We wonder if the most viable hypoxic cancer stem cells concentrate in more alkaline regions of tumors, favoring their survival and evolution. Alternately, or in addition, do some cancer stem cells themselves maintain a more alkaline internal environment, achieving the same result. Based upon the response of cultured cells, including stem cells, to a certain degree of hypoxia and of most if not all proliferating cells to a somewhat more alkaline ambient and especially endogenous pH, their survival and proliferation should be favored. The broad outline of the argument, abstracted from a number of the available examples is developed: that the survival of cancer stem cells is favored by these conditions, contributing to their limited response to various therapies and their subsequent development of more malignant properties.
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