With the progress of society, economic development, people’s living standards and medical services gradually improved, China is gradually entering the aging society, with which the elderly has become the largest population suffering from malignant tumors. At present, malignant tumors have become the main cause of death for people aged 60-79 years. In the United States, more than 50% of the tumors and 70% of the tumor-related deaths occur in the elderly over 65 years old, and it is estimated that by 2030, about 70% of the patients with tumors will be elderly people over 65 years old. Jing Liang, Department of Oncology and Chemotherapy, Shandong Qianfoshan Hospital As a medical worker specializing in oncology, what reasonable adjustments should be made to the direction of work in the face of the increasing number of elderly patients with tumors? When an elderly patient is diagnosed with a malignant tumor and his family is ready to give up the treatment because of the patient’s age or concomitant chronic diseases, what rationalized suggestions with scientific basis can we provide? Currently, there is a lack of medical personnel with expertise in both oncology and geriatrics in China, and the development of geriatric oncology is in its infancy. In Europe and the United States, after more than a decade of development and based on a large number of multi-center clinical studies, an independent theoretical system on geriatric oncology treatment has been formed, and the National Cancer Research Network (NCCN) of the United States has been publishing and updating clinical treatment guidelines on geriatric oncology for many years in a row. Many of the above research progresses strongly support oncologists to provide scientific, systematic and reasonable medical advice to elderly tumor patients. I. Age is not a determining factor for whether geriatric oncology patients receive treatment Geriatric patients can be divided into three categories: (1) 65-75 years old are young geriatric patients; (2) 76-85 years old are geriatric patients; (3) 85 years old and above are elderly geriatric patients. the NCCN Clinical Guidelines for Geriatric Oncology point out that a greater age should not be a reason for refusing effective antitumor treatments to improve the quality of life and prolong the survival period effectively. Evidence-based medicine confirms that older adults in good physical condition tolerate chemotherapy comparably to younger patients, especially when accompanied by aggressive supportive care. The patient’s physical status, comorbidities and preferences are the main influencing factors in the choice and tolerability of treatment. Although ECOG and KPS scores have been developed to assess the functional status of elderly patients with tumors, scientific and systematic assessment of the functional status of elderly patients is particularly important in evaluating their prognosis and safety of treatment, given that most elderly patients have age-related comorbidities, which affect their tolerance of antitumor therapy. The Comprehensive Geriatric Functional Assessment System (CGA) established by Prof. Balducci and Prof. Extermann has been widely recognized by the international oncology community, which mainly includes: (1) survival prognosis; (2) assessment of functional status (ADL score of ability to live, IADL of ability to use devices in daily life, and VES-13 of the Vulnerable Elderly Survey, etc.); and (3) comorbidities assessment (Adult Comorbidities Evaluation ACE-27, Charlson Comorbidity Index CCI, Cumulative Illness Rating Scale CIRS, etc.); (4) assessment of compounded medications (Beers Criteria, Medication Adequacy Index MAI, Geriatric Prescribing Screening Tool STOPP, and Screening Tool to Remind Physicians of Correct Treatment START Criteria, etc.); (5) assessment of nutritional status (MNA); and (6) assessment of cognitive functioning (MMSE and MoCA Assessment Scale, Geriatric Depression Scale (GDS), etc.); (7) Evaluation of geriatric syndromes: the presence or absence of geriatric syndromes in each elderly patient will directly affect his/her choice of treatment and prognosis. Geriatric syndromes mainly include dementia, delirium, depression, adverse stress, debility, fatigue, falls and osteoporosis, etc. There are several assessment scales for each of the above symptoms. How to choose reasonable anti-tumor treatment for elderly tumor patients Professor Balducci, the leader of geriatric oncology at Moffitt Cancer Center of National Cancer Institute (NCI), is the founder of International Society of Geriatric Oncology and one of the creators of comprehensive functional evaluation system for the elderly, and Professor Martine Extermann is the current president of International Society of Geriatric Oncology. is the current President of the International Society of Geriatric Oncology and Chairman of the NCCN Division of Geriatric Oncology. The two professors have led more than 100 multi-center clinical studies in Europe and the United States during more than a decade, and have developed a system for assessing the physical functional status of the elderly such as the SAOP2 Screening Questionnaire, the IADL for evaluating the ability to use devices on a daily basis, the CIRS-G for grading cumulative diseases in the elderly, the Mini-Mental State Examination (MMSE), the Mini Nutritional Assessment (MNA), and the Comorbid Record Rating Scale (CRRS). Meanwhile, more than 70 clinical studies on geriatric risk assessment for 50 commonly used chemotherapy regimens have been carried out, and CRASH, the Chemotherapy Risk Analysis System for High-Risk Elderly Patients, has been created to provide individualized multifactorial chemotherapy risk assessment for each elderly tumor patient. These assessment systems based on evidence-based medical research provide strong theoretical and clinical practice support for scientific, systematic and rational assessment of the prognosis of elderly tumor patients and selection of treatment options. Through the assessment, compared with a 70-year-old patient suffering from multiple chronic diseases, a senior citizen over 85 years old with good physical function may have better tolerance to treatment and can benefit more from anti-tumor therapy. Fourth, the related work we can carry out for the elderly tumor The prevention and treatment of tumor includes seven aspects: screening of high-risk groups, behavioral intervention and health education, diagnosis, prognosis assessment, treatment, disease recurrence and survival support. Currently, lung cancer is still the number one most prevalent tumor in elderly patients in China, but with the changes in living habits and dietary structure, in the next 20-30 years, China may see the same trend of tumor prevalence as in Europe and the United States, i.e., high prevalence of tumors such as prostate, breast, and colon cancers in the elderly population. Based on the fact that these types of tumors have a long survival period in elderly patients, all seven aspects of the whole process of tumor prevention and treatment are the focus of our work. Through my study at Moffitt Cancer Center as a visiting scholar in geriatric oncology in 2012-2013, and the strong support of Balducci and Extermann professors, we are now able to provide chemotherapy and biologics for the elderly. At present, the Department of Chemotherapy and Biotherapy of Oncology of our hospital can carry out the SAOP2 screening questionnaire, the evaluation criteria of ability to use devices in daily life IADL, the evaluation of cumulative illness grading in the elderly CIRS-G, the mini mental status examination MMSE, the micro nutritional status assessment MNA, the comorbidity record score, etc. on the physical functioning status of the elderly and the risk of chemotherapy for elderly patients at high risk CRASH analysis. We provide scientific, systematic and reasonable medical guidance and intervention for the screening and behavioral intervention of high-risk elderly people, and the physical condition, prognosis and treatment selection of elderly tumor patients. Meanwhile, based on our department’s advanced level in tumor biotherapy, we actively carry out immune function monitoring and immune prevention interventions for elderly tumor patients and high-risk groups, and combine tumor biotherapy with surgery, chemotherapy, targeted therapy, radiotherapy, minimally invasive therapy and other treatments, so as to provide effective, safe and comprehensive anti-tumor treatments for elderly tumor patients.