Cancer Care in Older Adults: What to Know About Screening, Treatment, and Personalized Decisions

Cancer is often thought of as a disease of aging. In fact, most cancer diagnoses occur in adults over age 65. As people live longer and healthier lives, more older adults are facing important questions about cancer screening, diagnosis, and treatment.

How do cancer care decisions change as we get older?

Today, physicians increasingly recognize that cancer care for older adults should be highly individualized—based not just on age, but on overall health, independence, and personal goals.

Why Cancer Care Looks Different for Older Adults

Older adults often have unique health considerations that can influence cancer screening and treatment decisions. Many people have chronic conditions such as heart disease, diabetes, or arthritis and may take multiple medications.

These factors can affect how well someone tolerates certain tests, surgeries, or cancer treatments.

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“When patients ask me, ‘Am I too old for screening?’ my answer is almost always the same: age isn’t the whole story,” says Anna Serur, MD, chief of colon and rectal surgery at Englewood Hospital. “What matters much more is how healthy you are and what screening could realistically do for you.”

Cancer Screening in Later Life

Cancer screening plays an important role in detecting disease early or preventing it altogether. However, screening recommendations may change as people get older.

For many cancers—including colorectal cancer, breast cancer, and prostate cancer—guidelines suggest routine screening through about age 75 for individuals at average risk.

After that, screening decisions often become more individualized.

Physicians consider several factors, including:

• Overall health and chronic medical conditions
• Functional status and independence
• Prior screening history
• Family history of cancer
• Estimated life expectancy

In some cases, screening may still provide meaningful benefit. For example, a healthy and active person in their late 70s who has never been screened for colorectal cancer may still benefit from testing. In other situations, continued screening may offer little advantage.

“The goal isn’t to keep screening forever,” Dr. Serur says. “The goal is to screen when it’s likely to help someone stay healthy or catch a cancer early. That decision should always be based on the individual patient.”

Treatment Decisions in Older Adults With Cancer

If cancer is diagnosed, treatment decisions for older adults often require additional consideration.

Some patients tolerate surgery, chemotherapy, or radiation therapy very well. Others may benefit from targeted, less intensive approaches that prioritize their independence and quality of life.

Cancer specialists increasingly use geriatric assessments—evaluations that look at physical function, cognition, nutrition, and social support—to help guide treatment planning. These tools help physicians determine which treatments are safest and most appropriate for each individual patient.

“Older adults often worry that cancer treatment will automatically be too hard on them,” Dr. Serur says. “But many patients do very well with treatment. The key is choosing the approach that fits the patient’s overall health and priorities.”

Geriatric Cancer Care at Englewood Health

At Englewood Health, older adults with cancer benefit from a multidisciplinary team that includes oncologists, surgeons, geriatric specialists, and supportive care experts. This team works together to evaluate each patient’s overall health and develop a treatment plan that reflects both their medical needs and personal goals.

“At Englewood Health, we focus on the whole patient—not just the cancer,” says Dr. Serur. “Older adults often have unique considerations, so our team works closely together to design treatment plans that address the cancer while also protecting a patient’s strength, independence, and everyday life.”

Learn more about cancer care at Englewood Health or to schedule an appointment