduction surgery should be strongly considered at an appropriate time of a woman’s life.

 

What steps can be taken to prevent endometrial cancer?

 

In patients with unknown or unsuspected genetic conditions, the most important way to prevent endometrial cancer is to keep a healthy weight.

 

What are the best methods to treat endometrial cancer?

 

The assessment of patients with postmenopausal bleeding requires a pelvic ultrasound, often followed by a diagnostic hysteroscopy (where a small camera is used to look inside of the womb) and a biopsy of the endometrium (the lining of the womb).

 

After this, minimal access surgery (laparoscopic or robotic) is the “gold standard” of surgical treatments for endometrial cancer. Some patients will require radiotherapy or chemotherapy.

 

Around 80 per cent of patients with endometrial cancer will present at an early stage. The majority of them will be cured with surgery alone.

 

 

Dr Natalia Povolotskaya is a leading consultant gynaecologist and cancer surgeon with over 20 years’ experience.

 

If you require expert diagnosis and treatment for endometrial cancer, do not hesitate to book an appointment with Dr Natalia Povolotskaya via her Top Doctors profile today.

By Dr Natalia Povolotskaya
Obstetrics & gynaecology

Dr Natalia Povolotskaya is a consultant gynaecologist and cancer surgeon with over 20 years of experience, based in Portsmouth. Dr Natalia Povolotskaya is an expert in gynaecological cancers, cancer prevention, colposcopy and complex gynaecological problems.  She offers rapid cancer diagnosis and treatment for ovarian cancer, cervical cancer, endometrial cancer and vulval cancer.
She has expertise in minimal access (keyhole surgery) laparoscopic and robotic, complex open surgery. She offers hysterectomy for cancer, fibroids, ovarian cysts, heavy periods. She offers risk reduction hysterectomy and removal of tubes and ovaries. She offers surgery for vulval cancer and sentinel lymph node biopsy. She offers all range of diagnostic procedures.

She currently practises at the Spire Portsmouth Hospital and Queen Alexandra Hospital/ Portsmouth University Hospitals NHS Trust.

Dr Povolotskaya completed her medical studies in St Petersburg, achieving a degree in pharmacology (diploma with distinction), before being awarded her medical degree from Pavlov State Medical University in Saint-Petersburg (Diploma with Distinction). She undertook complete UK based postgraduate training in obstetrics and gynaecology. She worked in the best UK hospitals under mentorship of renowned clinicians and surgeons. In addition to completion of general training in obstetrics and gynaecology, she completed extra 3 years of rigorous training in the Subspeciality in Gynaecological Oncology.

She has worked as a consultant in gynaecological oncology since 2015 and has performed hundreds of complex surgeries. Some of her work was featured on the Channel 4 programme 'Shut-Ins'.

Dr Povolotskaya was elevated to fellow status of the Royal College of Obstetricians and Gynaecologists for significant contribution to the obstetrics and gynaecology specialty, furthering the standards of practice, teaching and research.

She is clinical lead for gynaecological oncology at Queen Alexandra Hospital, as well as a surgical lead for the Regional Genetics Multidisciplinary Meeting for Familial Gynaecological Cancers. Previously Dr Natalia Povolotskaya held the position of gynaecological oncology network chair for Wessex Cancer Alliance for three years.

As a Royal College of Obstetricians and Gynaecologists (RCOG) recognised supervisor of sub-speciality training in gynaecological oncology, she is responsible for training the next generation of subspecialty trainees in gynaecological oncology. She is also a colposcopy trainer.

She led a team of clinicians who won a Pride of Portsmouth Award in 2019 for implementing a new approach to follow up in patients with endometrial cancer.

Dr Povolotskaya has multiple publications in scientific journals. She takes active part in Clinical Research. She was a PI for the FORECEE and SUCCOR studies. She is currently a PI for the PROTECTOR study.
 

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