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Pain is one of the most common symptoms in patients with cancer. Pain not only negatively affects the quality of life of patients with cancer, but it has also been associated with reduced survival. Pain management is therefore a critical component of cancer care. Prescription opioids remain the first-line approach for the management of moderate-to-severe pain associated with cancer. However, there has been increasing interest in understanding whether these analgesics could impact cancer progression. Furthermore, epidemiological data link a possible association between prescription opioid usage and cancer development. Until more robust evidence is available, patients with cancer with moderate-to-severe pain may receive opioids to decrease suffering. However, future studies should be conducted to evaluate the role of opioids and opioid receptors in specific cancers. [ABSTRACT FROM AUTHOR]

Radiation induced cell death is one of the detrimental effects of ionizing radiation causes acute radiation syndrome leading to mortality. The cytotoxic and genotoxic effects caused by ionizing radiation are mainly through the oxidative damage induced by free radical release. IL-6 is known to protect many types of cells from oxidative stress, ischemia/reperfusion injury and other stress induced cell death. Therefore, we tested the hypothesis, if IL-6 treatment before irradiation will protect the cells from radiation induced cell death. First, we tested the radio-protective potential of IL-6 in multiple cell model systems such as hematopoietic (Raw264.7), fibroblast (NIH3T3) and intestinal epithelial (INT407) cells. We treated the cells with pleiotropic IL-6 as a prophylaxis (2hr prior to radiation) and analyzed radiation induced cell death. We found a significant increase in cell survival (30% to 40%). Further, we observed that IL-6 also control the radiation induced oxidative stress by enhancing the Nrf2 levels, which resulted in the reduction of ROS and subsequently ROS mediated macromolecular damage (lipid, protein and DNA).The result of IL-6 mediated reduction in radiation induced cell death substantiated by the reduced levels of pro (Bax, p21, p53, PARP and caspase 3 cleavages) and enhanced anti apoptotic proteins (Mcl-1, Bcl2, Bclxl). Together, we found that IL-6 induced STAT-3 signaling not only reduces the radiation induced cell death but also play important role in early detection of DNA damage and facilitates faster repair. The gamma-H2AX foci and Comet assays suggest faster repair kinetics in IL-6 pre-treated samples. These results were further supported by increased levels of DNA repair proteins ATM, Rad51, NBS1 and Neil-1 & OGG-1 (major mitochondrial DNA repair enzymes) in IL-6 treated samples. Therefore, these findings suggest that IL-6 induced STAT-3 mediated pro-survival signaling, anti-oxidant defense and faster repair kinetics protects the cells from radiation induced cell death. [ABSTRACT FROM AUTHOR]