Prostate and colon cancers are among the most common cancers diagnosed annually, and both often require treatment with radiation therapy. Advancement in radiation delivery techniques has led to highly accurate targeting of tumor and sparing of normal tissue; however, in the pelvic region it is anatomically difficult to avoid off-target radiation exposure to other organs. Chronically the effects of normal urogenital tissue exposure can lead to urinary frequency, urinary incontinence, proctitis, and erectile dysfunction. Most of these symptoms are caused by radiation-induced fibrosis and reduce the quality of life for cancer survivors. We have observed in animal models that the severity of radiation-induced fibrosis in normal tissue correlates to damaged fat reservoirs in the pelvic region. We hypothesize that adipocytes may secrete a factor that prevents the induction of radiation-associated fibrosis in normal tissues. In these studies we show that the adipokine, adiponectin, is secreted by primary mouse adipocytes and protects fibroblasts from radiation-induced cell death, myofibroblast formation, and senescence. Further, we demonstrated that adiponectin does not protect colorectal or prostate cancer cells from radiation-induced death. Thus, we propose that adiponectin, or its downstream pathway, would provide a novel target for adjuvant therapy when treating pelvic cancers with radiation therapy. Radiation is used to treat a variety of pelvic cancers, including prostate and colorectal cancers. While radiation is an effective tool to treat these cancers, radiation also damages surrounding normal tissues. The chronic side effects of radiation treatment are similar for either prostate or colorectal cancer and include: urinary frequency, urinary incontinence, proctitis, erectile dysfunction, and bowel fibrosis 1-4. Most of these long-term side-effects are due to radiation-induced fibrosis. Fibroblasts are the cell type that is most studied in the context of radiation-induced fibrosis. In particular, fibroblasts, which function to maintain normal extracellular matrix (ECM) by producing proteins such as collagen and fibronectin, can become chronically activated after radiation exposure 5. Activated fibroblasts, or myofibroblasts, are initiated by ionizing radiation that activates the TGFβ pathway and chronic production of reactive oxygen species (ROS), which ultimately produces aberrant amounts of ECM 6-8. Irradiation of fibroblasts in normal tissue can lead to cell death, fibroblast activation, or cellular senescence, all of which can produce long term side effects including inflammation, fibrosis, and chronic tissue dysfunction 5,9. There are other cell types involved in fibrosis besides fibroblasts. Immune cells can provide a pro-fibrotic niche to activate fibroblasts and cause epithelial to mesenchymal transformation 10-12. Additionally, the pelvic region contains a large depot of visceral and subcutaneous adipose tissue. The role of adipocytes in radiationinduced fibrosis is unknown. Previously we have published ...