Practical brachytherapy solutions to an age-old quandary

•Age should not be a limiting factor for brachytherapy in patients with localised cancer or for palliation in metastatic disease.•In tumour streams where brachytherapy forms part of the curative management, it should not be omitted in elderly patients who are medically fit for treatment.•Treatment decisions should factor in patient preferences, the relative merits of different therapeutic approaches and maintaining minimal impact on quality of life.