As populations worldwide continue to grow and age, the number of older adults with cancer is rapidly growing. Depression and anxiety are prevalent in this population but can be under-reported, under-recognized, and undertreated. Specific psychiatric disorders such as depressive and anxiety disorders may occur throughout the cancer journey and are significantly associated with adverse outcomes. Challenges in diagnosis in this population can arise from factors such as the direct neuropsychiatric effects of certain cancers and their treatment leading to overlap of symptoms, or the presence of concomitant cognitive impairment leading to symptoms being obscured. Current clinical practice guidelines recommend for their routine screening, assessment, and management as part of everyday oncology care.