The population in developed countries is growing older, with the number of people over 85 years of age increasing especially rapidly. The incidence of a head and neck cancer increases with age, only a few patients are under 40 years of age and the highest incidence in many sites occurs in patients over 70 years of age. The aging population has increasing amounts of comorbidities. The treatment protocols for head and neck cancer have over the last two decades become intensified as a consequence of larger surgical resections with reconstruction, high dose radiotherapy often in combination with chemotherapy or targeted therapeutic drugs. Should the elderly and old patients be treated similarly to the younger counterparts or should the treatment be altered based on chronologic age? During the EUFOS Congress in Oto-Rhino-Laryngology Head and Neck Surgery in Vienna, Austria 2007, a panel addressed this issue and this is a summary of the conclusions.