In a conversation with an outpatient today, the question was asked about when to start other treatments. I was using the analogy of a bow and arrow, and it would be inappropriate to start again at the end of a strong crossbow. At night, I thought that this analogy is not very good, it is now the 21st century, and the bow and arrow are too far away for us to understand, so I would like to use a three-stage rocket to illustrate it. This patient is a colon cancer liver metastasis, after palliative colon cancer resection, liver interventional embolization chemotherapy once, intravenous chemotherapy seven times, after the liver metastasis lesion increased, adjust the program and chemotherapy three times, a total of 11 times chemotherapy. At present, his mental status and all biochemical indicators are normal, only two indicators, CA199, are higher than normal. The post-section CT showed that the liver mass had doubled in size compared to the CT volume after embolization chemotherapy and invaded the renal envelope, indicating that the recent chemotherapy had lost its effect. Microwave or radiofrequency treatment of the liver metastases followed by radiotherapy is recommended to achieve better results. Both treatments, which are less time-consuming and indeed effective, should be more cost-effective among the current treatments. When to start? Can I survive with tumor? For the question of timing of initiation, let’s look at the separation of the three stages of the launch vehicle and the timing of ignition. The role of the three-stage rocket as well as the timing are very clear, which is the same as the utility of surgery, chemotherapy, radiotherapy, ablation, etc. No one stage of rocket can complete all the lift-off tasks, and no one treatment can complete all the treatment work of tumor (except for early stage tumor and individual special types). Therefore all stages of rockets should be left at regular intervals to facilitate ignition of the next stage, and any lag would be an accident of godsend. The time of ignition, that is, the time when our next treatment modality is initiated, should be when the power of the previous rocket fades, not when the speed of the current rocket stage decreases (this is for therapeutic activities, not preventive initiatives). Therefore, when we find that one treatment modality is ineffective, we should promptly change to an effective treatment modality, rather than sitting back and waiting for the failure situation to expand and for the opportunity to intervene to be lost. As for the issue of survival with tumor, it needs to be understood dialectically. The biological characteristics of tumors vary, and even if the same tumor is in different anatomical sites, its harm is very different. Therefore, survival with tumor generally lies in slow-growing tumors or growth in non-vital organs or tissues. Metastatic lesions in the liver, on the other hand, are an irreconcilable tumor growth. For this kind of tumor that metastasizes to extremely important organs, to quote Putin, “There is no negotiation in territorial disputes, only war! .”. And in this kind of war, the only way is to seize the time, the opportunity to fight is fleeting!