1.Over-treatment of tumors 1.Over-surgery As the first choice of treatment for most malignant tumors, surgery emphasizes complete and radical treatment. The so-called radical surgery means that not only the tumor should be completely removed, but also the appropriate normal tissues around the tumor should be included. Considering that malignant tumors often do not have clear boundaries and are prone to metastasis of adjacent lymph nodes, many doctors believe that the scope of surgery should be as large as possible, and sometimes even go to the extent of removing some important organs, which results in more trauma, more complications, and even life-threatening. For example, for young patients with cervical carcinoma in situ, many units blindly expand the scope of surgery and perform extensive hysterectomy plus pelvic lymph node dissection, which will not only cause serious complications such as damage to blood vessels, nerves and ureter and swelling of lower limbs, but also seriously affect the quality of life (QOL) of patients. Hundahl et al. reported that among 5,583 cases of thyroid cancer, well differentiated papillary thyroid cancer and follicular adenocarcinoma stage I and II accounted for more than 70% of cases, but 50%-60% of patients underwent total thyroidectomy. . Less than 30% of these cases have multicentric lesions and all of the patient’s thyroid gland is removed, causing serious sequelae. 2, excessive radiotherapy Radiotherapy has good therapeutic effect on many malignant tumors, such as cervical cancer and nasopharyngeal cancer. While killing tumor, radiotherapy also has damage to normal tissues around tumor, especially the distant chronic damage which is not valued by people, which is more harmful to human body. Some medical units only have a single radiotherapy equipment, and there is no equipment and means to effectively monitor the quality control and quality assurance of radiotherapy, coupled with the fact that clinicians do not consider the patient’s previous radiotherapy and radiotherapy response for the sake of cure, and give a larger dose of radiotherapy, which often results in tumor control, but the patient has serious radiation damage, such as radiation pneumonia and pulmonary fibrosis, resulting in serious decline of respiratory function. After radiotherapy to the pelvis of cervical cancer patients, it causes vaginal stenosis, radioactive enteritis and even vesicovaginal fistula and rectovaginal fistula, which will bring great damage to the quality of life of patients, and the physical and mental pain caused by these complications far exceeds the tumor itself. 3. Excessive chemotherapy Chemotherapy is one of the most common means of malignant tumor treatment. Chemical drugs kill and inhibit the growth and reproduction of tumor cells by affecting the synthesis and replication of cellular DNA. However, up to now, most of the anti-cancer drugs lack selectivity, and while killing cancer cells, they also cause damage and destruction to normal cells, which can cause a series of toxic side effects. The “Guidelines for the Treatment of Unresectable Non-Small Cell Lung Cancer” published by the American Society of Clinical Oncology (ASCO) in 2003 clearly states that for patients with stage III non-small cell lung cancer treated with radiotherapy, the number of cycles of chemotherapy should be between two and four; for stage IV patients, chemotherapy should be stopped at four cycles, and even if chemotherapy is effective, it should not exceed six cycles. Earl, an oncologist at Harvard Medical School, noted at the 2006 ASCO Annual Meeting that more and more patients with advanced cancer are still receiving chemotherapy or other extremely damaging treatments before they die. Earle and colleagues surveyed the final treatment status of 215,488 cancer patients who died between 1991 and 2000 and found that nearly 10 percent of patients with advanced cancer were receiving chemotherapy two weeks before they died in 1993, a figure that increased to nearly 12 percent by 1999. The survey also showed that the percentage of patients receiving chemotherapy in ICU (Intensive Care Unit) one month before the end of life increased from 7.8% to 11%. Second, to eliminate overtreatment, pay attention to palliative care 1, to eliminate overtreatment The goals of medicine (the goals of medicine, referred to as GOM) study was proposed as early as the 1980s, the WHO-supported international study group of fourteen countries warned: “the current development of medicine is creating unaffordable and unjust medicine around the world “; “many countries are now on the verge of availability”. The principles of clinical care for patients with tumors that have no hope of cure should be to weigh the pros and cons of each treatment against the ethical principle of “doing good and minimizing harm”; doctors should assist patients in “managing their money” and make them Doctors should assist patients in “managing their finances” by asking them to “watch their wallets” and choose the tests and treatments with the “highest efficiency ratio”. The meaning is to respect life, reflect humanistic care, let the medical insurance system play the maximum public welfare, reasonably allocate and utilize medical resources, and reflect the principle of social equity. At present, the over-treatment of tumors has become a public hazard. The reasons for this phenomenon are very complicated. Among them, the asymmetry of information knowledge is one of the main reasons, and there is a tendency to conceal the real situation from patients in clinical work more or less intentionally or unintentionally. The motives are sometimes well-intentioned and sometimes not necessarily so. To take a comprehensive view of the statistical results, to overcome the “cult of statistics”. In the 20th century, the “war of position” against malignant tumor was very costly, and the more difficult it was, the more doctors and patients were fighting and retreating, repeatedly frustrated, and gradually showed the declining trend. This has made us realize that the current radical treatment has no definite efficacy in prolonging the life of tumor patients, and the goal of treatment should be to relieve pain and improve the quality of life, not only to prolong life. When the choice is between “living longer” and “living better”, the latter is preferred. Now, it is time for palliative support care to come to the forefront and become the main character. Palliative care should not only be implemented in the late stage of tumor, but also in the early stage of the disease, combined with surgery, radiotherapy and chemotherapy, so that patients can have a good psychological state, nutritional knowledge and general knowledge of treatment, as well as relieve pain and other symptoms that cause suffering. Patients with advanced disease should be taken care of wholeheartedly so that they can live actively as much as possible when they are in remission, which not only relieves the burden of family and society, but also gives patients moral and spiritual and psychological satisfaction; when the disease progresses to the end stage, a care system should be given to family members to provide technical support for proper care of patients; after the death of patients, we should assist relatives and friends to properly handle the afterlife, so that they can smoothly pass the period of residence and mourning. The overall aim is to affirm life and see death as a normal process, to improve the quality of patients’ survival, and to have a positive impact on the disease process as much as possible. 3. Give play to the characteristics of Chinese medicine treatment Chinese medicine is a great treasure trove. Chinese medicine also has its unique features in tumor treatment. Although certain Chinese medicines are not very ideal for shrinking tumor masses, they can achieve good efficacy when applied in combination with modern treatment methods. Chinese medicine can play a positive role in the whole process of tumor treatment, for example, many medicinal and food plants in Chinese medicine have the effect of supporting the righteousness and improving immunity, which can help to prevent the occurrence of tumor and recurrence after surgery when taken by high-risk people for a long time. For patients who cannot tolerate radiotherapy and chemotherapy, Chinese medicine has certain curative effects on some complications such as jaundice, ascites, pain, etc. It is especially unique in improving patients’ survival quality and prolonging survival period. However, people used to think that the role of TCM in tumor treatment is only a supplementary measure when Western medicine is not available. It is because of this lack of understanding that the investment in Chinese medicine is not enough and the research is not deep enough, so that the characteristics and advantages of Chinese medicine in the field of tumor prevention and treatment cannot be fully and effectively played. 4.Let advanced tumor patients “die well”. Patients and their families should be provided with appropriate “death education”. We have long emphasized one-sidedly that “cancer is not equal to death”, so the publicity and education on “how to face death” is missing. Is cancer not equal to death? If we are all “living to die”, why do cancer patients avoid the topic of death? This literary slogan is well-intentioned and can sometimes have a positive effect, but the effect may not always be good. While we encourage patients with the concept of “cancer is not equal to death”, we should also prevent patients from creating an unrealistic expectation, turning into fear and complaint when the end of death is approaching due to the lack of preparation for it, and even misjudging the “well-intentioned lies” of health care workers as “malicious lies”. They may even misjudge the “well-intentioned lies” of the medical staff as “malicious deceptions” and leave the world with a sense of resentment and disappointment. We should let patients know that no matter how advanced medicine is, there are still many diseases and pains without proper treatment; but no matter how difficult it is, no matter what happens, doctors and nurses will be by his side, lend him a helping hand, alleviate his pain, and become his most trusted person who accompanies him on his final journey through life. Death is a great equality. All equality is relative and discounted, but death is not. What we are pursuing is “eugenic death”, so that the patient can live happily and comfortably, and die without pain and with dignity. “Life to death” is just a graceful turn of life in two different forms, and we should try our best to assist patients to make this turn more graceful.