The Emperor of All Maladies

by Siddhartha Mukherjee

Gilman and Goodman began with animal studies. Injected intravenously into rabbits and mice, the mustards made the normal white cells of the blood and bone marrow almost disappear, without producing all the nasty vesicant actions, dissociating the two pharmacological effects. Encouraged, Gilman and Goodman moved on to human studies, focusing on lymphomas—cancers of the lymph glands. In 1942, they persuaded a thoracic surgeon, Gustaf Lindskog, to treat a forty-eight-year-old New York silversmith with lymphoma with ten continuous doses of intravenous mustard. It was a one-off experiment but it worked. In men, as in mice, the drug produced miraculous remissions. The swollen glands disappeared. Clinicians described the phenomenon as an eerie “softening” of the cancer, as if the hard carapace of cancer that Galen had so vividly described nearly two thousand years ago had melted away. But the responses were followed, inevitably, by relapses.