In the United States, chemotherapy and radiation therapy are not recommended for cancer patients over the age of 60, as these treatments generally only shorten the patient's survival time. If a tumor develops before the age of 70, it is considered pathological. Tumors that develop after the age of 70 are physiological and hold no pathological significance. We should not panic at the mention of cancer but approach it scientifically. Today's methods of dealing with tumors are akin to a police officer chasing a thief—addressing the symptoms rather than the root cause.

Dr. Huang Youpeng, who graduated from the University of Geneva Medical School in Switzerland, has over 30 years of experience in immunology and cancer research. Currently, he is a highly influential returnee expert in the field of immunology in China. Recently, he shared insights with a reporter on the Western medical community's understanding of cancer prevention and treatment, offering a refreshing perspective.

Professor Huang once saw a news report on television where a hospital performed surgical removal of a tumor on an 80-year-old patient. During an exchange with experts at a renowned hospital in Beijing, he observed an 87-year-old veteran receiving chemotherapy. He asked them, "Why is such an elderly patient still undergoing chemotherapy?" They replied, "It is necessary." Professor Huang found this very perplexing. He explained that if a tumor in the cardia prevents a patient from eating and affects their quality of life, surgery might be the only option. If autopsies were performed on everyone who died before the age of 80, tumors would be found in 100% of them. Professor Huang noted that in Europe, doctors emphasize basic research and scientific thinking, advocating for "scientist-like doctors" rather than mediocre practitioners.

Why do people develop tumors?

There is a widespread misconception in cancer treatment globally: focusing solely on the tumor itself and striving to eliminate it. Using chemotherapy and radiation to kill tumor cells often results in the destruction of many healthy cells as well. Meanwhile, little consideration is given to why tumors develop in the first place.

DNA mutations during replication are beneficial for species evolution. Therefore, errors during replication and the resulting gene mutations leading to tumors are inevitable. Species evolution is based on gene mutations, but this comes with a byproduct: the growth of malignant tumors. This is an inevitable cost of human evolution. Eradicating tumors entirely is impossible. The emergence of tumor cells is one of the genetic mechanisms of biological aging. Nature does not allow any organism to live forever. The decline of immune function, the appearance of tumors, and eventual death have positive implications for species evolution. This is why nature allows humans to develop tumors.

The older one gets, the lower the risk. The American Cancer Society stated in 2001 that chemotherapy and radiation therapy are not recommended for malignant tumor patients over 60. This is because the older a person is, the lower the malignancy risk of the tumor. Elderly individuals already have weakened immune systems and cannot withstand the extensive damage to immune cells caused by chemotherapy and radiation, which typically only shortens their survival time. However, in China, patients over 60 are still receiving these treatments, which Professor Huang finds deeply troubling. According to foreign statistics, patients who underwent liver transplants, chemotherapy, or radiation had shorter survival times and lower quality of life compared to those who did not receive treatment. The untreated group lived one-third longer and had a better quality of life.

Professor Huang emphasized that our approach to tumors is too extreme and one-sided, failing to deeply consider why tumors develop. If a person lives to 120, they may have three to four malignant tumors, but these would not affect their quality of life. The older a person is, the lower the malignancy and risk of the tumor.If a person develops a tumor before the age of 70, it is considered pathological. After the age of 70, the tumors that grow are physiological and hold no pathological significance. We should not panic at the mention of cancer but approach it scientifically. It is incorrect to view it with absolute hatred. A tumor is simply a mass of tissue, a group of cells with its own will to survive. We should strive to understand it and prevent its early appearance. Developing a tumor in one's seventies or eighties is a normal physiological phenomenon and should not be a cause for concern. However, we should aim to delay its onset and growth and control it effectively.

Most people die from fear

The occurrence of tumors is a normal process in biological evolution, and everyone has the potential to develop tumors. Tumor cells grow slowly and do not kill a person within days, months, or even years. It is a chronic process. Unlike coronary heart disease, which can cause sudden death, tumors do not. Most tumor patients die from fear, as it causes terror, sorrow, depression, immune system collapse, and endocrine disorders. This fear-induced death occurs because people lack an objective understanding of tumors.

Our oncologists have not communicated this information to the public, resulting in immense fear due to ignorance about tumors. Patients who could have lived several more years end up with reduced survival. When Professor Huang was in Europe, he performed 200 autopsies annually on individuals over 75 years old, who died from diabetes, coronary heart disease, stroke, etc. They showed no symptoms of tumors during their lifetime, but autopsies revealed that 48% had one or two malignant tumors, some quite large.

As people age, the incidence of tumors increases. However, this does not affect their quality of life; metabolic syndromes do, and these are the causes of death. They were unaware of their tumors, so they did not experience mental fear or immense pressure. Foreigners also fear cancer greatly. In reality, the danger of tumors lies in their late detection, making them difficult to cure once found, thus causing immense fear.

Treating symptoms or the root cause

The ultimate victory over tumors lies in prevention. The traditional approach of simply cutting out or irradiating tumors to eliminate cancer is a one-sided understanding. The global fight against cancer has been ongoing for 50 years, consuming vast amounts of money, yet the number of cancer patients has not decreased but increased. Our current approach to dealing with tumors is like police catching thieves; once found, they must be eliminated. This is treating the symptoms. If we could eliminate the "social environment" that leads to "crime," we could largely prevent "crime."

Preventing and monitoring tumor cell mutations is a way to prevent "crime" before it happens. Early detection, followed by enhancing the body's overall immune system using substances like thymosin extracts, amino acids, etc., to increase cellular immunity, can more effectively combat tumors. Selenium, a rare element, can directly cause tumor cells to collapse. Traditional Chinese medicines like Cordyceps and Ganoderma also significantly boost immunity. This is the latest concept in tumor prevention and treatment worldwide. This is treating the root cause.Source: http://www. nanfangdaily. com. cn/ southnews/ z. . . 00607130600. asp

After Dr. Huang publicly announced this conclusion that shocked the Western medical community, there were immediate counterattacks:

----------------------------------------------------------------------------"Most cancer patients die from fear" lacks evidence

A discussion with Dr. Huang Youpeng
By Jiang Bin

After reading the article "Most cancer patients die from fear" published in the Science section of your newspaper on July 13, 2006, I feel that Dr. Huang Youpeng's viewpoint has many areas that are quite inappropriate and lack scientific evidence.

First of all, the title of the article lacks evidence. What exactly does "most" refer to? Through searching both Chinese and foreign literature (including the Chinese Wanfang Database and the American PubMed medical database), we have not found any papers discussing the idea that most cancer patients die from fear. In our decade-long clinical oncology practice, we have also not encountered any patients who died directly from fear of cancer. I wonder if Dr. Huang is simply making assumptions or if he is referencing some authoritative medical literature? In fact, physicians with clinical oncology experience know that while it is true that most patients are nervous and scared during the initial discovery of a tumor, they generally adjust their mindset, face reality, and actively cooperate with treatment. The causes of death from cancer are usually late-stage complications or systemic failure.

In the introduction, the statement "In the United States, chemotherapy and radiotherapy are not recommended for cancer patients over 60, as these treatments generally shorten the patient's survival period" is incorrect. We acknowledge that some individuals are not suitable for chemotherapy, even younger ones. However, the decision to undergo chemotherapy is not based on age. Through searching the latest literature, we found that in the United States, age is not a contraindication for chemotherapy in cancer patients. On the contrary, many older patients can benefit from chemotherapy.

"Chemotherapy" is a systemic treatment for cancer patients using cytotoxic drugs and is currently one of the main treatment methods alongside surgery and radiotherapy. However, surgery and radiotherapy are local treatments, whereas chemotherapy is a "systemic treatment." Oncologists have reached a consensus: malignant tumors are "systemic diseases," not local lesions, so chemotherapy is often essential.

Chemotherapy for malignant tumors can be categorized into "adjuvant chemotherapy," "neoadjuvant chemotherapy," "palliative chemotherapy," and "curative chemotherapy." "Adjuvant chemotherapy," as the name suggests, is chemotherapy performed after radical surgery or radiotherapy, aiming to eliminate residual tumor cells or micrometastases to the greatest extent possible, thereby reducing the chances of postoperative recurrence and metastasis or prolonging the time before recurrence or metastasis. Of course, it is still impossible to completely and thoroughly eradicate tumor cells through chemotherapy alone. Chemotherapy can kill most residual tumor cells, and the remaining few can be eliminated by the body's immune system or immunotherapy. It is unscientific to overemphasize the use of immune regulation to cure tumors at different stages; immunotherapy is only meaningful when the tumor burden is small. "Comprehensive treatment," including surgery, chemotherapy, radiotherapy, immunotherapy, and supportive care, is currently the globally recognized best treatment model for cancer.

However, a significant number of patients are diagnosed with advanced-stage cancer, often losing the opportunity for "curative surgery" and sometimes only able to undergo "palliative surgery." For these patients, the most important method is chemotherapy, known as "palliative chemotherapy."Palliative chemotherapy does not imply a "passive and negative" approach; rather, it carries a proactive connotation: extending life, alleviating suffering, and improving quality of life. Some patients who are sensitive to chemotherapy can benefit from it long-term or even achieve a cure.

For chemotherapy-sensitive tumors such as malignant lymphoma, small cell lung cancer, and seminoma, "curative chemotherapy" should be decisively implemented upon diagnosis. After the tumor has completely disappeared, an additional 2-3 cycles of chemotherapy should be administered, followed by radiation therapy or surgical resection as needed.

In summary, cancer treatment is highly complex. The most authoritative treatment guidelines currently are the latest NCCN guidelines from the United States, which provide standardized treatment protocols for every type of cancer. Age is merely a reference factor. For instance, in the guidelines for non-small cell lung cancer treatment, it is stated that "elderly patients with a good PS score should be given appropriate chemotherapy."

In 2003, a large-scale clinical meta-analysis presented at the American Society of Clinical Oncology (ASCO) annual meeting revealed that for patients with advanced non-small cell lung cancer and good physical condition, chemotherapy outperforms best supportive care in terms of survival (refer to asco.org). This demonstrates that chemotherapy can extend the survival of patients with advanced lung cancer.

With the continuous emergence of new chemotherapy drugs, the cure and remission rates for cancer are steadily improving. However, chemotherapy is a double-edged sword; while it kills cancer cells, it also damages normal tissue cells. Only through proper use can its therapeutic effects be maximized and its toxic side effects minimized. This underscores the importance of standardized treatment—neither overusing chemotherapy nor arbitrarily abandoning it.

Deciding whether a patient should undergo chemotherapy involves many objective factors: the origin of the tumor, pathological type, clinical stage, immunohistochemical markers, the patient's Karnofsky or PS score (performance status, with Karnofsky scores generally requiring at least 70 and PS scores no more than 2), liver and kidney function, bone marrow status, and chemotherapy benefit assessment. The formulation of a "chemotherapy regimen" is both a science and an art, involving decisions on which drugs, combinations, sequences, dosages, methods, and courses to use. While we must respect the results of international clinical trials, treatment must not be one-size-fits-all. Instead, it should be personalized, as recommended by the NCCN guidelines. For example, elderly or frail patients may be considered for low-dose, single-agent chemotherapy. Throughout chemotherapy, efficacy and side effects must be comprehensively monitored, and treatment plans adjusted promptly based on overall assessments. Additionally, a competent oncologist must continuously update their professional knowledge, as the field evolves rapidly, to provide patients with the most scientifically advanced treatment options.

As for the claim that "tumors before the age of 70 are pathological, while those after 70 are physiological and lack pathological significance," this is utterly absurd and conflates physiological and pathological concepts, amounting to mere wordplay. The distinction between tumors and normal tissue is made through microscopic examination of tissue samples, sometimes supplemented by immunohistochemistry, and is never based on age. However, it is correct to say that tumors in the elderly may have different biological characteristics compared to those in younger individuals.

With the rapid advancements in chemotherapy and supportive care, chemotherapy has significantly improved cancer cure rates in the United States. In recent years, the incidence and mortality rates of malignant tumors in developed countries like the U.S. and Canada have been steadily declining. From 1993 to 2002, the overall cancer mortality rate in the U.S. decreased by an average of 1.1% annually, with male cancer mortality dropping by 1.5% per year and female mortality by 0.8%.In recent years, the overall cure rate for cancer in the United States has exceeded 50%, with some sensitive cancers achieving cure rates of 80% or even over 90%. Although China's cancer treatment level lags behind that of the United States, it has also made rapid progress in recent years, achieving many encouraging results. This year, under the leadership of Academician Sun Yan, China has also formulated the NCCN Clinical Practice Guidelines for Breast Cancer and Non-Small Cell Lung Cancer (Chinese version), further standardizing the comprehensive treatment of cancer in China.

The general public should not be terrified by cancer; instead, they should prevent cancer scientifically, actively engage in prevention, and persist in regular health check-ups to prevent and strive for early detection. Cancer patients should not seek medical treatment indiscriminately, believe in unlicensed doctors or folk remedies, or easily trust commercial advertisements and promotions. Additionally, since the domestic medical market is not yet very standardized, and some hospitals also have non-standard treatment practices, those with good English skills can consult the www.nccn.org website to understand the latest international treatment standards, or go to a regular hospital's oncology department for comprehensive evaluation and treatment, in order to obtain the greatest benefits.

(The author is currently the Director of the Oncology Department at the Third People's Hospital affiliated with Shanghai Jiao Tong University School of Medicine.)

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Dr. Huang immediately responded to the above article:

Huang Youpeng: The consequences of chemotherapy and radiotherapy in elderly patients are well known.

On July 13, after the publication of the article "Most Cancer Patients Are Scared to Death" in this edition, it sparked strong reactions among domestic readers. Some professionals in the domestic oncology field strongly questioned some of the views in the article. Therefore, the reporter recently interviewed Dr. Huang Youpeng, who responded from an immunological perspective.

Dr. Huang said that his earliest understanding of the dangers of chemotherapy and radiotherapy came from an animal experiment at the Ludwig Institute for Cancer Research in Lausanne, Switzerland, in 1980. At that time, the medical community did not understand the toxic side effects of chemotherapy and radiotherapy in oncology as deeply as it does today. Treatment was still "disease-oriented," unlike today's focus on "patient-oriented."

"In the winter of 1999, I returned to China for the first time and was invited to participate in the 'Scientists' Salon' held at the Capital Institute of Pediatrics. The meeting required each expert and scholar to present their latest views, and then everyone discussed them together, creating a very lively atmosphere. I talked about the 'physiological' and 'pathological' issues of cancer, stating that 'the main factor for cancer around the age of 70 is physiological.' Some experts present expressed dissent, including Professor Lü Yongyou from the Peking University Cancer Institute, who had returned from the United States. Two years later, Professor Lü Yongyou said in a lecture at Peking University that 'the main factor for cancer over the age of 60 is physiological.' He was even more 'left' than I was."

Dr. Huang pointed out that 60 years ago, why were there few people who got cancer and few who died from it? This is because people had shorter lifespans, and they died from other diseases before they could get cancer. Before 1949, due to wars, famine, natural disasters, and other causes of death, the average life expectancy in China was around 40-50 years. In the 1950s, the average life expectancy was around 60 years, and now it is around 72 years. Therefore, the incidence of cancer is increasing. This is related to age. Cancer is referred to by Western experts as an "aging disease," with 50%-70% of general cancer patients being elderly over 60 years old. The incidence rate in the elderly is 20 to 40 times that of young patients. The National Institutes of Health (NIH) statistics show 60%, and the Centers for Disease Control and Prevention (CDC) statistics show 58%.The proportion in China will not be lower than this statistical figure and may be even higher.

As people age, their immune function declines. If illustrated with a curve: the thymus becomes smaller, the secretion of thymic hormones decreases, the function of T cells diminishes, and the incidence of tumors increases. The formation of tumors is the result of genetic mutations, but only a very small number of mutated cells (tumor cells) can survive. As age increases, the proportion of genetic mutations rises, and the survival rate of tumor cells also increases. Aging further reduces the body's immune function to combat tumor cells, making it increasingly difficult to suppress them, allowing them to survive. This principle is universally recognized worldwide; how can it not be related to age!

Dr. Huang stated that tumors are actually a disease closely related to human aging. If we could live to 120 years old, we would all die from cancer, which is the ultimate change in human aging. This is known by experts in immunology and oncology research both domestically and internationally. Some foreign experts believe that the higher the pathological proportion of tumors, the lower the physiological proportion. Roughly speaking, for a 70-year-old with a tumor, 50% is physiological and 50% is pathological; for an 80-year-old, 70% is physiological and 30% is pathological; for a 90-year-old, 90% is physiological and 10% is pathological; and for those over 100 years old, 100% is physiological.

Professor Huang does not exclude the possibility that some elderly patients with stronger immune functions may benefit from chemotherapy drugs with fewer side effects and high target specificity. However, this is not feasible for most patients. In the elderly population aged 60 or 65 and above, healthy individuals account for only about 30% of the total. Professor Huang pointed out: "If, as some doctors suggest, the decision to undergo chemotherapy is based on a physical examination of elderly patients, is this feasible in China? I have visited some hospitals in China, and currently, comprehensive immune testing is not even performed. Moreover, how many hospitals and doctors conduct immune tests before administering chemotherapy or radiotherapy to patients? At most, they check the patient's white blood cell count. Elderly patients with poor immune function and declining organ functions may experience reduced bone marrow function and a decline in the immune system after chemotherapy or radiotherapy. As a result, patients often die from severe secondary infections caused by side effects. This is not a direct result of the tumor but a consequence of the side effects of chemotherapy and radiotherapy. This is a basic principle well-known to oncologists internationally. If a patient undergoes painful treatment for several years only to extend their life by one year, what is the therapeutic value? Currently, some doctors in China are even administering chemotherapy to patients in their 70s and 80s, which is indeed incomprehensible."

"To determine whether an elderly patient should undergo chemotherapy, there must be sufficient evidence. If there is evidence that the patient is in good physical condition with strong bone marrow and immune functions, and it is found that the side effects of the drugs do not severely damage their bone marrow and immune system, then the patient can undergo chemotherapy. If the patient's immune function declines rapidly after the first chemotherapy session, they are not suitable for chemotherapy. Chemotherapy may destroy their last line of defense—the immune system," said Huang Youpeng.