Choosing the right surgeon is one of the most important decisions for anyone diagnosed with uterine or endometrial cancer. Surgery is usually the main treatment, and the skill of the doctor — and the quality of the cancer center — can affect both survival and long-term quality of life.
Gynecologic oncologist Peter Frederick, MD, FACOG, of Roswell Park Comprehensive Cancer Center, outlines the essential questions patients should ask before deciding where to receive care.
Are you a gynecologic oncologist?
The standard treatment for cancer in the uterus is a hysterectomy, the surgical removal of the uterus. Although all gynecologists are trained to perform the procedure, cancer surgery is often more complex. It may involve nearby organs, tissues, or lymph nodes.
“You want a gynecologic oncologist,” Dr. Frederick explains. “This is a gynecologist with advanced specialty training in cancers of the female reproductive system.”
How many of these surgeries have you performed?
Experience matters. Research shows that surgeons and centers with higher case volumes provide better outcomes. A general gynecologist may perform many types of procedures, while a gynecologic oncologist focuses specifically on cancer.
A good benchmark is 80 uterine cancer surgeries per year. Roswell Park averages more than 120 robotic hysterectomies annually for uterine cancer, in addition to many procedures for precancerous or complex benign conditions.
High-volume experience in minimally invasive surgery is also crucial. Robotic surgery often leads to fewer complications, less pain, and a faster recovery. Roswell Park introduced robotic surgery to its region decades ago and continues to be a leader in these techniques.
Should I get a second opinion?
Yes. Most patients have enough time to seek a second opinion. A review by specialists helps confirm the diagnosis and ensures the recommended treatment is appropriate for the individual’s cancer and health needs.
Can I preserve my fertility?
A hysterectomy is the standard treatment, but younger patients or those who hope to have children may have other options.
“Some people with low-risk cancers may begin with hormonal therapy instead,” says Dr. Frederick. “This approach keeps the uterus intact, but it requires careful monitoring by specialists.”
At Roswell Park, a team from gynecologic oncology, radiology, pathology, and fertility medicine evaluates whether fertility-sparing care is safe. Patients may also receive counseling on IVF, egg or embryo freezing, and the effects of delaying hysterectomy.
What advanced testing will be done on my tumor?
All uterine cancers at Roswell Park are tested for mismatch repair (MMR) deficiencies, a type of DNA error.
An abnormal result may signal an inherited condition that raises the risk for several cancers, including colorectal and ovarian cancers. It may also guide the use of immunotherapy and help predict prognosis.
What side effects might occur from a hysterectomy?
A hysterectomy is the second most common major surgery for women, but it is still a significant operation.
Removing the uterus triggers menopause for those who have not yet begun it. When both the uterus and ovaries are removed, patients may experience symptoms such as vaginal dryness, intimacy concerns, and changes in body image.
However, for many women with cancer, surgery can also greatly improve symptoms like abnormal bleeding and pelvic discomfort.
Roswell Park’s Sexual Health Clinic provides support and treatment options to help patients maintain or restore sexual well-being after surgery.
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