What is the concept of holistic treatment of tumor

In 1971, President Nixon announced a “cancer war” with the goal of eradicating cancer within 10 years. 30 years have passed, but the incidence of malignant tumors is increasing year by year worldwide, and the overall efficacy of conventional treatment on tumors has not improved significantly. According to the latest statistics, there are 2 million new malignant tumor patients in China every year, and more than 1.5 million deaths due to tumors every year; in some regions of China, tumors have become the number one cause of death. According to WHO prediction, malignant tumor will become the number one killer of human in the 21st century. In recent decades, with the development of science and technology, a large number of high-tech diagnostic equipments have been applied to the diagnosis of tumors, and a large number of early tumors have been discovered, meanwhile, several times or even tens of times more social resources than before have been used for the treatment of tumors. However, the overall efficacy of malignant tumor treatment is still unsatisfactory, what is the crux of the problem? Some oncologists who are open-minded and take the lead in abandoning the prejudice of the industry began to reflect on the traditional concept of tumor treatment and suggested that “holistic treatment” should replace “simple tumor treatment” in tumor treatment. What is “holistic treatment” of tumor? It should start from our existing tumor treatment philosophy. Traditional tumor treatment physicians believe that malignant tumor is a poisonous tumor that has been formed in human body and is growing and spreading, once the tumor cells are formed, it is irreversible, and the tumor and the host are in an antagonistic relationship. “The greater the extent of resection, the better the curative effect; all postoperative recurrence is attributed to the insufficient extent of resection; when the tumor is too invasive to be surgically removed, other treatments are considered, which are called “conservative treatment” or “palliative treatment These methods are called “conservative treatment” or “palliative treatment”; while the assessment of efficacy is almost exclusively based on tumor size; and the hallmark of cure is tumor-free survival. Obviously, these traditional concepts of tumor treatment are not all correct, and the application of incorrect treatment concepts in clinical practice will definitely affect the final outcome. Imagine that there are two patients with identical tumors: there are already micro-metastases around the primary lesion. Patient A was determined to have surgery, but the tumor was cut down, but after three months, the tumor spread throughout the body and metastasized, which soon became life-threatening; while patient B’s physician thought that surgery was more difficult and the possibility of residual tumor after surgery was high, so the patient was treated with less invasive local ablation, which resulted in the tumor remaining in the body and growing, but at a very slow pace. After several years, patient B is still alive and the quality of life is not bad. This kind of case is by no means uncommon in clinical practice, why is radical surgery not curative? Why is palliative care not a cure but a long-term survival of the tumor patient? Holistic anti-cancer concept Holistic anti-cancer concept believes that the ratio between host (organism) and tumor is the key to determine the prognosis of tumor patients. In the local treatment of tumor, it is equally important to reduce trauma and maintain the body’s resistance to disease as to remove and inactivate tumor cells, especially in tumor cases with the possibility of dissemination (the biological boundary of tumor is not easily determined). The greater the extent of surgery, the more tumor is removed, but not necessarily the better the outcome. Surgery is still the first and primary treatment for solid tumors and was once considered the only “possible cure” for tumors. However, surgery is not suitable for all tumor patients. Generally speaking, for early stage and limited tumors, surgical resection can achieve satisfactory results, and some of them can even achieve the purpose of radical treatment; while for middle and late stage or metastatic tumors, surgery not only cannot cure the tumor, but also the trauma of surgery will stimulate the residual tumor cells to accelerate the growth and metastasis. Modern science has confirmed that tumor is not just a local lesion, but a systemic disease produced by the body under the effect of long-term carcinogenic factors, and also a genetic disease: even in early stage tumor patients, there may be scattered tumor cells in the blood, only that these cells have not yet become tumor and have not settled in other places. At this time, even a thorough surgical operation cannot eliminate all the tumor cells in the body, but at best it is a tumor reduction operation, and the tumor cells remaining after the operation are eventually recognized and killed by the immune system of the body. Unfortunately, almost all conventional tumor treatments (e.g. surgery, chemotherapy, radiotherapy) have been carried out at the expense of the normal tissue function or organ integrity of the body, and while some of the tumor cells are eliminated, the anti-tumor immune function of the body is invariably also damaged. Therefore, from the viewpoint of overall treatment, the final efficacy of tumor treatment should not simply depend on the number of tumor cells killed, but should be the comprehensive result of killing the tumor and preserving the host’s anti-tumor function, and simply expanding the scope of surgery to emphasize complete eradication may not necessarily lead to a better comprehensive result. Surgical oncology has undergone development from standard radical surgery to extended radical surgery in the past 100 years, and the current trend is the transition from minimally invasive surgery to local treatment that preserves organs and their functions. Since the overall treatment efficacy of tumor is not satisfactory, and various treatment methods have their own limitations, comprehensive treatment has become a reasonable treatment mode for tumor today. With the rapid development of engineering technology, especially computer science and material science in recent years, various high-tech tumor treatment methods have emerged, such as multi-bullet radiofrequency ablation, microwave ablation, argon helium cryotherapy, photodynamic cytotoxic therapy, cancer gene therapy, intra-tumor implantation of radioactive particles and high-energy focused ultrasound knife (HIFU), all of which have the following characteristics: high technological content, not purely relying on the manual skills of clinicians. They do not rely solely on the clinician’s manual skills, but demand more from the treating physicians in terms of comprehensive tumor treatment and understanding and grasping of the latest advances in tumor treatment. These technologies have a short history of development, some of them are only a few years old, and most oncologists do not know much about them, and some of them take a wait-and-see attitude. Although these treatments are not yet included in the mainstream of oncology treatment, they have irreplaceable advantages in at least one or several aspects compared with traditional treatments. Therefore, a large number of new tumor treatment methods together with the existing conventional treatment methods constitute the family of comprehensive tumor treatment, and each type of treatment methods can complement each other to form the overall tumor treatment advantage. Tumor treatment should emphasize individualized treatment. Since the development of tumor disease is very different and the patients’ individualization is also very different, the clinical treatment should have the attitude of specific analysis for the same kind of disease, even for the same patient, in different stages of the disease, it is not possible to “respond to all changes” with the unchanging pattern. For example, for an early stage tumor, surgery is undoubtedly the first choice and other treatments are adjuvant, but for a patient with recurrent tumor or multiple metastases after surgery, surgery is useless. Therefore, we should not classify all kinds of tumor treatments into “preferred treatment” and “adjuvant treatment” in a general way. The clinicians should see the essence of each type of technology, including their advantages and limitations, and apply them rationally to avoid single-armed combat, so as to achieve the best therapeutic effect. The highest level of tumor treatment is, of course, cure, and the previous understanding of cure is “tumor-free survival”, so obviously surgical resection is the way to go. However, as we all know, the scalpel is a double-edged sword, and the number of patients who are cured by surgery is definitely a minority. More patients are inoperable or have recurrence or metastasis after surgery, and these patients have lost the chance of cure in the traditional sense. However, if the development of tumor can be significantly stopped or slowed down by various minimally invasive new treatments, so that the tumor and the body can coexist peacefully for a long time, this can not be considered as “cure”, but it is indeed the control of the tumor. What is the difference between “long-term control” and “cure” of tumor? This is the latest understanding of tumor treatment strategy: it is not realistic to solve tumor at once, but to turn tumor into a chronic disease like hypertension or diabetes, and to closely monitor and effectively control it is a more realistic and practical treatment plan. The unique Chinese medicine treatment in China has accumulated a large number of successful cases in this regard, and High Intensity Focused Ultrasound (HIFU), which is nearly non-invasive, conformal ablation and can be repeatedly applied, as the latest local tumor treatment technology, has also brought new hope to a large number of patients with mid- to late-stage tumors.