**8. Ethical issues**

**7. Forbidden area**

48 Prevention, Detection and Management of Oral Cancer

more sensitive tumors for testing other compounds.

Firtz Haber was a hero to some for getting a Nobel Prize for capturing nitrogen directly from atmosphere by burning magnesium metal in the air and hydrolyzing magnesium nitride to produce nitrate the fertilizer. To others, he was the greatest criminal because he released hundreds of cylinders of chlorine gas at the Western front killing thousands of soldiers in the trenches. It was Haber who made the nitrogen mustard and its deadly analogs which were used during WWII. Soldiers exposed to nitrogen mustard burns died of a sharp drop in the white blood cell (WBC) count. Since all cancers showed a sharp increase in WBC count, Ross decided to use modified derivatives of nitrogen mustard to control the cancer growth. Ross was successful. He attached amino acid phenylalanine as a carrier for the nitrogen mustard moiety to make melphalan for treating pharyngeal carcinoma. Over a 10-year period, I made dozens of analogs of nitrogen mustards for Ross. The deadliest among them was the phenylenediamine mustard. We use these compounds to check the sensitivity of the tumors in the tumor bank. If tumors in the tumor bank become resistant, we have to replace them with fresh

Proteins in our body are made of 20 amino acids. When Ross made melphalan by using 1 amino acid out of 20, most of my colleagues thought that they could use the following 19 amino acid to treat all 13 forms of oral cancers including lung cancer: alanine, arginine, aspartic acid, asparagine, cysteine, glycine, glutamic acid, glutamine, histidine, isoleucine, leucine, lysine, methionine, phenylalanine (Ross used this amino acid to make melphalan for treating pharyn-

Aliphatic nitrogen mustards are deadlier than aromatic nitrogen mustards. They decided not to proceed because they do not want to risk their life to save the life of nicotine addicts. If you want to save smokes' life by risking your own, you are welcome to it. I will show you how to make the nitrogen mustard by describing Haber's crudest method. Haber reacted methylamine with ethylene oxide to make 2-bis dihydroxy ethylene methyl amine. It was chlorinated by heating with phosphorus pentachloride in the phosphoric acid. If you noticed a faint smell of mustard seed, Congratulations, you got nitrogen mustard; you are dead. No matter how much precaution you take, after the experiment, if you take an alcohol swab of walls, doors, and knobs and run mass spectra of alcohol extract, you find a line corresponding to nitrogen mustard. If you are exposed to nitrogen mustard and cross the threshold level, your WBC drops sharply and the energy-providing mitochondria die and you are most likely to freeze to death. Will anyone approve this study, probably no one. Your IRB will reject your proposal; your

safety committee will reject it and who will provide the funds for such study. No one.

cancers by selling tobacco products but also by treating some cancers.

Tobacco companies are rich and can afford to invest money in curing cancers. Since most of their work is conducted behind closed doors, why not make nitrogen mustard analogs of all other 19 amino acids. Like melphalan, they might find some of these analogs of amino acids of nitrogen mustard to cure oral to lung cancers. They could make money not only by giving

geal carcinoma), proline, serine, threonine, tryptophan, tyrosine, and valine.

Some of my best friends smoke and most of them are not scientists. Do I tell them not to smoke and keep their friendship? Not a chance. So I tell them experimental facts as gently as possible. My readers are my best friends. All I want is to make them think. If they think, my job as a friend is done.

Scientists in our group are working on different kinds of cancers. As I stated above, there are more than 220 different types of tissues and they could all become cancerous if they are exposed to radiations or chemical environmental pollution. We are all working to cure those cancers. Unfortunately, there is no great enthusiasm for working on either oral cancer or lung cancer. Such diseases are considered self-inflicting wounds. The users of tobacco products are addicted and frequently developed these types of cancers. Many scientists believe that all of us have a free will. We have a right to live and we have a right to die. If you do not smoke or chew tobacco, you will not expose yourself to a host of carcinogens. Some of us believe that you are addicted to nicotine if we cure your oral cancer, you will go back and chew tobacco again. How can we protect you from yourself? If we protect you from yourself, we create a monster. On the other hand, if you are one of those unfortunate persons who inherit a mutated gene, or exposed to secondhand smoking or exposed to radiations or heavy metal particles, you deserve all our help and many of us have been designing drugs for treating oral and lung cancers for these innocent victims.
