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Morphine promotes tumor growth and metastasis via induction of angiogenesis and lymphangiogenesis. Opioids can also have pro-cancer progression effect via dysregulation of apoptosis and inhibition of natural killer (NK) cells leading to the reduction in immune response. Opioid-induced mast cell activation can lead to enhanced tumor growth via action of substance P and other mediators on endothelial cells and tumor cells.
