Q: For stage 4 it recommends DCA to be taken constantly. Does this mean without breaks? For how long? I'd guess until markers are normal and there is no need to continue. Or do you recommend continuing as a preventative? Please clarify. Thanks, Dana A: Dear Dana, it means that you still need to take breaks, otherwise peripheral neuropathy can ''kick-in" more swiftly and prevent you from using DCA for cancer prevention as soon as you‘re in remission. If one has stage IV cancer, the treatments that are given by the oncologist should also be continued. Most of the time, it will be chemotherapy, target therapy or immunotherapy. DCA goes well with most of these treatments, however, it goes especially well with target therapy and immunotherapy. A lot of cancers develop some sort of resistance to chemotherapy after its given frequently. Please understand that the main goal of treating stage IV cancer is transforming it into a chronic disease and prevent it from causing further harm through metastastis and growth. To achieve this, someone with stage IV cancer should constantly take some kind of anti-cancer treatment and monitor his health as well as tumors as a routine. Therefore, take DCA as a single agent or in combination with other methods to prevent cancer from spreading and getting larger. This means taking it for the rest of your life. Sometimes you develop any side effects such as peripheral neuropathy, which will make you to take a pause until they resolve. After they‘re gone, resume the DCA protocol. Cancer markers are one of the main ways to follow the progress / regress of the tumor advancement. The most accurate tumor markers that correlate with the size of the tumor are – 1) CA-125 (for ovarian cancer), 2) PSA (for prostate cancer) and 3) CEA (for colon cancer). You can repeat them every 3 months to see how well is the cancer responding to treatment. If they drop, it means that the malignancy is shrinking. One must also have imaging scans performed, to see if tumors are decreasing or increasing in size and to make sure if all the metastasis are gone. If you achieve remission, you can lower your DCA doses. DCA can be used as a preventative for cancer relapse if desired. Most of the cases take in doses lower than before, at least 50-80 % of the original dose that helped you achieve remission. Don’t forget that you can combine DCA with other natural methods or regimens that prevent cancer.