From The Trenches To The Oncology Units & The Chemical Warfare Origins Of Chemotherapy

In the mud-soaked trenches of the First World War, soldiers were blinded, burned, and suffocated by clouds of yellow gas. This was sulfur mustard, the infamous mustard gas. It scarred lungs, blistered skin, and, most significantly, wiped out bone marrow and immune cells. Military doctors soon noticed that those who survived exposure were left with dangerously low white blood cell counts [1].

Decades later, this terrible observation was turned into “medicine.”

From Gas Attack to “Therapy”

In the 1940s, during the Second World War, American pharmacologists Louis Goodman and Alfred Gilman began studying nitrogen mustards, close relatives of mustard gas, under military contract. They reasoned that if these compounds could destroy lymphoid tissue in soldiers, perhaps they could also shrink cancers of the lymphatic system [2].

In 1942, they secretly treated a man with non-Hodgkin lymphoma using intravenous nitrogen mustard. The tumours temporarily regressed, not cured, but reduced. This experiment marked the beginning of what is now called chemotherapy [3].

The Mechanism of Destruction

Chemotherapy drugs derived from mustard gas share one central trait is that they attack rapidly dividing cells indiscriminately. Cancer cells divide quickly, but so do:

Hair follicles (causing baldness)

Gut lining cells (causing nausea and diarrhoea)

Bone marrow stem cells (causing immunosuppression, anaemia, and infections)

Thus, the “therapy” was always a calculated poisoning, kill the cancer faster than the host [4].

The Lingering Question

Can something born from chemical warfare ever truly heal? While chemotherapy remains a standard treatment in oncology, its roots are not in healing but in war. Its widespread use speaks less of medical progress and more of the desperation to find any weapon against a complex disease.

Today, the very same compound once banned on the battlefield under the Geneva Protocol of 1925 is still deployed in hospital oncology units, dressed not as a weapon, but as medicine [5].

References

1. Papirmeister, B. et al. Medical Defense Against Mustard Gas: Toxic Mechanisms and Pharmacological Implications. CRC Press, 1991.
2. Goodman, L.S., Gilman, A. The pharmacological basis of therapeutics. 1941 (military contract research on nitrogen mustard).
3. DeVita, V.T., Chu, E. A history of cancer chemotherapy. Cancer Research, 2008;68(21):8643-53.
4. Chabner, B.A., Roberts, T.G. Timeline: Chemotherapy and the war on cancer. Nature Reviews Cancer, 2005;5:65-72.
5. Geneva Protocol. Protocol for the Prohibition of the Use in War of Asphyxiating, Poisonous or Other Gases. Signed 1925, Geneva.

Article posted with permission from Kate Shemirani

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