Hypoxia is a crucial feature of locally advanced solid tumors resulting from a poor oxygen supply delivery owing to excessive cellular proliferation and abnormal vascular architecture. Under these circumstances, cancer cells develop a series of responses in order to adapt to hypoxic conditions. The tumor suppressor p53 has been shown to mediate the cellular response to hypoxia depending on many contexts including cell type, duration and severity of hypoxic exposure. The sphingolipid ceramide, similar to p53, is involved in various growth suppressive activities such as the induction of cell cycle arrest, apoptosis and senescence. Accordingly, previous findings have generated conflicting data regarding a possible link between ceramide
