In the last twenty years a new philosophy in the management of gynaecological cancer has begun: the goal of the therapy is now not only to save the life but also the patient's quality of life. To this end, on the basis of a century's experience and of progress in the oncologic field, therapies have been progressively personalized and modulated, considering both the surgical pathological staging and the effective possibilities in terms of survival and quality of life, in order to avoid over or undertreatments. Moreover, in the last few years also the patients submitted to surgery for gynaecological malignancies are beginning to ask gynaecologists for access to hormonal replacement therapy in order to prevent the symptoms typical of menopause, and physicians have to decide when that is possible. Consequently gynaecologist oncologists have to bear in mind the therapy’s real cost/benefit balance for the patients, also from a psychological point of view, and in any case, treatments must be performed only if they are unquestionably useful and if they involve the patient’s consciousness in choices and decisions.