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Description
Hypoxia increases the deoxycytidine triphosphate (dCTP) level through the pentose phosphate pathway (PPP) via glucose metabolism and results in resistance to gemcitabine, a dCTP analog 87
This cellular energy crisis is the biological basis for post-exertional malaise (PEM) , where even minor physical or cognitive exertion leads to a disproportionate and debilitating crash in energy levels
Caregivers should focus on patterns rather than isolated symptoms
European Journal of Cancer 198:113495, 2024
