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The Emperor of All Maladies. A Biography of Cancer - Siddharta Mukherjee
If you’re a physician, a nurse, a patient, or whoever you are... you should read the history of cancer and of this war against the “emperor of all maladies”
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Reading Mukherjee’s Emperor of All Maladies, and a passage about Dr. Farber’s work with antifolates.
Farber used a synthetic antifolate (aminopterin) to starve cancer cells of the folate they need to divide. It was the first real proof that chemicals could induce remission in children with leukemia. Even though the cancer often came back, it opened the door for modern chemotherapy.
What struck me, though, is the parallel to the natural world. There are plants that produce compounds with a remarkably similar effect—they can disrupt cell production, acting as nature's own defense mechanism.
Here are some plants that exhibit this "antifolate" behavior:
· Tea Plant (Camellia sinensis): Produces a compound called EGCG (epigallocatechin gallate) . Research confirms EGCG is a natural inhibitor of DHFR, the exact enzyme targeted by aminopterin . This may contribute to tea's anticancer effects.
· Caralluma (Caralluma sinaica): This folk medicine plant shows strong inhibitory activity against the DHFR enzyme, suggesting its traditional use may involve a mechanism similar to modern antifolate drugs.
· Common Sowthistle (Sonchus oleraceus): Extracts from this plant have also been identified as being "strongly inhibitory to DHFR" in scientific studies .
It makes you realize that the "discovery" of these treatments is often a re-discovery. We’re just catching up to what plants have been doing all along. It really makes me want to learn more about the ethnobotany of cancer treatments. How many "aminopterins" are we walking past ? We need so much more research into the effectiveness of these plants.
Reading about Sidney Farber in The Emperor of All Maladies and thinking about how much the trajectory of cancer treatment was shaped by what doctors could simply see. They went after leukemia first because it was in the blood—a sample on a slide could tell you immediately if a drug was working. It makes you wonder how many breakthroughs are waiting on the technology to just get a good look at the problem.
