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Continuous interactions of the surrounding microenvironment with tumor cells result in the release or expression of paracrine factors, such as IGFs, which in turn initiate local signals fueling tumorigenesis and resistance to anti-cancer drugs (13)

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Lifestyle changes, especially adherence to regular physical exercise and Mediterranean diet-as reflected by reduced oxidative stress of adipocytes (as measured by plasma levels of F2-isoprostanes and carbonyls of proteins)-showed positive effects (135, 136)

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