Despite comprising 40% of US cancer cases, adults over 70 remain significantly underrepresented in oncology research and care optimization, with fewer than 3% participating in clinical trials. This demographic faces unique challenges including multiple comorbidities, frailty, and treatment modifications that younger patients rarely encounter. The geriatric oncology field has long recognized this disparity, but actionable solutions have been limited by the complexity of managing cancer alongside age-related conditions like cognitive decline, polypharmacy, and functional limitations. The proposed scalable care model represents a critical evolution in oncology practice, potentially addressing the paradox where our most vulnerable cancer population receives the least specialized attention. This approach acknowledges that standard cancer protocols often fail older adults, who may require dose reductions, alternative therapies, or palliative approaches that traditional oncology training inadequately prepares physicians to navigate. The model's emphasis on monitoring and support systems could significantly improve outcomes for a demographic expected to represent an even larger share of cancer cases as populations age globally.