In older patients with cancer, the balance between harms and benefits of treatment is delicate. There is a higher risk of adverse outcomes of cancer treatment due to comorbidity and geriatric impairments, while clinical benefit is uncertain due to their frequent exclusion in clinical trials [1,2]. Potential benefits of treatment (for example, increased survival) may come at a cost (for example, increased treatment side-effects or loss of function). As a result, treatment decisions are often preference sensitive, which means that the optimal treatment choice depends on a patient’s personal values and priorities [3].