Those readers who know about me realize that I am getting up there in age. In just a few years, I hope to cross over the threshold into the cohort known as the "old-old"age 85. 1 I have survived the adversities common to men my age, although many friends about my age are being treated for or have died of cancer. Luckily, my only skirmish with cancer was an actinic keratosis (AK) that yielded to topical treatment. Because most AKs do not become cancerous, I do not believe it should even be counted. As a humorous aside, I can remember my mother used this same acronym, AK, to describe a few older men she did not like; these men were all about my current age (AK stood for the Yiddish/German expression alte kacker 2). Curiously, she never used a comparable term to describe older women she did not like. This month, Dr. William Hung, our Topic Editor for Geriatric Therapeutics, has assembled an update entitled "Cancer Care in Older Adults." The included articles shed light on several important topics, including screening for lung cancer, palliative care for hepatocellular carcinoma, and weighing the risks and benefits of cancer therapies. 3-6 Because some gynecologic cancers are more prevalent in elderly women, I would like to return to and expand last month's Note. 7 In the Western world, ovarian cancer (OC) leads to more deaths than any other gynecologic cancer. 8 OC is the leading cause of death in American women between the ages of 65 and 74 years (35.1%) and 75 and 84 years (23.5%). 9 I am a staunch advocate for early detection. My position has been especially reinforced by two experiences. Many years ago, I recognized signs and symptoms consistent with the need for further diagnosis and treatment in a woman who was then in her early 40s. Like many women, she was ignoring her symptoms. She described the following to me: a feeling of abdominal fullness accompanied by intermittent, one-sided abdominal pain; occasional spotting at times other than during her menses; urinary frequency; and increased fatigue. She had noted these changes for 2 months but had not mentioned them to anyone. Her OC was surgically treated; she is still doing well and is now in her mid-80s. My second experience involved a close relative who died in her late 80s. Sadly, her OC was not detected until it was too late for her to be helped. For readers unfamiliar with OC, I want to review certain information. Although aggregated as OC, in most statistical reports there are a number of different entities that make up this diagnostic category 10 : (1) endometrioid carcinoma and clear cell carcinoma, these are sometimes associated with somatic mutations in the tumorsuppressing gene ARID1A; (2) mucinous carcinoma, sometimes linked to teratomas and some have KRAS mutations; (3) low-grade serous carcinomas, a rare type that is often indolent; and (4) high-grade serous carcinomas, the most common, highly aggressive, and associated with P53 and BRCA1 and BRCA2 gene mutations. OC may also arise nearby in the fallopian tubes or peritoneum. From statistics fr...