As a medical oncologist, I have been working in the clinic for 5 years and found that tumor patients and their families often ask some common questions. I always want to summarize and organize these questions. Today, I would like to share with you the three most common questions. (1) Hair loss When it comes to chemotherapy, the image that comes to your mind may be “bald head”. TV dramas are so broadcast, as if only the bald head to prove that he played chemotherapy. For a long time in the eyes of the public chemotherapy is equivalent to hair loss. But in fact, there are many different drugs that can be used for chemotherapy, and the adverse effects of each drug are different. Only a small number of drugs are likely to cause hair loss, such as irinotecan (commonly used in gastrointestinal tumors, gynecological tumors), paclitaxel (commonly used in gastrointestinal tumors, gynecological tumors, lung cancer) and some drugs used for lymphoma leukemia. Conversely, there are many drugs that do not cause hair loss or are insignificant in terms of hair loss. For example, oxaliplatin, fluorouracil drugs, etc. So many bowel cancer patients will not lose their hair during adjuvant chemotherapy. Even if they do lose their hair, we see many patients’ hair will grow back after chemotherapy, and even some of the original gray hair will grow back to black hair after hair loss. And now there are many wigs that can be so fake that you can’t tell at first glance. My advice as a doctor is to consult with your physician before chemotherapy about whether your regimen will result in hair loss, and if so, shave your hair when it starts, because it can affect your mood to wake up every day and look at the large clumps of hair on your pillowcase. In conclusion, not all patients who receive chemotherapy will lose their hair, even if the hair loss is reversible, new hair will grow and there is no need to worry. (B) Domestic and imported drugs This question will be asked by the doctor before starting chemotherapy in each regimen. The doctor will help you decide the treatment plan, but not help you decide which variety to use. Often patients will ask the physician in return: Which is better? What’s the difference? In the eyes of many patients, the difference between domestic and imported drugs is like the difference between an A-list LV bag and a real LV bag. But this is not the case, although the price difference between many domestic and imported drugs is indeed as big as the difference between A-goods and genuine LV bags, but the active ingredients of domestic and imported drugs are actually the same, while the material ingredients of A-goods and genuine products are very different. Which is better and which is worse, this is a difficult question to answer. Most of the domestic drugs are generic drugs, because our country is still relatively backward in terms of drug originality, but our generic technology is more mature, the reason why many imported drugs are very expensive is because of the preliminary original, clinical trials and promotion process requires a lot of money, once the imported drugs are on the market, after the patent period, domestic drugs can be copied, and domestic drugs can eliminate the preliminary clinical trials, indications The process of exploring, so its cost will be much cheaper. Patients often say whether imported drugs are more effective and have less side effects. To really answer this question, a head-to-head clinical study needs to be done, with one group of patients using a domestic drug and another group using an imported drug, and a prospective double-blind study to compare the effects and side effects of the drugs. But no manufacturer would fund such a study. All we can say is that based on our clinical observations, more than half of the patients in clinical practice will use domestic drugs, and we have observed that the efficacy and side effects of these patients are comparable to those of imported drugs. Chemotherapy for tumor is a chronic disease, he does not want to operate once, many times chemotherapy is played repeatedly, besides the cost of chemotherapy drugs, there are also many support treatments and follow-up observation need to be paid, in a word, if money is not a problem, of course you can choose imported drugs, after all, these drugs have more data, but if you need to sell your house for chemotherapy, the effect of domestic drugs is also very good. (iii) Tumor markers Tumor markers are indicators that we internists love and hate. We love them because they provide some information for us to judge the efficacy and prognosis of patients, and we hate them equally because of their sensitivity, and many patients are shocked when they see the elevated data of tumor indicators. First of all, let’s get to know what tumor markers are. Tumor markers are a class of biochemical substances produced by tumor tissue itself, which can reflect the existence and growth of tumor. They are mainly embryonic antigens, glycoantigens, natural autoantigens, cytokeratins, tumor-related enzymes, hormones and certain oncogenes, etc. (extracted from Baidu Encyclopedia). However, the specificity of tumor markers is not high, except for PSA (prostate antigen) and AFP (alpha-fetoprotein) which are relatively specific, many tumor markers can be found in different tumors and even some inflammatory diseases. Therefore, elevated tumor markers do not necessarily mean tumor progression. For example, the normal range of CEA is 0-5ng/ml, but when it changes from 2 to 3 or 4, some patients will be very worried. In fact, there is no need to worry about it. In addition, some patients with tumor cell necrosis after chemotherapy may release tumor markers into the blood, causing transient elevation of tumor indexes, so tumor indexes should be viewed dynamically. The existing medical treatment guidelines clearly suggest that the tumor index cannot be used as a criterion to judge the tumor progression, but mainly depends on CT. The results showed that the survival of these two groups of patients was the same, but obviously the quality of life was higher in the group that started treatment later.