The aging population poses new challenges to all fields of medicine and to gynecologic oncology in particular. In gynecologic oncology, issues that are germane to general medicine, cancer chemotherapy, radical surgery, and routine gynecology are all encountered on a regular basis. In clinical practice, the "very old" are often thought to tolerate standard treatments poorly. While comorbid conditions may be more prevalent, management decisions should be based on an assessment of individual function and not solely on numerical age. In the article by Mirhashemi and colleagues, this theme is conveyed throughout, as they describe the current management of gynecologic malignancies in older women.