First, it needs to be clear that surgery is the primary treatment modality for hard fibroids. For patients with a first diagnosis of hard fibroids, surgery is preferred in such cases if a complete, radical, and extensive resection can be performed, and if the surgery will not cause too much damage to the body (e.g., impairment of limb function, etc.). Because sclerofibromas are not life-threatening, they do not require radical resection at the expense of limb function, unlike general malignancies. Radiotherapy can be considered when the tumor is unresectable or when resection will lead to severe functional impairment. In addition, when the tumor is removed, if there are still residual lesions around it, radiotherapy is also needed at this time. However, it is worth noting that radiotherapy has some restrictions on the age of patients. It is generally believed that radiotherapy is not ideal for patients with hard fibroids under 30 years of age, and the efficacy is relatively good for patients over 30 years of age. The main reason why radiotherapy is not recommended for young patients or pediatric patients is that radiotherapy may cause late complications for such patients, mainly the following three kinds: 1. limb contracture: radiotherapy will lead to muscle atrophy and joint deformation, which in turn will cause limb dysfunction. 2. Growth and development disorders: Children with hard fibroids who are in the growth and development period may have abnormal development as a result of choosing radiotherapy. For example, if a hard fibroid grows on a child’s leg and receives radiotherapy after surgery, the leg is likely to stop growing afterwards, and over time, the two legs will be unequal in length; 3. Induced malignancy: hard fibroid is a benign tumor, but if the tumor cells are stimulated after radiotherapy, the patient may grow a malignant tumor, such as fibrosarcoma, 10 years later. Therefore, for young patients with hard fibroids, radiotherapy should be chosen with great caution. So, what should be done for patients who can neither have surgery nor radiotherapy? Drug therapy can be considered at this time. There are three most common types of drug therapy: chemotherapy, anti-estrogen therapy, and targeted therapy. The literature reports that chemotherapy is the most effective, followed by targeted therapy, and anti-estrogen therapy is the least effective. If patients are not sensitive to the drugs, or if they become resistant to the drugs, and some patients do not want to receive drug therapy, conservative treatment is available at this time. However, conservative treatment of hard fibroids is not doing acupuncture, physical therapy, massage, etc. On the contrary, these measures will stimulate the tumor to some extent and even cause tumor malignancy. Therefore, it is recommended that patients with hard fibroids should never try them. So, what is the conservative treatment for hard fibroids? It is actually “wait and see” how the tumor grows. Because hard fibroids are benign tumors that are not fatal, if the tumor is growing slowly or at a standstill, there is no need to worry too much. However, if the tumor is still growing rapidly, the patient needs to understand the pros and cons of treatment and discuss treatment options with the doctor. Generally speaking, hard fibroids located in the abdominal cavity and pelvis grow in a manner more similar to malignant tumors and need to be treated promptly. For hard fibroids located in the trunk of the extremities, tumors that are found to be not growing rapidly through observation can continue to be observed for their growth rate and size if the patient is not willing to undergo treatment.