Older adults’ cancer diagnosis and decision making for its treatment can be shocking and burdensome to the whole family, especially to their designated caregivers. The decision making process for cancer treatment is complicated and sometimes changeable in complex ways, giving the unique structure of each family. While formal community based long-term care is designed to deliver the needed care to older adults in reducing their institutional or hospital admissions and facilitating aging in place, the formal care may be hard to involve in decision making process for cancer treatment that encompasses more than logical rationales within the family infrastructure. Thus, family members play an important role in making decision for cancer treatment when the older adults are physically and emotionally overwhelmed. In this article, we provide an overview on various responses in decision making for cancer treatment, critique what aspects of health services could be improved, and make suggestions to better inform patients, families, and health professionals who serve the aged population undergoing cancer treatment.