Altered S-adenosyl methionine (SAM) metabolism in cancer. SAM, a universal methyl donor for cellular methylation reactions, is produced from methionine. Folate cycle can support SAM production with serine. In addition to providing methyl group for DNA, RNA and histone methylation, SAM is also consumed by NNMT and GNMT to generate 1-methylnicotinamide and sarcosine, respectively. Red indicates altered metabolic proteins, and purple indicates the key metabolites that affect methylation modifications in cancer. SLC7A5, solute carrier family 7 member 5; SLC43A2, solute carrier family 43 member 2; SLC25A26, solute carrier family 25 member 26; PHGDH, phosphoglycerate dehydrogenase; SHMT, serine hydroxymethyltransferase; MTHFR, methylene tetrahydrofolate reductase; MTR, methionine synthase; MATs, methionine adenosyltransferases; NNMT, nicotinamide N-methyltransferase; GNMT, glycine N-methyltransferase.