Conducting effective medication reviews for older cancer patients undergoing chemotherapy involves a careful evaluation of all medications to ensure there are no harmful interactions or side effects, particularly important due to the complexity of chemotherapy regimens. Optimising medication involves tailoring treatments to the individual's health profile and specific chemotherapy needs, managing polypharmacy to reduce risks, and integrating geriatric assessments to adapt therapy choices based on functional and cognitive status. Active patient engagement in understanding their chemotherapy and overall medication plan, alongside coordinated care from an interdisciplinary team, is essential. Regularly reviewing and adjusting medications as health conditions evolve is crucial to enhancing therapeutic outcomes and improving the quality of life for these patients.