{"id":7610,"date":"2026-06-26T11:07:46","date_gmt":"2026-06-26T08:07:46","guid":{"rendered":"https:\/\/oncomsi.com\/tedavilerimiz\/metabolik-kontrollu-onkolojik-tedavi\/"},"modified":"2026-09-29T18:35:28","modified_gmt":"2026-09-29T15:35:28","slug":"metabolically-controlled-oncologic-therapy","status":"publish","type":"services","link":"https:\/\/oncomsi.com\/en\/treatments\/metabolically-controlled-oncologic-therapy\/","title":{"rendered":"Metabolically Controlled Oncologic Therapy (MCOT)"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-post\" data-elementor-id=\"7610\" class=\"elementor elementor-7610 elementor-5835\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-d3af33f elementor-section-boxed elementor-section-height-default elementor-section-height-default default\" data-id=\"d3af33f\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-no\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-a57e450\" data-id=\"a57e450\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-617171d elementor-widget elementor-widget-themeht-heading\" data-id=\"617171d\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"themeht-heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\r\n        <div class=\"\">\r\n\r\n          <h1 class=\"mb-0 \">Metabolically Controlled Oncologic Therapy (MCOT)\n<\/h1>       \r\n\r\n        <\/div>\r\n\r\n        \t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-d63d057 elementor-widget elementor-widget-text-editor\" data-id=\"d63d057\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p><strong>Metabolically controlled oncologic therapy (MCOT)<\/strong> is an integrative oncology protocol that targets the <strong>Warburg effect<\/strong>-based disorder in the glucose metabolism of cancer cells, combining low-dose chemotherapy with a ketogenic diet, controlled hypoglycemia, hyperthermia and hyperbaric oxygen therapy. At ONCOMSI, treatment is coordinated by medical oncologist Assoc. Prof. Mehmet Salih \u0130yikesici at our center in Istanbul, Turkey.<br \/><br \/><\/p><h2>What Is Metabolically Controlled Oncologic Therapy?<\/h2><p><strong>Metabolically controlled oncologic therapy (MCOT)<\/strong> is a treatment approach that intervenes in the metabolic pathways cancer cells use to produce energy, with the goal of increasing the effect of chemotherapy on the tumor. Its scientific basis is the phenomenon described by <strong>Otto Warburg in 1924<\/strong> and known as the <strong>&#8220;Warburg effect&#8221;<\/strong>: unlike normal cells, cancer cells metabolize glucose largely by converting it to lactate. The science behind this is explained in <a href=\"\/en\/warburg-effect-and-cancer\/\">the Warburg effect and cancer<\/a>.<\/p><p>This approach treats cancer not only as a genetic disease but also as a state of <strong>metabolic dysregulation<\/strong>. In practice, MCOT means giving chemotherapy in the metabolic window in which cancer cells are most sensitive, limiting their access to glucose at the same time through a ketogenic diet, and adding hyperthermia and hyperbaric oxygen therapy to the process.<\/p><p>At ONCOMSI this protocol is applied in a personalized way, under the coordination of a medical oncologist, together with nutrition specialists and a support team. The aim is to achieve an effective result with a <strong>chemotherapy load below the standard dose<\/strong> while protecting the patient&#8217;s quality of life.<\/p><h2>How Does MCOT Work?<\/h2><p>MCOT combines <strong>five components<\/strong> that target the metabolic vulnerabilities of cancer cells in a single treatment schedule: low-dose chemotherapy, a ketogenic diet, controlled hypoglycemia, hyperthermia and hyperbaric oxygen therapy. This combination is planned to make cancer cells more sensitive to chemotherapy while keeping the side-effect burden on healthy tissue relatively limited.<\/p><ul><li><strong>Controlled hypoglycemia:<\/strong> Before chemotherapy is given, after a period of fasting, blood sugar is lowered under medical supervision with insulin. The effect of insulin is intended to increase the membrane permeability of cancer cells, making it easier for chemotherapy drugs to enter them.<\/li><li><strong>Ketogenic diet:<\/strong> Carbohydrate intake is restricted and the emphasis shifts to ketones. This reduces the tumor microenvironment&#8217;s access to glucose.<\/li><li><strong>Low-dose chemotherapy:<\/strong> Chemotherapy drugs given below the standard dose are delivered within a wider window of sensitivity, while cancer cells are under metabolic pressure.<\/li><li><strong>Hyperthermia:<\/strong> The tumor region or the whole body is heated in a controlled way. Heat is intended to reduce the DNA repair capacity of tumor cells and increase their sensitivity to chemotherapy.<\/li><li><strong>Hyperbaric oxygen therapy (HBOT):<\/strong> Oxygen is given under high pressure to increase tissue oxygenation. Relieving tumor hypoxia is intended to reduce resistance to chemotherapy and radiotherapy.<\/li><\/ul><p>These five components are not independent of one another. The timing and dose of each is planned according to the patient&#8217;s medical condition, cancer type and stage. The process is directed by the medical oncologist.<\/p><h2>The MCOT Process: The Patient Journey<\/h2><p>At ONCOMSI the MCOT process has <strong>seven steps<\/strong>: initial assessment, investigations and staging, a personalized protocol plan, metabolic preparation, treatment sessions, side-effect management and follow-up after treatment. Every stage is coordinated by Assoc. Prof. Mehmet Salih \u0130yikesici.<\/p><ol><li><strong>Initial assessment and consultation:<\/strong> Medical history, existing imaging and laboratory results are reviewed, and suitability for treatment is assessed. For patients abroad, this step can be completed <strong>remotely<\/strong>.<\/li><li><strong>Investigations and staging:<\/strong> Additional imaging or laboratory tests are arranged where needed, and the cancer type and stage are confirmed.<\/li><li><strong>Personalized protocol plan:<\/strong> The medical oncologist, together with the multidisciplinary team, builds the plan for the ketogenic diet, hyperthermia and HBOT sessions.<\/li><li><strong>Metabolic preparation:<\/strong> The transition to the ketogenic diet is made with a dietitian, and blood sugar and ketone levels are monitored.<\/li><li><strong>Treatment sessions:<\/strong> Chemotherapy, hyperthermia and HBOT sessions are given in a planned sequence. A clinical evaluation is made before and after each session.<\/li><li><strong>Side-effect management and supportive care:<\/strong> Nausea, fatigue and nutritional problems are managed at an early stage.<\/li><li><strong>Follow-up after treatment:<\/strong> Regular check-ups are planned within the <strong>ONCOMSI five-year follow-up program<\/strong>, and the protocol is updated when needed.<\/li><\/ol><h2>Who Is MCOT Suitable For?<\/h2><p>MCOT is a protocol applied in <strong>pancreatic, breast (including triple-negative), gastric, rectal and non-small cell lung cancer<\/strong>. Suitability is determined by the medical oncologist according to cancer type and stage, performance status and previous treatment history.<\/p><ul><li>Patients diagnosed with pancreatic cancer<\/li><li>Advanced breast cancer, including the triple-negative subtype<\/li><li>Patients with advanced gastric cancer<\/li><li>Rectal cancer cases<\/li><li>Patients with non-small cell lung cancer<\/li><li>Patients looking for an additional approach alongside standard chemotherapy who are suitable for multidisciplinary evaluation<\/li><\/ul><p>This list is a guiding summary. Every patient&#8217;s clinical situation is different, so a treatment decision is made only after a medical evaluation.<\/p><p>MCOT is a protocol that requires <strong>medical oncology expertise<\/strong>. Chemotherapy dosing, hypoglycemia management and the timing of hyperthermia rely on the clinical judgment of a physician trained in oncology. Applying this protocol without oncology training carries serious risk. At ONCOMSI, the entire process is carried out under the coordination of a medical oncologist.<\/p><h2>MCOT and Standard Chemotherapy: The Difference in Approach<\/h2><p>The key difference between MCOT and standard chemotherapy is that MCOT gives <strong>low-dose chemotherapy together with<\/strong> a ketogenic diet, controlled hypoglycemia, hyperthermia and hyperbaric oxygen therapy. The table below shows the difference component by component.<\/p><figure class=\"wp-block-table\"><table><thead><tr><th>Dimension<\/th><th>Standard Chemotherapy<\/th><th>Metabolically Controlled Oncologic Therapy (MCOT)<\/th><\/tr><\/thead><tbody><tr><td>Treatment logic<\/td><td>Cytotoxic effect alone<\/td><td>Cytotoxic effect + metabolic intervention<\/td><\/tr><tr><td>Blood sugar management<\/td><td>Generally no specific intervention<\/td><td>Active management through controlled hypoglycemia<\/td><\/tr><tr><td>Nutrition<\/td><td>General dietary advice<\/td><td>Ketogenic diet, monitored by physician and dietitian<\/td><\/tr><tr><td>Accompanying treatments<\/td><td>Generally none<\/td><td>Hyperthermia and hyperbaric oxygen therapy<\/td><\/tr><tr><td>Goal<\/td><td>Shrink the tumor<\/td><td>Target the tumor in a more sensitive window, reduce side effects<\/td><\/tr><\/tbody><\/table><\/figure><p>MCOT <strong>does not replace standard chemotherapy<\/strong>; it means planning the same chemotherapy drugs together with metabolic interventions. A detailed comparison is on the page covering <a href=\"\/en\/mcot-vs-standard-chemotherapy\/\">MCOT and standard chemotherapy<\/a>. Possible side effects by component are covered in <a href=\"\/en\/mcot-side-effects\/\">MCOT side effects<\/a>.<\/p><h2>Scientific Evidence<\/h2><p>The MCOT protocol is supported by peer-reviewed international publications authored by Assoc. Prof. Mehmet Salih \u0130yikesici, reporting survival and response data in <strong>five main cancer types<\/strong>: lung, pancreatic, gastric, rectal and breast cancer. The most recent publication appeared in <em>Current Oncology<\/em> in <strong>August 2026<\/strong>. The findings below are quoted directly from these studies and are ordered by the number of patients included.<\/p><h3>MCOT in Lung Cancer<\/h3><p>In his 2019 publication (\u0130yikesici MS. <em>Int J Hyperthermia.<\/em> 2019;36(1):446-455. PMID 30931666), Assoc. Prof. Mehmet Salih \u0130yikesici reported a retrospective study of <strong>44 patients with metastatic (stage IV) non-small cell lung cancer<\/strong> in which weekly carboplatin\/paclitaxel-based MCOT was combined with a ketogenic diet, hyperthermia and hyperbaric oxygen therapy. The <strong>overall response rate (ORR) was 61.4%<\/strong>, <strong>mean overall survival 42.9 months<\/strong> (95% CI, 34.0 to 51.8) and mean progression-free survival 41.0 months (95% CI, 31.1 to 50.9). The authors state that the results need to be supported by larger comparative clinical studies.<\/p><h3>MCOT in Pancreatic Cancer<\/h3><p>In his 2020 publication (\u0130yikesici MS. <em>Complement Med Res.<\/em> 2020;27(1):31-39. PMID 31527373), Assoc. Prof. Mehmet Salih \u0130yikesici reported a retrospective study of <strong>25 patients with metastatic (stage IV) pancreatic ductal carcinoma<\/strong> in which MCOT with a gemcitabine-based or FOLFIRINOX regimen was combined with a ketogenic diet, hyperthermia and HBOT. <strong>Median overall survival was 15.8 months<\/strong> (95% CI, 10.5 to 21.1) and <strong>median progression-free survival 12.9 months<\/strong> (95% CI, 11.2 to 14.6). Age and sex showed no statistically significant effect on survival. The authors state that the results need to be supported by larger comparative clinical studies.<\/p><p>In his 2016 publication (\u0130yikesici MS. <em>J Pancreas.<\/em> 2016;17(1):36-41), Assoc. Prof. Mehmet Salih \u0130yikesici reported a retrospective evaluation of the MCOT protocol in <strong>33 patients with unresectable (stage III to IV) pancreatic adenocarcinoma<\/strong>. <strong>Median survival was 19.5 months<\/strong> and the <strong>one-year survival rate 82.5%<\/strong>. During treatment, 4 patients became eligible for surgery. The authors state that the results need to be supported by larger comparative clinical studies.<\/p><p>In his 2026 publication (\u0130yikesici MS. <em>Curr Oncol.<\/em> 2026;33(8):489. PMID 42645394), Assoc. Prof. Mehmet Salih \u0130yikesici reported a patient with <strong>drug-resistant advanced pancreatic adenocarcinoma<\/strong> and widespread liver metastases in whom the MCOT protocol maintained <strong>disease control for approximately 2.5 years<\/strong>. When the disease progressed again, the protocol was intensified; one month later PET\/CT showed a <strong>63.7% reduction in SUVmax<\/strong> (from 18.2 to 6.6), and performance status improved from ECOG PS 2 to PS 0. Treatment-related side effects were limited to Grade 1 nausea, Grade 1 vomiting and a fall in platelet count. As a single, uncontrolled observation, these findings do not establish causation; the authors state that the results need to be confirmed by prospective, controlled studies. More detail is on the page covering <a href=\"\/en\/mcot-pancreatic-cancer\/\">MCOT in pancreatic cancer<\/a>.<\/p><h3>MCOT in Gastric Cancer<\/h3><p>In his 2020 publication (\u0130yikesici MS. <em>Niger J Clin Pract.<\/em> 2020;23(5):734-740), Assoc. Prof. Mehmet Salih \u0130yikesici reported a protocol of MCOT + ketogenic diet + local hyperthermia + HBOT in <strong>24 patients with stage III to IV locally advanced or metastatic gastric adenocarcinoma<\/strong>. A <strong>complete response was achieved in 88% of patients (22\/24)<\/strong>; <strong>mean overall survival was 39.5 months<\/strong> (95% CI, 28.1 to 51.0) and mean progression-free survival 36.5 months (95% CI, 25.7 to 47.2). No significant problems related to fasting, hypoglycemia, the ketogenic diet, hyperthermia or HBOT were observed. The authors state that the results need to be supported by larger comparative clinical studies.<\/p><h3>MCOT in Rectal Cancer<\/h3><p>In his 2020 publication (\u0130yikesici MS. <em>Arch Clin Exp Med.<\/em> 2020;5(1):16-20), Assoc. Prof. Mehmet Salih \u0130yikesici reported a protocol of MCOT (oxaliplatin-based first line, irinotecan-based second line) + ketogenic diet + hyperthermia + HBOT in <strong>21 patients with stage II to IV rectal carcinoma<\/strong>. <strong>Mean overall survival was 58.6 months<\/strong> (95% CI, 43.3 to 73.9) and mean progression-free survival 45.1 months (95% CI, 28.9 to 61.2). No additional safety concerns were observed. The authors state that the results need to be supported by larger comparative clinical studies.<\/p><p>In his 2016 publication (\u0130yikesici MS. <em>Int J Cancer Res Mol Mech.<\/em> 2016;2(1):1-4), Assoc. Prof. Mehmet Salih \u0130yikesici reported an 81-year-old patient with stage III (T3N2M0) lower rectal cancer who had declined surgery. With a FOLFOX6-based MCOT protocol combined with radiotherapy and local hyperthermia, <strong>complete clinical and pathological remission<\/strong> was achieved, and no recurrence was observed over more than 27 months of follow-up. This is a single case report; broader studies are needed before general conclusions can be drawn.<\/p><h3>MCOT in Breast Cancer<\/h3><p>In his 2021 publication (\u0130yikesici MS. <em>Cureus.<\/em> 2021;13(4):e14686), Assoc. Prof. Mehmet Salih \u0130yikesici reported a 47-year-old premenopausal patient with end-stage (T4N3M1) breast cancer and metastases to the brain, lung, mediastinum, liver, abdomen and bone. After six months of MCOT + ketogenic diet + hyperthermia + HBOT, <strong>all detectable lesions resolved<\/strong>; complete remission was confirmed by PET-CT and maintained for two years. This is a single case report; broader studies are needed before general conclusions can be drawn.<\/p><p>In his 2017 publication (\u0130yikesici MS. <em>Cureus.<\/em> 2017;9(7):e1445. PMID 28924531), Assoc. Prof. Mehmet Salih \u0130yikesici reported a 29-year-old patient with <strong>stage IV triple-negative<\/strong> (T4N3M1) invasive ductal breast carcinoma and liver metastases. After six months of MCOT + ketogenic diet + hyperthermia + HBOT, a complete therapeutic response was seen on PET-CT, and a <strong>complete pathological response<\/strong> was confirmed at the subsequent mastectomy. This is a single case report; broader studies are needed before general conclusions can be drawn.<\/p><h2>MCOT at ONCOMSI: Assoc. Prof. Mehmet Salih \u0130yikesici<\/h2><p><strong>ONCOMSI<\/strong> is an international medical oncology center based in Istanbul, Turkey, that has applied the metabolically controlled oncologic therapy protocol <strong>continuously since 2010<\/strong> under the coordination of medical oncologist <strong>Assoc. Prof. Mehmet Salih \u0130yikesici<\/strong>. The integrative nature of the treatment requires the medical oncologist to act like the <strong>conductor of an orchestra<\/strong>, synchronizing chemotherapy, nutrition, hyperthermia and HBOT for each individual patient.<\/p><p>The MCOT protocol was introduced to Turkey under the pioneering leadership of <strong>Prof. Dr. B\u00fclent Berkarda<\/strong> and Assoc. Prof. Mehmet Salih \u0130yikesici. The years of clinical experience and patient data accumulated with this protocol are reflected in the internationally published studies listed above, all authored by Assoc. Prof. \u0130yikesici. Through these internationally cited studies, ONCOMSI has become one of the pioneering centers in this field worldwide. This accumulated clinical know-how is the basis on which the protocol is refined separately for each patient.<\/p><p>Assoc. Prof. \u0130yikesici is a physician with years of clinical experience in metabolically controlled oncologic therapy. He trained in hyperthermia in <strong>Germany and Switzerland<\/strong>, is one of the <strong>pioneers of metabolically controlled oncologic therapy and hyperthermia in Turkey<\/strong>, and his articles in international peer-reviewed journals form the scientific foundation of ONCOMSI. More information is on his <a href=\"\/en\/team\/assoc-prof-dr-mehmet-salih-iyikesici\/\">physician profile<\/a>.<\/p><p><strong>MCOT in Turkey.<\/strong> ONCOMSI is located in Istanbul, Turkey. Istanbul&#8217;s direct international flight connections make planning easier for patients traveling from abroad. The need for travel over the course of treatment is assessed with our team during the initial consultation. The full process for international patients is on the page covering <a href=\"\/en\/mcot-turkey\/\">metabolically controlled oncologic therapy in Turkey<\/a>.<\/p><h2>Protocols Applied Together With MCOT<\/h2><p>MCOT works in integration with <strong>three core protocols<\/strong>: the ketogenic diet, hyperthermia and hyperbaric oxygen therapy (HBOT). Each component has its own scientific rationale; used together, they are planned to support the effect of chemotherapy.<\/p><ul><li><strong><a href=\"\/en\/treatments\/ketogenic-diet\/\">Ketogenic diet<\/a><\/strong>: limits the tumor microenvironment&#8217;s access to glucose.<\/li><li><strong><a href=\"\/en\/treatments\/hyperthermia\/\">Hyperthermia<\/a><\/strong>: local or whole-body heating intended to increase sensitivity to chemotherapy.<\/li><li><strong><a href=\"\/en\/treatments\/hyperbaric-oxygen-therapy\/\">Hyperbaric oxygen therapy (HBOT)<\/a><\/strong>: increases tissue oxygenation.<\/li><\/ul><h2>Which Cancer Types Is It Considered For?<\/h2><p>The MCOT protocol is considered in <strong>five main cancer types<\/strong>: pancreatic cancer, breast cancer (including the triple-negative subtype), gastric cancer, rectal cancer and non-small cell lung cancer. In each cancer type, the treatment plan is built separately.<\/p><ul><li><a href=\"\/en\/mcot-pancreatic-cancer\/\">Pancreatic cancer<\/a>: MCOT data have been published in international journals.<\/li><li><a href=\"\/en\/cancers-we-treat\/breast-cancer\/\">Breast cancer<\/a><\/li><li><a href=\"\/en\/cancers-we-treat\/gastric-cancer\/\">Gastric cancer<\/a><\/li><li><a href=\"\/en\/cancers-we-treat\/colorectal-cancer\/\">Rectal cancer<\/a><\/li><li><a href=\"\/en\/cancers-we-treat\/lung-cancer\/\">Lung cancer (non-small cell)<\/a><\/li><\/ul><h2 id=\"faq\">Frequently Asked Questions<\/h2>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-5bbde9d elementor-widget elementor-widget-accordion\" data-id=\"5bbde9d\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"accordion.default\">\n\t\t\t\t\t\t\t<div class=\"elementor-accordion\">\n\t\t\t\t\t\t\t<div class=\"elementor-accordion-item\">\n\t\t\t\t\t<h3 id=\"elementor-tab-title-9611\" class=\"elementor-tab-title\" data-tab=\"1\" role=\"button\" aria-controls=\"elementor-tab-content-9611\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-accordion-icon elementor-accordion-icon-right\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-accordion-icon-closed\"><i class=\"flaticon flaticon-view\"><\/i><\/span>\n\t\t\t\t\t\t\t\t<span class=\"elementor-accordion-icon-opened\"><i class=\"flaticon flaticon-hide\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-accordion-title\" tabindex=\"0\">What is metabolically controlled oncologic therapy?<\/a>\n\t\t\t\t\t<\/h3>\n\t\t\t\t\t<div id=\"elementor-tab-content-9611\" class=\"elementor-tab-content elementor-clearfix\" data-tab=\"1\" role=\"region\" aria-labelledby=\"elementor-tab-title-9611\"><div class=\"rank-math-list-item\"><div class=\"rank-math-answer\"><p>Metabolically controlled oncologic therapy (MCOT) is an integrative oncology protocol that targets the glucose metabolism of cancer cells and combines low-dose chemotherapy with a ketogenic diet, controlled hypoglycemia, hyperthermia and hyperbaric oxygen therapy. The aim is to increase the effectiveness of chemotherapy and reduce the side-effect burden.<\/p><\/div><\/div><div class=\"rank-math-list-item\">\u00a0<\/div><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-accordion-item\">\n\t\t\t\t\t<h3 id=\"elementor-tab-title-9612\" class=\"elementor-tab-title\" data-tab=\"2\" role=\"button\" aria-controls=\"elementor-tab-content-9612\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-accordion-icon elementor-accordion-icon-right\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-accordion-icon-closed\"><i class=\"flaticon flaticon-view\"><\/i><\/span>\n\t\t\t\t\t\t\t\t<span class=\"elementor-accordion-icon-opened\"><i class=\"flaticon flaticon-hide\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-accordion-title\" tabindex=\"0\">What is the difference between MCOT and standard chemotherapy?<\/a>\n\t\t\t\t\t<\/h3>\n\t\t\t\t\t<div id=\"elementor-tab-content-9612\" class=\"elementor-tab-content elementor-clearfix\" data-tab=\"2\" role=\"region\" aria-labelledby=\"elementor-tab-title-9612\"><div class=\"rank-math-list-item\"><div class=\"rank-math-answer\"><p>Standard chemotherapy relies on cytotoxic drugs given on their own. MCOT involves giving the same drugs together with metabolic interventions, usually at a lower dose. The aim is to target cancer cells in a window in which they are metabolically more sensitive.<\/p><\/div><\/div><div class=\"rank-math-list-item\">\u00a0<\/div><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-accordion-item\">\n\t\t\t\t\t<h3 id=\"elementor-tab-title-9613\" class=\"elementor-tab-title\" data-tab=\"3\" role=\"button\" aria-controls=\"elementor-tab-content-9613\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-accordion-icon elementor-accordion-icon-right\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-accordion-icon-closed\"><i class=\"flaticon flaticon-view\"><\/i><\/span>\n\t\t\t\t\t\t\t\t<span class=\"elementor-accordion-icon-opened\"><i class=\"flaticon flaticon-hide\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-accordion-title\" tabindex=\"0\">Which cancer types is MCOT applied in?<\/a>\n\t\t\t\t\t<\/h3>\n\t\t\t\t\t<div id=\"elementor-tab-content-9613\" class=\"elementor-tab-content elementor-clearfix\" data-tab=\"3\" role=\"region\" aria-labelledby=\"elementor-tab-title-9613\"><div class=\"rank-math-list-item\"><div class=\"rank-math-answer\"><p>MCOT is considered in pancreatic, breast (including triple-negative), gastric, rectal and non-small cell lung cancer. Suitability is decided by the medical oncologist according to cancer type and stage, the patient&#8217;s general condition and treatment history.<\/p><\/div><\/div><div class=\"rank-math-list-item\">\u00a0<\/div><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-accordion-item\">\n\t\t\t\t\t<h3 id=\"elementor-tab-title-9614\" class=\"elementor-tab-title\" data-tab=\"4\" role=\"button\" aria-controls=\"elementor-tab-content-9614\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-accordion-icon elementor-accordion-icon-right\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-accordion-icon-closed\"><i class=\"flaticon flaticon-view\"><\/i><\/span>\n\t\t\t\t\t\t\t\t<span class=\"elementor-accordion-icon-opened\"><i class=\"flaticon flaticon-hide\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-accordion-title\" tabindex=\"0\">How do the side effects of MCOT compare with standard chemotherapy?<\/a>\n\t\t\t\t\t<\/h3>\n\t\t\t\t\t<div id=\"elementor-tab-content-9614\" class=\"elementor-tab-content elementor-clearfix\" data-tab=\"4\" role=\"region\" aria-labelledby=\"elementor-tab-title-9614\"><div class=\"rank-math-list-item\"><div class=\"rank-math-answer\"><p>The MCOT protocol generally uses low-dose chemotherapy, delivered together with a ketogenic diet, hyperthermia and HBOT. One of the aims of this approach is to reduce the side-effect burden. In the 2026 case report, treatment-related side effects were limited to Grade 1 nausea, Grade 1 vomiting and a fall in platelet count. The type and severity of side effects vary from patient to patient.<\/p><\/div><\/div><div class=\"rank-math-list-item\">\u00a0<\/div><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-accordion-item\">\n\t\t\t\t\t<h3 id=\"elementor-tab-title-9615\" class=\"elementor-tab-title\" data-tab=\"5\" role=\"button\" aria-controls=\"elementor-tab-content-9615\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-accordion-icon elementor-accordion-icon-right\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-accordion-icon-closed\"><i class=\"flaticon flaticon-view\"><\/i><\/span>\n\t\t\t\t\t\t\t\t<span class=\"elementor-accordion-icon-opened\"><i class=\"flaticon flaticon-hide\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-accordion-title\" tabindex=\"0\">Is the ketogenic diet compulsory during MCOT?<\/a>\n\t\t\t\t\t<\/h3>\n\t\t\t\t\t<div id=\"elementor-tab-content-9615\" class=\"elementor-tab-content elementor-clearfix\" data-tab=\"5\" role=\"region\" aria-labelledby=\"elementor-tab-title-9615\"><div class=\"rank-math-list-item\"><div class=\"rank-math-answer\"><p>The ketogenic diet is one of the core components of the MCOT protocol. How it is applied and for how long are planned by the dietitian and the physician according to the patient&#8217;s medical condition and tolerance.<\/p><\/div><\/div><div class=\"rank-math-list-item\">\u00a0<\/div><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-accordion-item\">\n\t\t\t\t\t<h3 id=\"elementor-tab-title-9616\" class=\"elementor-tab-title\" data-tab=\"6\" role=\"button\" aria-controls=\"elementor-tab-content-9616\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-accordion-icon elementor-accordion-icon-right\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-accordion-icon-closed\"><i class=\"flaticon flaticon-view\"><\/i><\/span>\n\t\t\t\t\t\t\t\t<span class=\"elementor-accordion-icon-opened\"><i class=\"flaticon flaticon-hide\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-accordion-title\" tabindex=\"0\">How many sessions does MCOT involve?<\/a>\n\t\t\t\t\t<\/h3>\n\t\t\t\t\t<div id=\"elementor-tab-content-9616\" class=\"elementor-tab-content elementor-clearfix\" data-tab=\"6\" role=\"region\" aria-labelledby=\"elementor-tab-title-9616\"><div class=\"rank-math-list-item\"><div class=\"rank-math-answer\"><p>The number of sessions depends on the cancer type, the stage of the disease, the response to treatment and the patient&#8217;s general condition. The process is planned individually by the medical oncologist.<\/p><\/div><\/div><div class=\"rank-math-list-item\">\u00a0<\/div><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-accordion-item\">\n\t\t\t\t\t<h3 id=\"elementor-tab-title-9617\" class=\"elementor-tab-title\" data-tab=\"7\" role=\"button\" aria-controls=\"elementor-tab-content-9617\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-accordion-icon elementor-accordion-icon-right\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-accordion-icon-closed\"><i class=\"flaticon flaticon-view\"><\/i><\/span>\n\t\t\t\t\t\t\t\t<span class=\"elementor-accordion-icon-opened\"><i class=\"flaticon flaticon-hide\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-accordion-title\" tabindex=\"0\">Does MCOT work in pancreatic cancer?<\/a>\n\t\t\t\t\t<\/h3>\n\t\t\t\t\t<div id=\"elementor-tab-content-9617\" class=\"elementor-tab-content elementor-clearfix\" data-tab=\"7\" role=\"region\" aria-labelledby=\"elementor-tab-title-9617\"><div class=\"rank-math-list-item\"><div class=\"rank-math-answer\"><p>In a 25-patient retrospective observational study in which MCOT was combined with a ketogenic diet, hyperthermia and HBOT in metastatic (stage IV) pancreatic cancer, median overall survival was 15.8 months and median progression-free survival 12.9 months (Assoc. Prof. Mehmet Salih \u0130yikesici, 2020; PMID 31527373). The authors state that the results need to be supported by larger clinical studies.<\/p><\/div><\/div><div class=\"rank-math-list-item\">\u00a0<\/div><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-accordion-item\">\n\t\t\t\t\t<h3 id=\"elementor-tab-title-9618\" class=\"elementor-tab-title\" data-tab=\"8\" role=\"button\" aria-controls=\"elementor-tab-content-9618\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-accordion-icon elementor-accordion-icon-right\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-accordion-icon-closed\"><i class=\"flaticon flaticon-view\"><\/i><\/span>\n\t\t\t\t\t\t\t\t<span class=\"elementor-accordion-icon-opened\"><i class=\"flaticon flaticon-hide\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-accordion-title\" tabindex=\"0\">How can I apply for MCOT from outside Turkey?<\/a>\n\t\t\t\t\t<\/h3>\n\t\t\t\t\t<div id=\"elementor-tab-content-9618\" class=\"elementor-tab-content elementor-clearfix\" data-tab=\"8\" role=\"region\" aria-labelledby=\"elementor-tab-title-9618\"><div class=\"wp-block-rank-math-faq-block\"><div class=\"rank-math-list\"><div class=\"rank-math-list-item\"><div class=\"rank-math-answer\"><p>For patients applying from abroad, the initial consultation can be arranged remotely by reviewing existing imaging, pathology and laboratory reports. Once the treatment plan is confirmed, travel to Istanbul and accommodation are planned together with our team.<\/p><\/div><\/div><\/div><\/div><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t<script type=\"application\/ld+json\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@type\":\"FAQPage\",\"mainEntity\":[{\"@type\":\"Question\",\"name\":\"What is metabolically controlled oncologic therapy?\",\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"<div class=\\\"rank-math-list-item\\\"><div class=\\\"rank-math-answer\\\"><p>Metabolically controlled oncologic therapy (MCOT) is an integrative oncology protocol that targets the glucose metabolism of cancer cells and combines low-dose chemotherapy with a ketogenic diet, controlled hypoglycemia, hyperthermia and hyperbaric oxygen therapy. The aim is to increase the effectiveness of chemotherapy and reduce the side-effect burden.<\\\/p><\\\/div><\\\/div><div class=\\\"rank-math-list-item\\\">\\u00a0<\\\/div>\"}},{\"@type\":\"Question\",\"name\":\"What is the difference between MCOT and standard chemotherapy?\",\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"<div class=\\\"rank-math-list-item\\\"><div class=\\\"rank-math-answer\\\"><p>Standard chemotherapy relies on cytotoxic drugs given on their own. MCOT involves giving the same drugs together with metabolic interventions, usually at a lower dose. The aim is to target cancer cells in a window in which they are metabolically more sensitive.<\\\/p><\\\/div><\\\/div><div class=\\\"rank-math-list-item\\\">\\u00a0<\\\/div>\"}},{\"@type\":\"Question\",\"name\":\"Which cancer types is MCOT applied in?\",\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"<div class=\\\"rank-math-list-item\\\"><div class=\\\"rank-math-answer\\\"><p>MCOT is considered in pancreatic, breast (including triple-negative), gastric, rectal and non-small cell lung cancer. Suitability is decided by the medical oncologist according to cancer type and stage, the patient&#8217;s general condition and treatment history.<\\\/p><\\\/div><\\\/div><div class=\\\"rank-math-list-item\\\">\\u00a0<\\\/div>\"}},{\"@type\":\"Question\",\"name\":\"How do the side effects of MCOT compare with standard chemotherapy?\",\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"<div class=\\\"rank-math-list-item\\\"><div class=\\\"rank-math-answer\\\"><p>The MCOT protocol generally uses low-dose chemotherapy, delivered together with a ketogenic diet, hyperthermia and HBOT. One of the aims of this approach is to reduce the side-effect burden. In the 2026 case report, treatment-related side effects were limited to Grade 1 nausea, Grade 1 vomiting and a fall in platelet count. The type and severity of side effects vary from patient to patient.<\\\/p><\\\/div><\\\/div><div class=\\\"rank-math-list-item\\\">\\u00a0<\\\/div>\"}},{\"@type\":\"Question\",\"name\":\"Is the ketogenic diet compulsory during MCOT?\",\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"<div class=\\\"rank-math-list-item\\\"><div class=\\\"rank-math-answer\\\"><p>The ketogenic diet is one of the core components of the MCOT protocol. How it is applied and for how long are planned by the dietitian and the physician according to the patient&#8217;s medical condition and tolerance.<\\\/p><\\\/div><\\\/div><div class=\\\"rank-math-list-item\\\">\\u00a0<\\\/div>\"}},{\"@type\":\"Question\",\"name\":\"How many sessions does MCOT involve?\",\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"<div class=\\\"rank-math-list-item\\\"><div class=\\\"rank-math-answer\\\"><p>The number of sessions depends on the cancer type, the stage of the disease, the response to treatment and the patient&#8217;s general condition. The process is planned individually by the medical oncologist.<\\\/p><\\\/div><\\\/div><div class=\\\"rank-math-list-item\\\">\\u00a0<\\\/div>\"}},{\"@type\":\"Question\",\"name\":\"Does MCOT work in pancreatic cancer?\",\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"<div class=\\\"rank-math-list-item\\\"><div class=\\\"rank-math-answer\\\"><p>In a 25-patient retrospective observational study in which MCOT was combined with a ketogenic diet, hyperthermia and HBOT in metastatic (stage IV) pancreatic cancer, median overall survival was 15.8 months and median progression-free survival 12.9 months (Assoc. Prof. Mehmet Salih \\u0130yikesici, 2020; PMID 31527373). The authors state that the results need to be supported by larger clinical studies.<\\\/p><\\\/div><\\\/div><div class=\\\"rank-math-list-item\\\">\\u00a0<\\\/div>\"}},{\"@type\":\"Question\",\"name\":\"How can I apply for MCOT from outside Turkey?\",\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"<div class=\\\"wp-block-rank-math-faq-block\\\"><div class=\\\"rank-math-list\\\"><div class=\\\"rank-math-list-item\\\"><div class=\\\"rank-math-answer\\\"><p>For patients applying from abroad, the initial consultation can be arranged remotely by reviewing existing imaging, pathology and laboratory reports. Once the treatment plan is confirmed, travel to Istanbul and accommodation are planned together with our team.<\\\/p><\\\/div><\\\/div><\\\/div><\\\/div>\"}}]}<\/script>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-8780e80 p-mb-0 elementor-widget elementor-widget-text-editor\" data-id=\"8780e80\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<h2>Appointments and Contact<\/h2><p>Only a medical evaluation can determine whether metabolically controlled oncologic therapy is suitable in your case. The ONCOMSI team evaluates you and your family at our center in Istanbul and stays beside you throughout the process.<\/p><div class=\"wp-block-buttons\"><div class=\"wp-block-button\"><a class=\"wp-block-button__link wp-element-button\" href=\"\/en\/contact\/\">Request a Consultation<\/a><\/div><\/div><p><em>This page is for informational purposes only. Please consult your doctor for diagnosis, treatment, and personal health decisions.<\/em><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-234eae2 elementor-widget elementor-widget-our-team-single\" data-id=\"234eae2\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"our-team-single.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\n\n       <div class=\"swiper team-swiper\">\n      <div class=\"swiper-wrapper\">\n\n                          <div class=\"swiper-slide\">\n               \n\n                            <div class=\"team-member style-2\">\n                        <div class=\"team-images\">\n            <img fetchpriority=\"high\" decoding=\"async\" width=\"1214\" height=\"1579\" src=\"https:\/\/oncomsi.com\/wp-content\/uploads\/2024\/11\/doc-dr-mehmet-salih-iyikesici.webp\" class=\"attachment-post-thumbnail size-post-thumbnail wp-post-image\" alt=\"Assoc. Prof. Dr. Mehmet Salih \u0130yikesici - Medical Oncologist\" srcset=\"https:\/\/oncomsi.com\/wp-content\/uploads\/2024\/11\/doc-dr-mehmet-salih-iyikesici.webp 1214w, https:\/\/oncomsi.com\/wp-content\/uploads\/2024\/11\/doc-dr-mehmet-salih-iyikesici-231x300.webp 231w, https:\/\/oncomsi.com\/wp-content\/uploads\/2024\/11\/doc-dr-mehmet-salih-iyikesici-787x1024.webp 787w, https:\/\/oncomsi.com\/wp-content\/uploads\/2024\/11\/doc-dr-mehmet-salih-iyikesici-768x999.webp 768w, https:\/\/oncomsi.com\/wp-content\/uploads\/2024\/11\/doc-dr-mehmet-salih-iyikesici-1181x1536.webp 1181w, https:\/\/oncomsi.com\/wp-content\/uploads\/2024\/11\/doc-dr-mehmet-salih-iyikesici-600x780.webp 600w\" sizes=\"(max-width: 1214px) 100vw, 1214px\" \/>          <\/div>\n                        <div class=\"team-desc\">\n                            <span>Medical Oncologist<\/span>\n                        <p class=\"h4\"><a href=\"https:\/\/oncomsi.com\/en\/team\/assoc-prof-dr-mehmet-salih-iyikesici\/\">Assoc. Prof. Dr. Mehmet Salih \u0130yikesici<\/a><\/p>\n                        \n                        <ul class=\"list-unstyled team-media\">\n                <li><i class=\"bi bi-telephone-outbound\"><\/i><a href=\"tel:+90 212 385 31 00\">+90 212 385 31 00<\/a>\n                <\/li>\n                <li><i class=\"bi bi-envelope\"><\/i><a href=\"mailto:info@oncomsi.com\">info@oncomsi.com<\/a>\n                <\/li>\n                <\/ul>\n                <ul class=\"team-social-icon list-inline mb-0\">\n                <li><a href=\"https:\/\/www.instagram.com\/oncomsi.oncologycenter\" rel=\"nofollow noopener\" target=\"_blank\"><i class=\"flaticon-instagram\"><\/i><\/a>\n                <\/li>\n                <li><a href=\"https:\/\/www.youtube.com\/@oncomsi\" rel=\"nofollow noopener\" target=\"_blank\"><i class=\"bi bi-youtube\"><\/i><\/a>\n                <\/li>\n                <li><a href=\"https:\/\/www.facebook.com\/oncomsi.oncologycenter\" rel=\"nofollow noopener\" target=\"_blank\"><i class=\"flaticon-facebook-app-symbol\"><\/i><\/a>\n                <\/li>\n                <li><a href=\"https:\/\/www.linkedin.com\/company\/oncomsi\/\" rel=\"nofollow noopener\" target=\"_blank\"><i class=\"flaticon-linkedin\"><\/i><\/a>\n                <\/li>\n                <\/ul>\n                        <\/div>\n        <\/div>\n                \n          <\/div>\n                       <\/div>\n        \n     <\/div>\n         \n        \t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Explore ONCOMSI\u2019s approach to combining low-dose chemotherapy with metabolic and supportive interventions. Learn about MCOT\u2019s components, the available scientific evidence, and how individual suitability is assessed.<\/p>\n","protected":false},"featured_media":7191,"parent":0,"comment_status":"open","ping_status":"closed","template":"","tedavi-kategorileri":[108],"class_list":["post-7610","services","type-services","status-publish","has-post-thumbnail","hentry","tedavi-kategorileri-treatment-protocols"],"acf":[],"_links":{"self":[{"href":"https:\/\/oncomsi.com\/en\/wp-json\/wp\/v2\/services\/7610","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/oncomsi.com\/en\/wp-json\/wp\/v2\/services"}],"about":[{"href":"https:\/\/oncomsi.com\/en\/wp-json\/wp\/v2\/types\/services"}],"replies":[{"embeddable":true,"href":"https:\/\/oncomsi.com\/en\/wp-json\/wp\/v2\/comments?post=7610"}],"version-history":[{"count":11,"href":"https:\/\/oncomsi.com\/en\/wp-json\/wp\/v2\/services\/7610\/revisions"}],"predecessor-version":[{"id":8044,"href":"https:\/\/oncomsi.com\/en\/wp-json\/wp\/v2\/services\/7610\/revisions\/8044"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/oncomsi.com\/en\/wp-json\/wp\/v2\/media\/7191"}],"wp:attachment":[{"href":"https:\/\/oncomsi.com\/en\/wp-json\/wp\/v2\/media?parent=7610"}],"wp:term":[{"taxonomy":"tedavi-kategorileri","embeddable":true,"href":"https:\/\/oncomsi.com\/en\/wp-json\/wp\/v2\/tedavi-kategorileri?post=7610"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}