The incidence of most cancers increases with age, including colorectal-, lung- and breast carcinomas. Each year, approximately 50,000 new cases of colorectal carcinoma (CRC) are diagnosed in Germany with a peak incidence around the age of 65. At diagnosis, 50% of CRC-cases show already metastases. Cure of metastatic disease with chemotherapy, radiology or surgery alone or in combination can be rarely achieved in this situation. However, palliative therapy regimens can significantly prolong life in most cases. Besides systemic therapy, minimal invasive techniques for tumor reduction are an interesting option in the palliative situation, especially in elderly patients. Yet the clinical impact of these new techniques has to be determined in future studies.