In summary, Piezo1 is not merely a “pro-oncogenic” or “tumor-suppressive” factor, but rather a “biomechanical–metabolic switching threshold.” Upon activation, the magnitude and duration of Ca2+ signals, together with ECM stiffness, oxygen metabolism, and other contextual variables, jointly determine whether downstream signaling promotes proliferation/invasion or apoptosis/ferroptosis. The gene discussed is PIEZO1; the disease is neoplasm.