Cancer is a disease of old age. The risk of developing cancer increases with advancing age. Demographic transition occurs in various regions of the world due to improvement in heath conditions and leads to increase in life expectancy which in turn leads to increases in the risk of developing cancers. There are some molecular mechanisms involved in the process of aging and carcinogenesis. Though there is no robust biomarker for the aging process, the possibility of assessing the risk of development of cancer in the elderly exists. The chronological age alone may be considered as a marker of aging as biological aging is directly related to the development of various geriatric syndromes. Management of cancer in the elderly is challenging and is associated with inherent morbidity and mortality. The management of cancer among the elderly is a specialized area where various factors need to be taken into account. The risks of undertreatment and overtreatment are glaringly evident. The quality of life is an important outcome measure while planning the treatment. Comprehensive geriatric assessment shall be an important tool in selecting patients for the management. If appropriately selected, the outcome of management of elderly patients with cancer is found to be similar to that in younger patients. Some specific issues related to elderly cancer patients such as sleep disturbances, cancer-related fatigue, etc. worsen the quality of life of these patients. The involvement of caregivers in the management is an appropriate and laudable strategy to improve compliance and results.