The elderly are often the population affected by urologic cancer, especially prostate adenocarcinoma and urothelial tumors. Treatment, especially at the metastatic stage, is the subject of debate due to the problem of iatrogenic consequences compared to potential benefit. A treatment is beneficial when it leads to an increase in the duration and / or quality of life. The evaluation of a patient before treatment should allow estimation of the risk of morbidity, mortality for the patient and treatment should be the tailored to the patient's physiological condition. The scales of assessment of competitive morbidity and measurement of the level of activity now available provide useful prognostic information to help the urologist to make the best decision concerning the therapeutic approach.