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What does biodiversity have to do with cancer?

A few years ago, a team of cancer scientists were the first in the world to sequence the durian genome. The passion project sparked a movement to leverage biodiversity in Singapore and the region to advance biological, health and pharmacological sciences.

The movement reached new heights with the SingHealth Duke-NUS Institute of Biodiversity Medicine launch at the sixth SingHealth Duke-NUS Scientific Congress 2021 this September.

But what does biodiversity have to do with human health and cancer?


A close-up of flowers on the roof-top garden space on the SingHealth Campus that the SingHealth Duke-NUS Institute of Biodiversity Medicine is cultivating.

Credit: SingHealth Duke-NUS Institute of Biodiversity Medicine

It's all in the genes

Almost 12 years ago, Professor Teh Bin Tean, the National Cancer Centre Singapore's (NCCS) Deputy Medical Director of Research, and his team were studying Asian-prevalent cancers using a multiple gene approach. Their efforts paid off as they were the first to decode the cancer genome and related pathways of several Asian prevalent cancers. For this work and other notable contributions to cancer research, Professor Teh and the team received the Singapore's President's Science Award in 2015, the American Association of Cancer Research (AACR) Team Science Award in 2018 and the Japanese Cancer Association International Award in 2021. 

Their earlier successes in sequencing Asian cancers galvanised these cancer scientists to explore broader applications to improve human health.  

Why biodiversity?

Singapore alone has more than 4,000 local flora species and cultivated plants. The region already has a rich history of plant-based traditional medicine. While anecdotal evidence suggests that these medicines are effective in treating many different ailments, there aren't enough studies that support this.

Prof Teh and his team saw an opportunity to study the genetic make-up, nutrition and medicinal benefits of local and regional plants – and harness that understanding to fight disease.

With that, the SingHealth Duke-NUS Institute of Biodiversity Medicine (BD-MED), a joint institute under the SingHealth Duke-NUS Academic Medical Centre, was launched with Prof Teh at its helm. The Institute is the region's first to use advancements in genomics, proteomics, metabolomics and molecular expertise to shed light on how local and regional herbal plants, fruits and vegetables can improve human health and well-being.


To commemorate the launch of the SingHealth Duke-NUS Institute of Biodiversity Medicine (BD-MED), scientists from BD-MED and A*STAR's Genome Institute of Singapore (GIS) uncovered the genomic make-up of Singapore's national flower, the Papilionanthe Miss Joaquim, commonly known as the Vanda Miss Joaquim (VMJ). In this picture, (from left to right) Prof Teh Bin Tean, Director, BD-MED and Prof Patrick Tan, Executive Director, GIS, are pictured with the VMJ.

Credit: SingHealth

Using biodiversity to improve cancer outcomes

Efforts to improve treatments and outcomes for cancer patients are already underway as part of BD-MED's Herbal Biodiversity and Medicine Programme. The Programme aims to leverage technological advancements in molecular biology to identify molecular pathways and chemicals derived from local plants, to accelerate drug discovery and provide alternative treatment options.

In 2013, Prof Teh and his team were the first to identify the genome-wide mutational signature of the herbal carcinogen known as aristolochic acid. Produced by the Aristolochia plant, aristolochic acid is associated with genitourinary and hepatobiliary cancers. Remarkably, the Aristolochia plant has been used in various cultures for medicinal purposes as its believed to boost the immune system. The team is currently trying to study the genetic information and related biology of the Aristolochia plant, with the hope of eventually producing a safe alternative for medicinal use through genetic manipulation. 

The team is collaborating with Associate Professor Koh Hwee Ling and her team, from the National University of Singapore's Department of Pharmacy, on medicinal plant research for bile duct cancer. Caused by the consumption of raw fish infested with liver flukes, more than 10,000 cases of bile duct cancer occur in the northeast region of Thailand, neighbouring Laos and Cambodia, annually. Most patients are diagnosed late, and there is no effective treatment. They are currently testing a number of local plants found in Singapore, Malaysia and Thailand that have previously been reported to have anti-cancer properties. Eventually, it is hoped that these studies can lead to a novel, effective and affordable treatment for these patients.

Together with NCCS' Division of Supportive and Palliative Care, BD-MED has also launched the Aromatherapy in Cancer SupporTivE CaRe (ASTER):  Inhalation Aromatherapy to combat anxiety, stress, insomnia, nausea and vomiting. Worldwide, essential oils are increasingly being used as complementary therapy for cancer patients to relieve the side effects of cancer treatment. BD-MED has identified over 10 local plants with phytochemicals that purportedly have effects in alleviating cancer-related symptoms. The research on these extracted compounds will be used to create new aromatherapy blends from local plants and will be further validated by patient studies.

Growing support for a movement that will revolutionise medicine


This roof-top garden is part of the 12,000 square metres that the SingHealth Duke-NUS Institute of Biodiversity Medicine will cultivate on the SingHealth Campus to research different regional plant species.

Credit: SingHealth Duke-NUS Institute of Biodiversity Medicine

Support for BD-MED has been encouraging, with the Verdant Foundation providing a generous lead gift of S$5 million to support the Institute's research programmes.

Prof Teh shared, "I believe it was Hippocrates, the Greek founder of western medicine who said, 'Let thy food be thy medicine, and let medicine be thy food.' Food is a part of everyday life, making it easy for people to appreciate and relate to. Imagine that through our research, we may be able to shed light on what pathways and compounds can provide the medicinal properties of food. The possibilities are endless!"

One of the ways BD-MED will study the medicinal properties of plants is via the 12,000 square metres of roof-top garden space that the Institute will cultivate on the SingHealth Campus to study different regional plant species. Plants in this garden will primarily be used in research and there are future plans to scale up to provide food for SingHealth hospitals' inpatients, with an aim to improve food security and be a buffer from any supply disruptions.

BD-MED is poised to lead Singapore's efforts to harness the therapeutic potential of local plants for the benefit of all.