Figure 2.

Altered cellular metabolism among cancer cells. Due to the altered physiological and metabolic demands, cancer cells undergo metabolic reprogramming. For example, due to their high energy demand as a response to their fastidious growth and proliferation, cancer cells depend on aerobic glycolysis, causing lactate accumulation and an increased acidic environment. Furthermore, increased aerobic glycolysis elevates oxygen consumption inducing hypoxia. The increased hypoxia and acidity (lactate accumulation) cause immunosuppression to escape from the host immune response. Immunosuppression promotes tumor growth. Additionally, other metabolic mechanisms (polyamine synthesis, glutamine metabolism) also increase in tumor cells, limiting nutrient availability to residential and infiltrated immune cells, causing their immunosuppression. Details are mentioned in the text.