Last year, a post titled “A Hangzhouer’s medical experience in the United States” hit the Internet. A man who suffered from cervical spine tumor after 70 years was told in a hospital in China that he could only undergo surgery directly and then went to the U.S. The doctor first confirmed his cervical spine single plasma cell tumor through puncture biopsy and was cured by radiotherapy without surgery, which seems to show the “other side of the coin” on the difficult road of medical treatment. In fact, surgery, radiotherapy and chemotherapy are no longer the “three axes” for the treatment of tumors. With the increasing rise of precision medicine, minimally invasive interventional diagnosis and treatment under the guidance of imaging has eliminated the pain of surgery and radiotherapy for many tumor patients. In the last decade or so, interventional therapy has not only achieved good results in patients with advanced inoperable disease, but also comparable to traditional surgery in terms of local cure rate for some early stage tumor patients. Liu Chen, director of the Imaging Interventional Treatment Center of New Mileage International Medical Department of Beijing Cancer Hospital, is a young expert in tumor interventional treatment, and the puncture needle in his hand can always pierce the center of the tumor precisely and remove or destroy it. Recently, in the International Department of Beijing Cancer Hospital, Liu Chen was interviewed by the health sector. When most people first see Liu Chen, their first impression is “handsome”. Just like the doctor in the movie “Get Out, Tumor King”, it seems that once the gentle and cool Liu Chen appears, the patient’s illness can be half cured. Liu Chen explained in detail to the health sector about interventional therapy, which is a trendy tumor treatment nowadays. Regarding the saying that “puncture is easy to cause tumor metastasis”, Liu Chen clearly said that this is a long-standing misconception. Health sector: Why should puncture biopsy be performed? Liu Chen: The purpose of puncture biopsy is to clarify the diagnosis. Take lung cancer as an example, even for patients with high suspicion of lung cancer on imaging, they need to know the specific type of lung cancer, the degree of differentiation, the sensitivity of targeted drug therapy and other related information through pathological testing after puncture biopsy. Puncture biopsy is to determine “whether it is cancer”, “what kind of cancer” and “whether it is a drug-sensitive cancer”, which is the most critical step for the success or failure of subsequent treatment. Health sector: What kind of technique is CT-guided puncture biopsy? Liuchen: Some lesions are most clearly displayed after CT imaging, which cannot be replaced by ultrasound or MRI. Since CT-guided biopsy requires a long journey through the skin layer by layer to the lesion, the technical requirements are very high. The slender puncture needle cannot be equipped with a camera at the front end, so the doctor cannot see the real tissues and organs during the operation, but can only recombine the tomographic images in the brain with the CT films taken before and during the operation, and adjust the puncture depth and angle in real time and quickly until the target is hit through the position relationship between the puncture needle and the virtual stereoscopic imaging. Health sector: Take lung cancer as an example, what are the difficulties of puncture? Chen Liu: The lung is a constantly moving organ due to breathing, so lung tumors are not as fixed as tumors growing on bones, which can easily cause errors during puncture. If the tumor is located close to the heart and large blood vessels, it will be affected by the heartbeat, which makes the puncture even more complicated, and the doctor needs to grasp the activity pattern of the tumor for accurate puncture. Lung puncture biopsy is like shooting at a target, because the target is not a fixed target but a moving target, so it is very difficult to hit the bull’s eye. Health sector: What is the biggest advantage of interventional therapy? Liu Chen: The most obvious advantage of interventional therapy is that it is minimally invasive. A puncture needle of two to three millimeters in diameter is inserted into the body and can kill the tumor directly in situ. For example, radiofrequency ablation is used to burn the tumor to death, or cryoablation is used to freeze the tumor to death, or even chemotherapy drugs or radiation source particles are directly injected into the tumor through the puncture needle, thus reducing the pain of radiotherapy that patients had to suffer in the past. Some patients who used to need to have a lobe of lung or a piece of liver removed also avoid damage to their normal organs and let this magic needle take care of it all. Health sector: How to avoid “pulling out the carrot and bringing out the mud” when performing puncture interventions? Liu Chen: Not only people think so, but also many colleagues in the field believe that “puncture is easy to cause tumor metastasis”, which is a long-standing misconception. First of all, there are millions of original tumor cells in human blood circulation, but they are removed by the immune system every day in time and cannot really form tumors. The tumor cells brought out through the puncture needle are very few, far from the number in the normal human blood circulation, so the chance of causing metastasis is negligible. Secondly, the concept of puncture biopsy and the instruments used have also been improved in recent years, and the practice of directly puncturing into the tumor and then pulling it out of the body is gradually being eliminated. Currently, the device for puncture biopsy has a protective jacket on the outside, and the device is like a ballpoint pen. After the outside pencil is attached to the tumor surface, a switch is pressed to allow the pencil inside the pencil to puncture into the tumor, and the pencil will be returned to the pencil after the work is finished. Since the pencil inside the body is not in contact with the tumor, the puncture needle avoids the leakage of tumor cells during the extraction process and provides maximum protection to the human body. Therefore, it can be said very responsibly that the current puncture technique does not theoretically lead to the outgrowth of tumor cells.