For some incurable advanced cancers, should we treat them at all costs, or focus on the care, comfort and concern for patients? From the bottom of his heart, the author presents his clinical insights for many years to the readers, hoping to draw wide attention from the society, but hopefully let the advanced cancer patients get more care from the whole society. Cao Jianxin, Department of Gastroenterology, The First People’s Hospital of Changzhou City, I am afraid that how to treat malignant tumor treatment (especially old age malignant tumor) wisely is not only a problem for doctors and patients, but more importantly, the whole society should update its concept and think seriously in all aspects. For advanced cancer patients, many developed countries have given up the life-preserving treatment mainly to prolong survival time, and have given up the simple debulking treatment for advanced cancer patients and those who have relapsed after conventional treatment, and replaced it with palliative treatment mainly to improve the quality of survival. The reason is that patients with advanced cancer are already physically weak, and surgical resection, radiotherapy, chemotherapy and other measures are bound to bring trauma, and while killing cancer cells, they also cause serious damage to normal cells or tissues, which aggravates their symptoms and pain, and even accelerates their death. Some patients, who were generally in good condition, deteriorate and become extremely weak after several courses of treatment, and a cold or a seemingly minor infection may cause their death. At this point, we have to reflect on how positive the effect of these treatments really is. The appearance of negative effects, on the contrary, prompts us to have a more correct understanding of medicine. Human beings cannot live without medicine, but we should not expect too much from it. Medicine is not omnipotent, medical knowledge of the human body is still very limited, we can not blindly believe in the “omnipotence” of medicine. Despite the rapid development of medical science and technology, many highly sophisticated diagnostic and treatment measures for clinical use, I am afraid that in a relatively long period of time, there are still many diseases that can not be cured. People can not live forever, and medicine can not make people live forever. Old age, sickness and death are objective laws and the inevitable process of life, and no one is exempt from them! The ancient and modern immortality techniques, in the end, are all empty baskets! Medicine cannot cure all diseases and cannot cure every patient. The discovery of diseases such as AIDS and SARS seems to have warned mankind that some new, incurable diseases will continue to appear. In today’s world of infinitely high medical needs, it is indeed necessary to think rationally beyond emotions and treat life with kindness in order to minimize ineffective medical investments and avoid unnecessary and wasteful dispositions. In our country, due to the influence of traditional culture, many parties still cling to the stereotype of simply prolonging survival time. In order to save the life of the elderly, the children and grandchildren borrow from all over the world, and even pour out all their money. They use “whatever it takes” to deal with old age malignant tumors or some terminal diseases, and use all kinds of expensive drugs and high-end means to prolong their short and poor quality lives. At this time, the patient is “in pain” and believes that “life is worse than death”. In a very short period of time, a large amount of resources are consumed, resulting in high costs for end-stage treatment, with the result that both families and society bear a great burden. Especially for families who are not rich, a terminal illness can bring down a family, or even several generations or families of friends and relatives to the brink of financial and affectionate overdraft. I am afraid that this is not the subjective desire of the patient, and even more so, I do not want to be dragged into a situation that future generations cannot afford because of their treatment consumption. Many of the cases are alarming. Behind the patient’s eagerness to save his life and pay expensive medical expenses, it is worth thinking about: whether it is tens of thousands of dollars or hundreds of thousands of dollars for the common people, the working class, or millions of dollars for the wealthy families, should the money be spent? Which treatments are most valuable to the patient’s quality of life? Among the expensive medical costs there is also the issue of consumption of medical resources …… Therefore, in today’s infinitely high demand for medical care, whether we can face sensibly, minimize the ineffective investment in medical care, avoid unnecessary wasteful disposal, really need to transcend feelings, treat life rationally. A hundred years ago, Venerable Hong Yi (Li Shutong) once proposed the idea of “seeking life for minor illnesses and death for major ones”. A “minor illness” is a curable disease; a “major illness” is a terminal illness, or a disease that causes a very low quality of life. He believed that it was better to die early after suffering from a “major disease” than to live in pain. The famous biochemist Zou Chenglu had lymphoma, which was compressing his trachea, and when his doctor discussed with him whether to cut his trachea to prolong his life, he refused: “Don’t torture me anymore.” Famous medical scientist Wu Yingkai, in his will two years before his death, said: “Old age, sickness and death, the laws of nature, I am 91 years old, life will soon come to an end, afterlife must be simple …… if found to be incurable, no need to actively treat, as far as possible to reduce pain, let me go naturally ……” People’s military doctor Hua Yi comfort has done thousands of surgeries on patients in his life, and finally he himself had many surgeries due to advanced stomach cancer, with many tubes inserted into his body, he became a patient, suffering from pain and suffering, experiencing “life is worse than death He experienced the feeling of “life is worse than death”. He asked his partner to tell the hospital leadership, “Stop using expensive drugs and expensive tests.” For terminal diseases, the purpose of treatment is not to “dispose of them at all costs”, but to alleviate their suffering; not to use high-end means to prolong the patient’s survival for a very limited period of time at any cost, but to carry out treatment according to the actual situation. The issue of “euthanasia” is not addressed here, as it has several dimensions that need to be seriously debated, and many different views do deserve attention. What we emphasize here is that the most important thing is the standardized and appropriate treatment for malignant tumors in the elderly. The so-called standardized and moderate treatment is based on the best clinical evidence from the current medical technology and economic situation, and fully respects the wishes and choices of patients or their families based on full communication with them. The appropriate disposition is given to the patient, which of course includes comprehensive treatment, such as supportive therapy, psychological-behavioral interventions, humanistic care, etc. It should not be less than, nor should it be excessive. There are numerous cases worldwide where moderate treatment has been effective, it is just a matter of how it is implemented. At first glance, moderate treatment is a matter between doctors and patients, but in fact, it requires the recognition and participation of the whole society. This is because it involves the scientific concept of life, old age, sickness and death and the issue of social acceptability. Therefore, for terminal diseases, the purpose of treatment is not to “dispose of them at all costs”, but to alleviate their suffering; not to use high-end means to prolong the patient’s survival for a very limited period of time at any cost, but to carry out treatment according to the actual situation. Let them spend their last days in this world with relative ease and leave this world peacefully. At this time, the attention should not only be focused on the size of the tumor, but also on the quality of life of the cancer patient, such as spiritual, psychological, social and other multi-level support and conditioning. Many advanced tumor patients are extremely thin and debilitated, but the main symptom is still pain. In 2000, WHO proposed to make “cancer patients pain-free” and measured a country’s level of pain relief in cancer treatment by the consumption of morphine. Therefore, the focus should be shifted to “care, comfort and concern” for terminal illnesses that are difficult to cure. As the medical motto from the shores of Lake Saranac, which has spread around the world, “Sometimes, to heal; often, to help; always, to comfort.”