The incidences of osteoporosis and cancer increase with age, and these two diagnoses are often made in the same individual. Both increasing age and hypogonadism associated with aging, as well as cancer therapies, can lead to loss of bone mass and increased risk for fragility fractures. Advancing age carries an association with increased incidence of cancers. Thus, cancer and its therapies may predispose an individual to osteoporosis and its associated morbidity and mortality. Prevention of bone loss and its consequent fractures is critical in the care of aging patients. This article reviews the mechanisms of bone metabolism and the principles of management of bone health in the older population with a history of cancer.