Recent acknowledgment of the prominence of cancer in the elderly has stimulated interest in this patient population at risk. Due to the newness of this interest, currently there is no formal recognized specialty of geriatric oncology that parallels pediatric oncology. However, there is growing concern and interest in identifying elder-specific indices of difficulty, disparity, and duty to optimize cancer prevention, control, therapy, support, and rehabilitation efforts for this growing population of aged patients. This article will provide a comprehensive review of relevant literature pertaining to nursing care of elderly adults who face cancer. Six realities to guide cancer nursing planning will be identified that address key patient-family-professional issues into the elder continuum.