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. Author manuscript; available in PMC: 2011 Jan 1.
Published in final edited form as: Int J Hyperthermia. 2010;26(7):662–680. doi: 10.3109/02656736.2010.507235

Figure 4.

Figure 4

The same cytokines are responsible for metabolic factors leading to cancer growth, fatigue, and temperature dysregulation (fever). High levels of TNF-α and IL-6 affect blood concentration and makeup leading to fatigue (blue). Increases in TNF-α and IL-6 promote metabolic syndrome (green) which induces gluconeogenesis and adipocyte production. These bodily changes lead to an upregulation of various immune regulators that result in cancer development and growth. These cytokines also lead to fever via a PGE-2 dependent pathway (red). Temperature dysregulation (feeling cold) has been related to fatigue and may also be associated with cancer growth. RBC: red blood cell; COX-2: inducible cyclo-oxygenase, PGE2: prostaglandin E2; IGF-1: insulin-like growth factor 1; NF-κB: nuclear factor kappa-light-chain-enhancer of activated B cells; ROS: reactive oxygen species; DNA: deoxyribonucleic acid; VEGF: vascular endothelial growth factor