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FAQ

Why do we only prescribe the COC Protocol?
Cancer is a complex disease with complex treatments, and we believe that the potential benefits and risks of adding any further therapies into this mix should be very carefully evaluated. Therefore, our whole approach is based on cautious evaluation of evidence.

Our knowledge of the existing research, plus our own clinical experience means we are confident that we have a good understanding how the protocol will behave in patients with differing stages and types of cancer, and in combination with other types of cancer treatments. Although many different medications on the market have at least some published evidence supporting their relatively effective use in cancer, they are not our specialty. Having a solid understanding is extremely important to us.

How does the COC Protocol work?
The COC Protocol is designed to work primarily by restricting the overall ability of cancer cells to take up and use (i.e., ‘metabolize’) energy.

Cancer cells need huge amounts of energy to survive, and the vast majority of cancers use an adaptive process called aerobic glycolysis to generate the excessive energy they need (Kroemer and Pouyssegur, 2008). The COC Protocol may target the various molecular metabolic processes involved in and surrounding aerobic glycolysis, and this may help lower the overall metabolic rate of the cancer cell (Jang et al., 2013).

We believe the COC Protocol may work in combination to consistently restrict energy supply and use, while simultaneously preventing cancer cells from adapting and using other pathways to take up energy (Jagust et al., 2019). As a result, cancer cells become increasingly weaker and less able to take in and use the nutrients (e.g. such as glucose and essential amino acids glutamine and arginine) they need from their surroundings (Andrzejewski et al., 2018; Liu et al., 2016b). This makes it more difficult overall for cancer cells to survive, grow, and spread in the body. Gradually, the weakened cells (including more resilient and previously treatment-resistant cells) become more vulnerable to attack from other cell-killing cancer therapies such as radiotherapy, chemotherapy, hormonal therapy, and targeted therapies (Bradford and Khan, 2013; Chen et al., 2012; Lacerda et al., 2014; Lamb et al., 2015a; Pantziarka et al., 2014).

By targeting the adapted metabolic mechanisms which are common to most cancers (but not usually healthy cells), we believe that the COC Protocol can be effective and selective for virtually any cancer regardless of specific type, stage, or location of cancer. Published epidemiological and lab studies increasingly support the potentially broad range of this therapy (Chae et al., 2015, 2016; Iliopoulos et al., 2011; Lamb et al., 2015b; Pantziarka et al., 2014).

Cancer stem cells are a particularly resilient type of cancer cell. The COC Protocol may target these cells in multiple ways: target the cell’s ‘batteries’ (called mitochondria) by making it very difficult for mitochondria to run the molecular reactions they need to produce energy, blocks the cell-DNA machinery that mitochondria need to replicate and repair (Skoda et al., 2019), alter cancer stem cell gene expression, making the cells more sensitive to other cancer therapies (Kodach et al., 2011), and interrupt numerous molecular processes involved in cell division to help block cancer stem cell growth (Hothi et al., 2012; Hou et al., 2015).

The COC Protocol may hit cancer stem cells (and other cancer cells) across multiple ‘weak spots’, and like a one-two punch, this leaves the cells less able to dodge and recover from standard treatments.

Lab studies are beginning to highlight the effectiveness of aspects of the COC Protocol. In mechanistic studies, combining specific medications greatly decreases the growth of prostate and endometrial cancer cells more than either agent alone (Kim et al., 2019b; Wang et al., 2017).

Observational studies have also reported potentially ‘synergistic’ effects of medications against various cancers (Babcook et al., 2014; Danzig et al., 2015; Lehman et al., 2012; Nimako et al., 2017). A clinical trial investigating select COC Protocol medications in breast cancer is now underway (NCT02874430), and our own research program, METRICS, is now also beginning to produce promising data.

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Can I take the COC Protocol long-term?
The COC Protocol is primarily designed to be a long-term ‘adjunctive’ therapy, to help optimize standard treatments. However, as metabolic treatment with the COC Protocol is intended to run long-term, patients may also take the protocol as a maintenance regime after standard treatment has been completed or during breaks from standard treatment and as part of a long-term strategy to mitigate the risk of recurrence or metastases. For this reason, it is also worth noting that aspects of the COC Protocol also have reported beneficial mechanisms of action in cancer which are not dependent on the co-administration of standard therapies, and which may independently help to reduce the risk of relapse and metastatic spread.

The Care Oncology model
Active medical supervision of each patient

Every patient’s situation is both complex and unique, and requires careful personalized assessment. This is why every patient who attends the Care Oncology Clinic is placed under the direct care of clinicians with specialist knowledge of prescribing the COC Protocol in the context of cancer. Our clinicians individually assess the potential benefits and risks involved in taking the COC Protocol with each patient. We will only recommend the COC Protocol to patients when we believe it will be safe and beneficial to do so. Each COC Protocol prescription is tailored to the needs of the patient, and doses and regimens are carefully reviewed and adjusted based on how the patient progresses.

It is therefore essential that patients are carefully monitored at our clinic throughout the course of their treatment.

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