Introduction
Supplements are a major magnet for cancer patients, many of whom want to either enhance their therapy or are looking for the 'magic bullet' when their conventional treatment begins to fail.  While there may be a supplement (or supplements) that will arise in the future that will greatly enhance survival, very little clinical trials are done on them because they are not profitable to the large pharmacutical companies.

One such supplement that may have promise is called Coenzyme Q10 (also commonly known as CoQ₁₀ and Vitamin Q10) which was discovered by Dr. Frederick Crane, a plant physiologist at the University of Wisconsin Enzyme Institute, in 1957 ¹.  This coenzyme⁶ is found all over your body but in greater concentrations in the heart, liver and lungs.  It is an important antioxidant in both mitochondria and lipid membranes, where it protects our cells in their battle against the destructive effects of free radicals⁷.

It was not until a widely talked about study by Knud Lockwood, M.D., a cancer specialist in Copenhagen, Denmark, talked about how CoQ10 supplementation (along with some other supplements) had a remarkable effect on his breast cancer patients.  All of his patients in this study had a 100% survival rate along with those, who at higher concentrations, had complete tumor disappearance.  This in light that he expected 4 of these patients not to live and after 24 months 6 should not have lived.⁸

The coenzyme has even shown to be benificial when used with certain chemotherapy agents; although studies on others have not been done there may be similar benefits and activity.

How Does It Work?

It is believed that CoQ10 acts in several ways mainly as an antioxidant (uses oxygen more effectively), stimulates the heart, and stimulates the immune system (believed to raise antibody levels especially IgG and T4-lymphocytes¹⁵)¹⁶.

How Does CoQ10 Assist in Ovarian Cancer Treatment?

The simple answer is we don't know for sure because it has not been the focus of any trials, studies, or research.  The more 'famous' cancers such as breast and prostate have taken up much of the CoQ10 studies.  Because of this, we can explain what they have done with these cancers (which are also estrogen receptive like ovarian and may be similar in some aspects) to see if they may have in impact on Ovarian Cancer. 

Can Be Used With Chemotherapy

• Use with Doxorubicin (or Doxil): There is plenty of research showing that CoQ10 may prevent heart damage by the cheotherapy drug doxorubicin (of which Doxil, a popular ovarian cancer chemotherapy, has in it) ^2,3,4.  We can assume from this that it may possible assist with any chemotherapy that causes heart damage.  For use with doxorubicin, 100 to 200mg (softgel) is recommended ⁵.
  
• Use with Tamoxifen:  CoQ10, when taken with the breast cancer drug Tamoxifen (which is in clincial trials with Ovarian Cancer now), increased the drugs effectiveness.⁸
  
• Possiblly Enhance Survival:  Breast cancer patients who took only 90mg of CoQ10 with other supplements had a 100% survival rate in a Denmark study.  In this study it was expected that 4 patients would have died and in 24 months 6 patients would have died.
  
• Possibly Result in Partial and Complete Regression of Tumors:  In the same Denmark study, 32 'high risk' breast cancer patients taking 90mg of CoQ10 had (as stated above) a 100% survival rate , two patients increased their dosage to 300 or 390mg of CoQ10 and had their tumors disappear.  The study doctor, Knud Lockwood, who has treated some 7,000 cases of breast cancer over 35 years, wrote that until using CoQ10, he had "never seen a spontaneous complete regression of a 1.5-2.0 centimeter breast tumor, and has never seen a comparable regression on any conventional anti-tumor therapy."¹⁴
  
• Excellent Safety Profile:  No serious toxicity has ever been reported with the use of CoQ10, even at the dosages shown in the studies.  In-fact, these patients even reported they had an imporved quality of life.^9,18

Dosage and the Stockholm Protocol

It should first be stated, there is no studies, clinical trials, or reports showing independent use of CoQ10 as a monotherapy (used alone).  Instead all have shown it's use with chemotherapy and/or other supplements.  Although the possibility exists that it may be benificial if used as a monotherapy in certain situations, there is no evidence of this.  So, until such research emerges, it should always be used as adjunct (traditional therapy + supplements) therapy along with your oncologists recommendations.

The dosage that has appeared often in reports, trials, and (pretty much) throughout the internet is 90mg (which supposedly provides sporatic responses) and then 390mg which provides the remarkable responses in these patients ^9,10.  I have heard different ways on how to achieve the 390mg by either taking it as divided doses (the theorey being to keep the CoQ10 in the bloodstream most or all of the time) or at once in one single dosage.

You may not be able to find a '390mg' pill or capsule, in that case you can simply combine one or two to achieve that response.  For example there are 150mg and 200mg pills or even 400mg pills.  It all depends on which dosage you and your oncologist determine is the right way to go.

Stockholm Protocol

Taking supplements in conjunction with CoQ10 seems to be how Dr. Knud Lockwood achieved the responses in his study and called it the Stockholm Protocol which appeared in one of his research papers^10,11.  This protcol consists of the following daily:

• 1.2 grams of Gamma Linolenic Acid
• 3.5 grams of Omega 3 Fatty Acids
• 58 mg (32,248 iu) Beta Carotene 2.8
• Vitamin C 2500 iu
• Vitamin E 385 micro grams
• Selenium 390 mg
• CoQ10

The presence of Omega 3 Fatty acids and vitamin Ebrings up yet another important supplement cancer patients should take.  Although I prefer the 'vegetarian' version of Omega 3 Fatty acids (typically of flakseed), most research shows that it is the fish oil version (with DHA and EPA) is better^12,13.  Although the amounts listed in the protocol are higher than what Dr. Murray suggests in his book, the two seem to have a synergetic effect that helps with severe cachexia of cancer patients, immune status, and survival ¹³.

Conclusion

There is still much research that needs to be done on CoQ10, especially in it's relation to Ovarian Cancer treatment.  It's future as an analog in cancer treatment in general¹⁷ is encouraging and is possibly the only way we can find out it's true benefit through clinical trials.  Ovarian Cancer patients who wish to take CoQ10 to assist their traditional chemotherapy treatment should consult with their oncologist with this (and other) research.  Those who wish to use it when taking heart damaging drugs such as Doxil should also make their oncologist aware of it's benefits to possibly help with the lifetime dose limiting drug. 

A health professional summaryof CoQ10 can be found on the National Cancer Institute website:
http://www.cancer.gov/cancertopics/pdq/cam/coenzymeQ10/HealthProfessional/Page2

Disclaimer

The information provided on this site is for informational purposes only and is not intended as a substitute for advice from your physician or other health care professional or any information contained on or in any product label or packaging. You should not use the information on this site for diagnosis or treatment of any health problem or for prescription of any medication or other treatment. You should consult with a healthcare professional before starting any diet, exercise or supplementation program, before taking any medication, or if you have or suspect you might have a health problem. You should not stop taking any medication without first consulting your physician.

These statements have not been evaluated by the FDA.  These products are not intended to diagnose, treat, cure, or prevent any disease.

References / Citations

¹ http://inventors.about.com/library/inventors/bl_vitamins.htm
² Res Commun Chem Pathol Pharmacol. 1979 Jun;24(3):595-8. (Abstract on PubMed: http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=PubMed&list_uids=451343&dopt=Abstract )
³ Dr. Michael Murray: http://www.doctormurray.com/articles/Chemotherapy.htm
⁴ http://www.annieappleseedproject.org/coq101.html
⁵ Dr. Michael Murray: http://www.doctormurray.com/conditions/Chemotherapy_Support.aspr.
⁶ More on CoQ10 and relation to vitamins: http://en.wikipedia.org/wiki/Coenzyme
⁷ http://en.wikipedia.org/wiki/Coenzyme_Q
⁸ Biochem Biophys Res Commun. 1994 Mar 30;199(3):1504-8 (Abstract on PubMed: http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=16013450 )
⁹ Mol Cell Biochem. 2005 May;273(1-2):151-60. (Abstract on PubMed:
¹⁰ Vol. 199. No. 3, 1994 March 30, 1994 BIOCHEMICAL AND BIOPHYSICAL RESEARCH COMMUNICATION Pages 1504 - 1508 PARTIAL AND COMPLETE REGRESSION OF BREAST CANCER IN PATIENTS IN RELATION TO DOSAGE OF COENZYME Q10 Knud Lockwood Sven Moesgaard Karl Folkers (link to abstract)
¹¹ http://www.cancer-info.com/coq10.htm
¹² http://www.scienceagogo.com/news/20051010003544data_trunc_sys.shtml
¹³ How to Prevent and Treat Cancer with Natural Medicine, Dr. Michael Murray, et.al.
¹⁴ http://www.thenutritionreporter.com/CoenzymeQ10.html
¹⁵ Biochem Biophys Res Commun. 1993 May 28;193(1):88-92 (Abstract on PubMed: http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=8503942 )
¹⁶ http://www.alternativehealth.co.nz/cancer/vitamins/coq10.htm
¹⁷ http://www.cancer.gov/cancertopics/pdq/cam/coenzymeQ10/HealthProfessional/Page2
¹⁸ http://www.cancer.gov/cancertopics/pdq/cam/coenzymeQ10/HealthProfessional/page6