Cancer care for older adults

How age, health, and daily life shape cancer care, and how a geriatric assessment can make treatment safer.

Rosa: Hi, I'm Rosa. Age is only one part of your story. Let's look at how your health and daily life can shape a treatment plan that is safe and right for you.

Most people with cancer are 65 or older. Age alone should not decide your treatment. Two people of the same age can be very different in health, strength, and what matters to them.

As we age, the body handles medicines differently. The kidneys and liver may clear drugs more slowly. The bone marrow may recover more slowly, so blood counts can stay low longer. Nerve damage and falls can be more common. Your care team can adjust the plan to fit your body.

Experts recommend a geriatric assessment for adults 65 and older starting cancer medicines like chemotherapy. This is a set of short questions and simple tests. It looks at daily activities, falls, memory, mood, and nutrition. It also looks at other health problems, your medicines, and who can help at home. Much of it you can fill out yourself.

This assessment helps your team see risks that a regular visit may miss. Studies show that using it to guide care can lower serious side effects. It may lead to a dose change, extra help at home, or physical therapy. It may also lead to a nutrition visit or a medicine review.

Many treatments work just as well in older adults. Some, like immunotherapy, targeted pills, shorter courses of radiation, and less invasive surgery, may be easier to handle. The best plan balances how well a treatment works with how it may affect your energy, independence, and thinking.

Tell your care team what matters most to you. For some people it is living as long as possible. For others it is staying independent, staying sharp, or being home. Palliative care can help with symptoms at any stage, alongside cancer treatment.

Bring all your medicines

Bring every pill bottle, including vitamins, supplements, and over-the-counter medicines. Taking many medicines raises the chance of side effects and drug interactions. Some may be safe to stop.

Preventing falls

Numb feet, dizziness, and weakness can cause falls. Remove loose rugs, use night lights, and add grab bars. Ask about physical therapy or a cane or walker.

Memory and thinking

Tell your team if you or your family notice memory changes, confusion, or trouble managing pills. Confusion that starts suddenly needs a call right away.

Eating well

Losing weight without trying, or poor appetite, can make treatment harder. Ask to see a dietitian.

Caregivers

The person helping you may also be older or have health problems. Caregivers need support too. Ask about social work, home health, and respite care.

Planning ahead

Choose a health care proxy, a person who can speak for you if you cannot. Write down your wishes in an advance directive. Share copies with your family and care team.

Questions to ask

Can I have a geriatric assessment? How might this treatment affect my energy, memory, and independence? Can the dose be adjusted? What support is available at home?

• Ask for a geriatric assessment before starting treatment.
• Make a full list of medicines and supplements and bring it to visits.
• Tell your team about any falls in the past year.
• Plan rides and help at home for treatment days.
• Name a health care proxy and fill out an advance directive.

Last updated: 2026-10-27. Medically reviewed by Veli Bakalov, MD, medical oncologist (October 2026). General education from Step by Step, the patient portal of HemeOncBuddy.