Objective: This study examined the influence of oncology social workers’ expectations regarding aging (ERA) and ERA with cancer (ERAC) on their clinical judgment. Methods: Oncology social workers (N = 322) were randomly assigned to one of four vignettes describing a patient with lung cancer. The vignettes were identical except for the patent’s age and gender. Structural equation modeling served as the primary tool for testing the study hypotheses. Results: Significant differences were found in clinical judgment based on patient’s age, and social workers’ ERA and ERAC which affected diagnostic and treatment judgment for all patients. Lack of congruence was also found between the diagnosis and treatment phases of care for older patients. Emotional reaction was more often reported for the younger patient. Conclusion: Results suggest a barrier to "whole patient" care for all cancer patients and a need for student and practitioner training to place greater emphasis on the treatment phase of patient care.