Since the overall efficiency of current chemotherapy drugs is relatively poor, usually around 30%, and it takes initial chemotherapy to have this effect. If the chemotherapy is repeatedly changed, the efficiency is hardly more than 10%. The toxic side effects of chemotherapy are unabated, and the cost of chemotherapy to the patient may even exceed the benefits of chemotherapy. Therefore, before chemotherapy, a careful choice should be made to reasonably assess the benefits and risks. The following are a few comments: 1, the choice of chemotherapy regimen, dose considerations, both to respect the guidance of evidence-based medicine, but also to consider the individual circumstances of the patient. As long as the condition is not complicated, for example, just after surgery, or just discovered the tumor, or the tumor just recurred after surgery, the chemotherapy regimen is relatively clear at this time, and the dosing is very consistent in all hospitals across the country, so just do it according to the cancer guidelines. However, this precisely also has risks, because patients have different constitution, different symptoms, different tumor sizes, different locations, different growth rates, and different urgency of patients for treatment …… The answers to these different situations are not listed in the book. And what we tend to see is that patients are sent to the same chemotherapy assembly line and their results are obviously mostly unsatisfactory. Therefore, we suggest that chemotherapy should follow both general guidelines and individualized dosing for each patient, in an effort to benefit more people and victimize fewer. 2. Do not be too aggressive in chemotherapy for post-operative patients. For small tumors with isolated metastases, be cautious with chemotherapy. Generally speaking, the earlier the disease is, the smaller the benefit of postoperative chemotherapy, and the more advanced the disease is, the relatively greater the benefit of chemotherapy. As an example, for early stage non-small cell lung cancer, the survival time after surgery is 10 years, and if chemotherapy is given, the survival time is 10 years plus 1 month. For intermediate to advanced lung cancer, the survival time is 3 years after surgery and 3 years plus 4 months after chemotherapy. Obviously, for early stage patients, the benefit of chemotherapy is minimal. In addition, the tumor is removed after surgery and is out of sight and out of mind, making it difficult to evaluate the near-term efficacy if chemotherapy is administered. Given the poor results of most chemotherapy, we do not recommend doing too much strong chemotherapy after cancer surgery, and chemotherapy should not be done simply for the sake of completing it. In addition, if there are isolated metastases after surgery, either in the liver, in the lung, or in the adrenal gland, etc., chemotherapy should not be too aggressive as long as there are no obvious symptoms and as long as the tumor is very small within 1~2 cm. Why? Because such a small tumor will hardly cause any disadvantage to the patient in the short term. If chemotherapy is rushed, even if the tumor will shrink by half to 0.5~1cm, this slight benefit is worthless to the patient. On the contrary, the toxic side effects of chemotherapy make the patient reduce the quality of survival in advance, and the tumor may rebound and grow faster after shrinking for a short period of time, which ultimately outweighs the loss. What is the most reasonable way to do without chemotherapy? It is better to be able to remove it by surgery again, or radiotherapy, or use methods of treatment with less side effects while observing, such as biological therapy or Chinese herbal medicine, and review it regularly. If the tumor develops slowly, chemotherapy continues to be not recommended. If the growth is fast, it is not too late to consider chemotherapy again. 3. For chemotherapy of progressive or advanced cancer, it is important to take it as it is. If the tumor is not removed, it can be reviewed with CT or MRI to evaluate the efficacy. Should chemotherapy be done more often in this case? Neither! Because what we see in the clinic is: after two chemotherapy sessions, the patient’s CT scan indicates that the tumor shrinks, so both the doctor and the patient are very happy, but after two more chemotherapy sessions, the CT scan indicates that the situation is not optimistic, the tumor no longer shrinks, and even increases. So the doctor changed the chemotherapy regimen, and the patient clenched his teeth again, and after two more chemotherapy sessions, the repeat CT indicated that the tumor continued to grow, and even metastasis of other organs appeared. Why would this happen? Because the chemotherapy drug itself cannot completely kill the cancer cells, no matter how strong the drug is. Once the cancer cells are resistant to a certain chemotherapy drug, they will be resistant to many other chemotherapy drugs, which is called multidrug resistance in medical science. More importantly, as chemotherapy is carried out, the patient’s physical condition decreases quickly, and the lowered immunity in turn promotes the spread of cancer cells. In addition, repeated chemotherapy can lead to a decrease in white blood cell platelets, and the repeated use of leukocyte-raising injections may potentially promote the recurrence of cancer in this plucky way. Therefore, we recommend that if chemotherapy is effective, to stop as soon as possible, do not try to wait until after the tumor is completely eliminated, and do not wait until the body is defeated, when it is too late to stop chemotherapy. Some people may ask, in case chemotherapy is still effective, wouldn’t it be a pity to stop it early? It is not a pity at all. Even if it is still effective, it will not bring much benefit in terms of survival time, and the tumor will grow back soon. To be clear, for most cancers, chemotherapy cannot control them at all, and even if they may be in remission for just a few months, they will continue to develop and even spread widely afterwards. And chemotherapy is a short-term therapy, which cannot be applied continuously. 4. We do not just do not recommend chemotherapy, but under what circumstances do we advocate active chemotherapy? There are several types of cancers that are sensitive to chemotherapy themselves, which is a good opportunity for chemotherapy, such as small cell lung cancer and lymphoma, and we will try to chemotherapy as much as possible. If the patient is very symptomatic, we will try chemotherapy as much as possible in order to relieve the disease and relieve the pain as soon as possible. If the tumor is growing fast, we will also try to treat it as much as possible because fast-growing tumors tend to be sensitive to chemotherapy and slow-growing tumors tend to be resistant to chemotherapy. It is important to point out that there is a prerequisite for chemotherapy, the patient should be in good health, so that the benefits do not outweigh the risks. Also, we try not to use leukocyte-raising injections in chemotherapy, unless it is used to save the critically ill. 5, to achieve the benefit of chemotherapy outweighs the risk, Chinese herbal medicine with treatment is essential. Why? Chinese medicine increases the effectiveness of chemotherapy and reduces toxicity! When chemotherapy is inconvenient to continue, TCM takes the main role to fight cancer and save the disease, repair the patient’s constitution and achieve survival with tumor. In fact, we have been doing the same thing and with better results. Without the cooperation of TCM, it would be purely Western chemotherapy, and it would be difficult to avoid the shortcomings and complement the strengths.