The geriatric population comprises more than 50% of the overall cancer burden, as per the recent global statistical data. Despite recent advances in the management of cancer patients, the geriatric age group often gets treated with non-standard treatment modalities. This is due to associated co-morbidities and polypharmacy that these patients are already receiving. Additionally, the evidence from of randomized clinical trials is not a true representative of aging population, as most trials include fit and younger patients only. Due to poor understanding of the gradually altering physiological and functional status of these patients, the current healthcare systems in most parts of the world are sub-optimally prepared to address the range of needs peculiar to this population. However, with the changing landscape and elderly cancer burden; the cancer management for persons above 60 years has gained importance. Multi-pronged approaches  due to introduction of contemporary practices such as organ-preserving and minimally invasive cancer surgery, hypofractionated radiotherapy, stereotactic techniques, particle therapy, modified systemic chemotherapy, immunotherapy and targeted therapy, have come together in the last three decades. Thus, the therapeutic armamentarium has expanded to tackle oncological challenges in the vulnerable elderly patient population. For optimal management of these elderly cancer patients, they need to be assessed holistically via a comprehensive geriatric score assessment prior to any cancer directed treatment.