At the 2003 Spring Festival Gala, there was a bridge in Zhao Benshan’s skit “Heart Disease”: Zhao Benshan said: to give you talk therapy, or chemotherapy for short. Fan Wei was immediately stunned. The public’s fear of chemotherapy is thus evident. Chemotherapy is portrayed in people’s minds as similar to the monsters in the Shanhaijing, and going on chemotherapy is like going on torture. One of the most blackened statements about chemotherapy is that cancer patients die faster with chemotherapy than without it. This statement, as if all oncology departments around the world should be closed down, really let oncologists internal injuries ~ ~ ~ chemotherapy is not so terrible? The answer is: chemotherapy is effective for cancer treatment; chemotherapy is not terrible. So, the question is, what makes chemotherapy effective? Chemotherapy is a health insurance program in most countries. Do you think these governments are so dumb as to invest large sums of money in a treatment that does not work? In fact, there is scientific evidence as to why chemotherapy works, and not only chemotherapy, but whether any medical treatment is effective or not, is evaluated by the same criteria in modern medicine: evidence-based medicine. So, before we talk about chemotherapy, we have to talk about evidence-based medicine first. Evidence-based medicine, in layman’s terms, is about proving whether a therapy is good or bad through comparative studies. Compared to what? Compared to no treatment, or compared to treatments that are already available. How is it compared? Through the evaluation of patient outcomes. How many patients are needed? The more patients, the better. The more patients, the more reliable the results. Of course, evidence-based medicine for this “comparison” (research methods) of a lot of care, for example, the source of patients, preferably different races, different characteristics (multicenter studies); for example, evidence-based medical research (clinical trials) is divided into 1-4 phases, and dozens of classification, for example, it is best to pool many studies to analyze ( meta-analysis); for example, evaluating the goodness of a medical treatment includes numerous indicators, of which survival is the most important one, etc. How important is evidence-based medicine to modern medicine? The worldwide accepted quintile of clinical evidence is: for a clinical evidence, its importance is divided into five levels of decreasing importance: Ⅰ Clinically relevant results from Meta-analysis of large sample double-blind randomized controlled clinical trials or medium sample controlled clinical trials Ⅱ Small sample controlled clinical trials; controlled clinical trials not using blinding, controlled clinical trials using validated surrogate markers Ⅲ Non-randomized controlled Clinical studies, observational (cohort) studies, case-control studies or cross-sectional studies Ⅳ Opinions of expert committees or relevant authorities Ⅴ Expert opinions The implication of this hierarchy is that the most useful evidence is based on a variety of clinical trials (the level of evidence is simply determined by the different approaches to clinical trials). What about expert opinion? The opinion of an expert committee, i.e., the consensus of a group of experts, ranks second to last; the opinion of a single expert ranks last. So, for modern medicine, the good or bad of any method needs to take clinical data to speak for itself. Back to the original question, does chemotherapy make people die faster? To answer this question, we must first ask, who said this? Is it Master Zhang next door? Is it the “old Chinese doctor”? Or some “expert”? In accordance with the guidelines of evidence-based medicine, the words of Master Zhang next door have no reference value at all, and the so-called “experts”, whether in pamphlets, or web pages, or a series of titles, even if the speaker is really an “expert”, in front of the data, but also Even if the person talking is really an “expert,” he or she is not very credible in the face of the data. What are the data on chemotherapy? A large number of clinical studies have proven that chemotherapy can indeed prolong the survival of patients. Therefore, there is no doubt about this. Specifically, what tumors should be treated with chemotherapy, what conditions are not suitable for chemotherapy, how the efficacy of chemotherapy differs for different diseases, and what chemotherapy drugs should be applied for a particular disease are things that specially trained physicians need to master. Because of this, hospitals have special oncology departments. Because of this, please trust the data and trust the oncologists. Because a well-trained oncologist will definitely talk to you about the data. Postscript: For modern medicine, data is the expert, and big data is the most authoritative expert. In fact, in medical-related academic conferences, experts talk about all kinds of data, and the real experts do not dare to say “I think”, they often say “according to the results of such and such trial, I think”. On the other hand, the public’s fear of chemotherapy is often based on individual cases, e.g., Zhang San’s chemotherapy treatment. Compared with the big data, the opinion of individual experts is insignificant, and the persuasive power of individual cases is almost zero.