Malignant tumors are currently the number one killer affecting human health. In the last hundred years, a series of basic and clinical studies on malignant tumors have achieved better efficacy and even cure in certain treatment-sensitive tumors such as Hodgkin’s lymphoma and leukemia. However, most malignant tumors are rarely curable, and patients often die from recurrence and metastasis of the tumor. Therefore, some scholars believe that the strategy should be changed to not only eliminate tumors but also “live in peace” with them. For example, Gatenby compares the treatment model of tumor with the evolutionary ecology of governing harmful microorganisms and believes that tumor eradication actually accelerates the emergence of cancer resistance and recurrence, so tumor control may be more important than tumor eradication. Professor Tang Zhaoyou, a liver cancer expert in China, also proposed the “Chinese model of cancer treatment” of “elimination and transformation at the same time”, emphasizing that while maximizing the elimination of tumors (surgery, radiotherapy, chemotherapy, local treatment), emphasis is placed on the modulation of a small number of residual tumors and the transformation of the tumor host (e.g., biological therapy). In addition to the maximum elimination of tumors (surgery, radiotherapy, chemotherapy and local treatment), we emphasize on the modification of a small number of residual tumors and the transformation of the tumor host organism (such as biological therapy and Chinese herbal medicine), so as to make the tumor cells change their evil and reduce the invasion and metastasis potential, and make the tumor host organism unsuitable for tumor growth. This change in thinking may become a direction for exploring tumor treatment pathways: 1. Among them, the main body of comprehensive treatment is still surgery, radiotherapy, chemotherapy, local treatment, targeted therapy and other therapies with the main purpose of “eliminating tumor”, while biological therapy and traditional Chinese medicine appear mostly as adjuvant treatment, especially the role of traditional Chinese medicine in tumor treatment is to reduce toxicity and increase effectiveness. However, the role of TCM in this regard is getting more and more attention from the researchers as seen in clinical practice. The purpose of tumor treatment is, in a way, to remove the tumor cells to the greatest extent possible and to prolong the survival of the patient as long as possible. From the history of surgical treatment of tumors, certain limited tumors can be completely cured by surgical resection alone, however, a considerable number of patients still have distant recurrence and metastasis even after undergoing “radical surgery” or even “super radical surgery”, which makes people realize that Early stage tumor is a systemic disease. At present, most of the tumors are treated with comprehensive treatment to remove the tumor cells as much as possible, however, a considerable number of patients still die because of the recurrence and metastasis of tumors, which makes us realize that trying to completely eliminate tumor cells is not the fundamental way. From the perspective of ecology, the proliferation, invasion and spread of malignant tumor cells are highly similar to the process of plant predation by pests, and the latter has also undergone the management measures from “extermination” to “coexistence” and achieved better results. Similarly, since tumor tissues contain a large number of tumor cells, their differentiation degree and phenotype are not identical, when radiotherapy or chemotherapy kills sensitive tumor cells, on the one hand, some cells in the center of tumor tissues are not harmed due to lack of oxygen or blood supply, on the other hand, some tumor cells that are not sensitive to treatment further proliferate, or enhance drug resistance through DNA repair. On the other hand, some of the tumor cells that are not sensitive to treatment may proliferate further or enhance drug resistance through DNA repair, and so on, and after different treatments, “super tumor cells” similar to “super bacteria” are often developed, which are highly malignant and unresponsive to treatment, thus accelerating the death of patients and reducing survival time. Currently, studies have shown that drug resistance can occur in chemotherapy, radiotherapy, targeted therapy, etc., and disappears when treatment is stopped. In addition, sensitive tumor cells and drug-resistant tumor cells also have a competitive relationship with each other, and sensitive tumor cells can inhibit the proliferation of drug-resistant tumor cells to a certain extent. The elimination of tumor cells can cure the tumor to a certain extent, but in some patients it shows to shorten their survival time, rather than surviving with tumor. Therefore, for the treatment of malignant tumors, it is not only necessary to eliminate the tumors, but also for some selected patients, it is necessary to modify the tumor cells and the environment of the body, so that long-term survival with tumors becomes possible. Traditional Chinese medicine has always emphasized the concept of balance, which is reflected in tumor treatment as balancing the state of human body and tumor, starting from transforming tumor and transforming the microenvironment of tumor, so as to restore a state of balance between human body and tumor, under which tumor cells do not proliferate or proliferate slowly and survive with tumor, thus prolonging the survival time of patients and improving the quality of life. 2.Modification of tumor cells: inducing differentiation The difference between tumor cells and normal cells mainly lies in the differentiation disorder, i.e., the activation of the original oncogene by some internal and external factors, which causes the interruption of the normal differentiation process of cells, thus returning to the original embryonic cell phenotype, i.e., dedifferentiation, whose malignant phenotype is the result of multiple factors interacting to cause dedifferentiation and overproliferation. In 1960, Pierce was the first to discover that mouse testicular teratoma cells could spontaneously differentiate into benign normal cells, initiating the idea of inducing differentiation. 1978, Sachs discovered that the abnormal differentiation of mouse leukemia cell lines could be reversed by the action of substances that inhibited proliferation and induced differentiation, thus introducing the concept of differentiation therapy. The concept of differentiation therapy was developed. Differentiation therapy refers to the application of various chemical drugs to induce differentiation of tumor cells and reverse their malignant phenotypes such as proliferation, infiltration, and metastasis to normal or near-normal cells, i.e., redifferentiation or tumor reversal, so as to achieve the purpose of treatment [3]. HL260 and U937 cell lines with differentiation-inducing effects. In China, Professor Wang Zhenyi applied all-trans retinoic acid (ATRA) to treat acute promyelocytic leukemia (APL) and achieved a 72% complete remission, making the clinical application of differentiation-inducing agents for leukemia a possibility. Another arsenic trioxide (As2O3), which was developed from the ancient Chinese “arsenic”, was made into “Cancer Ling No. 1” for the treatment of leukemia, and then Zhang Peng et al. used a single As2O3 injection to treat acute promyelocytic leukemia with high These two drugs have become the main inducers of leukemia. These two drugs have become the main differentiation-inducing agents at present. (2) cytokines, such as granulocyte colony-stimulating factor, macrophage colony-stimulating factor, interferon, transforming growth factor, etc.; (3) polar compounds, such as dimethyl sulfoxide, methyl formamide, dimethyl formamide, etc.; (4) chemotherapeutic agents, such as (5) Chinese herbal extracts, such as saponin Rh2, garlic oil, tansy ketone, soy glycosides, etc.; (6) others, such as sodium butyrate, phenylacetic acid, vitamin D3, etc. In addition to its application to leukemia, the study of solid tumors has also yielded some effects in inducing differentiation. For example, melanoma, hepatocellular carcinoma, lung cancer, prostate cancer, breast cancer, gastric cancer, and nasty lymphoma, etc. A large number of basic experiments and clinical observations have demonstrated the effect of differentiation-inducing agents. The understanding of the cause of disease in TCM is mainly the imbalance between good and evil. Evil can be generated from within or from outside, yet both are transformed by both positive energy. Under normal circumstances, the essence, blood, fluid, and so on, which make up the human body and perform physiological functions, are the positive qi. Under the action of various factors, due to abnormal metabolism or in an inappropriate position, they produce qi reversal, qi stagnation, blood stasis, phlegm, water and dampness, etc., and become the evil qi. As stated in the Secret Principles of the Medical Scriptures, “We must know that evil qi is the right qi in our body, and if we cure it, it is right qi, but if we do not cure it, it is evil qi.” The six foreign “evil spirits”, “spirits, too much, too much is called spirits”, the normal six spirits “to but too much”, or “not to but The normal six qi “arrive but are too much”, or “arrive but are not”, so that its nature from positive to evil. Malignant tumor cells are the typical manifestation of this transformation of positive and evil, where normal cells become tumor cells with malignant proliferation ability under the influence of various internal and external factors. According to the theory that good and evil can transform into each other, positive qi can be transformed into evil qi, and to some extent, evil qi should also be transformed into positive qi. In clinical treatment, there are two major rules for supporting the positive and eliminating the evil, among which the method of eliminating the evil, although it is said that the evil goes away and the positive is restored, in fact, it should still be classified as setting things right, correcting the deviation and restoring the positive. If the Qi is out of order and manifests as upward rebellion, it should be lowered to restore the righteousness. If blood stagnation is manifested as stasis of blood, the method of invigorating blood and removing stasis should be used to make the blood flow to restore righteousness. If water-dampness and phlegm-drink accumulate, warm up the fluid and resolve the phlegm to restore correctness. At present, there are a lot of researches on the role of Chinese medicine in tumor differentiation induction. The research of Chinese medicine on tumor cell differentiation induction regulates the dysregulation of proliferation and differentiation control at the cellular and genetic levels, so that the tumor cells develop into mature cells and lose their malignant phenotypic characteristics, which is also a kind of “corrective” treatment at the cellular level. The efficacy criteria are the appearance of differentiation index, the disappearance of malignant characteristics of tumor, and the prolongation of survival rather than or not only the change of lump size. This opens up a new way of thinking for the treatment method of Chinese medicine “supporting and cultivating the root”. Therefore, for the treatment of tumor, the application of transformation of tumor cells to make them return to their righteousness has become a pathway worth exploring for the treatment of tumor. In 1889, Paget, the father of modern pathology, put forward the famous “seed and soil theory” about tumor growth. This hypothesis compares tumor cells to “seeds” and the environment for tumor growth to “soil”, and suggests that tumor cells can be seeded to other tissues through blood and lymph and can change the nature of the surrounding cells, and that some specific organs can provide a suitable environment for the growth of specific metastases during the metastatic process [7]. Recent studies have found that the primary tumor may already be preparing the “soil” to create an environment for survival prior to metastasis. There is a dynamic balance between normal cells and their surrounding tissue environment, which together regulate cellular activity and determine cell proliferation, differentiation, apoptosis, and the secretion and expression of cell surface-associated factors. The process of tumor malignancy is a vicious cycle that constantly breaks this balance. As tumor cells continue to proliferate, they need to constantly establish an external tissue environment suitable for their growth. This is the basis for the continuous malignancy and metastasis of tumors. This constantly shaped tissue environment is called tumor microenvironment. The tumor microenvironment mainly contains cells (such as fibroblasts, glial cells, epithelial cells, adipocytes, inflammatory cells, immune cells and vascular endothelial cells, etc.), interstitial cells and extracellular factors (such as EGF, VEGF, FGF, HGF, chemokines, etc.). The characteristics are mainly hypoxia, acidity, interstitial hypertension, inflammation, immunosuppression, etc. The understanding of tumor in Chinese medicine is that it is local (tumor) is real and the whole body (human body) is deficient, but it is a mixture of real and deficient, not a single disease. The normal internal environment of the body is not suitable for the growth of tumor cells, but when various factors cause changes in the internal environment of the body, and after the continuous development of tumor cells, the microenvironment around the tumor cells can be changed. The microenvironment around tumor cells can be transformed into a suitable environment for tumor growth. The tumor-related immunosuppression, acidity, hypoxia, inflammation and neovascularization in the microenvironment together constitute the pathological state of “deficiency, toxicity, phlegm and stasis”, while the main manifestation is the deficiency of positive energy, mainly immunosuppression. When the tumor-related microenvironment is formed, it indicates that the balance of the body’s internal environment is broken, and this internal environment evolves in the direction suitable for tumor development, forming a vicious circle. Therefore, the treatment methods used in Chinese medicine to treat tumors, such as supporting the righteousness, detoxifying, resolving phlegm, invigorating blood circulation and resolving blood stasis, can actually change the state of tumor microenvironment to a certain extent and redirect to the normal body internal environment, which is not suitable for the growth of tumor cells and achieve the purpose of treating tumors. After surgery, radiotherapy and chemotherapy, most of the tumor cells have been killed, the tumor and human body have achieved a “balance of yin and yang”, which changes from time to time, and whether the tumor recurs or metastasizes depends on whether this balance will be broken again. The application of TCM can adjust this balance at any time to keep it within a certain homeostatic range, thus preventing tumor recurrence and metastasis. Chinese medicine has achieved certain effects in supportive treatment, adjuvant treatment and prevention of recurrence and metastasis of tumors. Changing the traditional treatment idea of eliminating tumor cells, combining elimination and transformation, from the perspective of transforming tumor cells and regulating tumor microenvironment, will make certain contributions to the prevention and treatment of tumors.