As cancer of the elderly becomes a mounting burden on global health care systems there is a need to increase the number of clinical trials aimed at older cancer patients. Dr Joanna Kazmierska, an oncologist specialising in head and neck cancer in the elderly, explains why age should not always be a major factor when deciding whether to administer radiotherapy to patients over the age of 70 and discusses how clinicians should adapt radiotherapy regimens for older patients when the level of comorbidities make radical programmes unsuitable. Dr Kazmierska talks about the need for geriatricians to be included in multi-discipline oncology teams in order to accurately establish patient health and decide which treatments each individual patient can tolerate.