Bladder Cancer natural and alternative treatment and prevention, vitamins, herbs, and supplements that may help
September 23 2018 by
Ray Sahelian, M.D.

Bladder cancer is the fourth and eighth most common cancer in men and women in the United States, respectively. Bladder cancer afflicts more than 60,000 Americans annually. Bladder cancer is quite common in the U.S., representing about 6 percent of all new cancer cases among men and 2 percent among women. This condition affected 70,000 people in 2017 in the United States and killed 15,000, according to the National Cancer Institute. It is more likely to affect men.

Natural ways to reduce incidence or prevent occurrence
While natural methods may be of some benefit, this path should not be taken as an alternative to the benefits that modern medicine offers. Surgery and chemotherapy should be seriously considered.

Avoid spending too much time in an pool or Jacuzzi. the high chlorine content can seep through the skin or be inhaled through the lungs. Chlorine is a known cause in bladder cancer.

An increase in intake from animal protein, especially processed meats, is associated with a higher risk of developing BC while an increase in energy from plant protein intake is associated with a lower risk.

While most people know that smoking can cause lung cancer, few know that it is a major risk factor for bladder cancer, too.

Drink bottled water instead of tap water. Many municipalities have water that has chlorine or chloramine, which increase the risk for bladder cancer.
   Am J Epidemiol. 1993. Case-control study of bladder cancer and water disinfection methods in Colorado.
   Mutat Res. 2007. Occurrence, genotoxicity, and carcinogenicity of regulated and emerging disinfection by-products in drinking water: a review and roadmap for research. Disinfection by-products (DBPs) are formed when disinfectants (chlorine, ozone, chlorine dioxide, or chloramines) react with naturally occurring organic matter, anthropogenic contaminants, bromide, and iodide during the production of drinking water. A recent epidemiologic study found that much of the risk for bladder cancer associated with drinking water was associated with three factors: THM levels, showering / bathing / swimming / jaccuzi (i.e., dermal / inhalation exposure), and genotype (having the GSTT1-1 gene). This finding, along with mechanistic studies, highlights the emerging importance of dermal/inhalation exposure to the THMs, or possibly other DBPs, for drinking-water-associated bladder cancer.
   J Epidemiol Community Health. 2003. Meta-analysis of studies on individual consumption of chlorinated drinking water and bladder cancer. Long term consumption of chlorinated drinking water is associated with bladder cancer, particularly in men.

Foods, diet and bladder cancer
Eating broccoli may help prevent or slow the spread of bladder cancer. Working in the laboratory, U.S. researchers found that certain compounds in broccoli appear to interfere with bladder cancer cells -- especially aggressive cells that tend to spread quickly around the body. These results are very preliminary, and it's too early to determine, for instance, how much broccoli people need to eat to get this benefit. Previous research has shown that men who eat broccoli regularly are less likely to develop bladder cancer, which kills more than 13,000 Americans each year. Broccoli and other cruciferous vegetables contain substances that morph into isothiocyanates, which research suggests may fight cancer. Glucosinolates in broccoli -- when chopped, chewed and digested -- turn into compounds called isothiocyanates that are believed to help fight bladder cancer. Whether a
Broccoli Sprouts supplement is as well as eating the vegetable is not clear at this time.

Substances found in cruciferous vegetables, like broccoli and cauliflower, may help protect people from bladder cancer, especially if eaten raw. People who consumed the most of these substances, called isothiocyanates (ITCs), had a lower risk of the disease than those who consumed the least. Studies in animals have found ITCs prevent tumor growth, while epidemiological studies suggest they may lower lung and colon cancer risk. International Journal of Cancer, 2007.

Cancer Epidemiol Biomarkers Prev. 2010. Intake of cruciferous vegetables modifies bladder cancer survival. Considering the strong preclinical evidence, intake of broccoli may improve bladder cancer survival.

Diets rich in selenium reduce the risk.

J Nutr. 2013. Fruit and Vegetable Intakes Are Associated with Lower Risk of Bladder Cancer among Women in the Multiethnic Cohort Study.

Dietary supplements
There are quite a number of nutrients, herbs and extracts that have been found, mostly in lab studies as opposed to human clinical trials, to have anti bladder cancer potential. It is difficult to know how much to take and in what combinations.

BJU Int. 2013. Complementary and alternative medicine (CAM) in prostate and bladder cancer. Initial clinical studies of pomegranate and green tea, investigating their chemotherapeutic properties in prostate and bladder cancer have yielded encouraging results. Curcumin, resveratrol, and silibinin have potential anticancer properties through multiple molecular targets; their clinical effectiveness in prostate and bladder cancer is yet to be evaluated. Zyflamend, like PC-SPES, is a combined CAM therapy used in prostate cancer. Conclusive evidence for the use of CAM in prostate and bladder cancer is lacking and not without risk.

Acai berry
Plant Foods Hum Nutr. 2012. Inhibition of mouse urinary bladder carcinogenesis by açai fruit intake.

Boswellia herb
Integr Cancer Ther. 2017. Cancer Chemopreventive Effects of Boswellia sacra Gum Resin Hydrodistillates on Invasive Urothelial Cell Carcinoma: Report of a Case. A 52-year-old Hispanic male presented with hematuria and was later diagnosed with a large invasive high-grade urothelial cell carcinoma (UCC) of the urinary bladder, but with ambiguous pT1/pT2 staging regarding musclaris propria invasion by UCC. The conventional treatment including radical cystoprostatectomy followed by neoadjuvant chemotherapy with or without radiation therapy was presented. The patient decided to delay the standard therapy until a later stage, but elected to go through transurethral resection of bladder tumor (TURBT) without Bacillus Calmette-Guérin instillation. Following TURBT, the patient started oral Boswellia sacra gum resin (aka frankincense or Ru Xiang in Chinese) hydrodistillates (BSGRH) administration at 3 mL daily with lifestyle changes, and continued this regimen in the last 25 months. Within the first year after diagnosis, the patient experienced 2 recurrences. Recurrent tumors were removed by TURBT alone and both tumors were far smaller than the original one. After the second recurrence, the patient has no detectible cancer in the bladder based on cystoscopy for 14 months and has an intact genitourinary system. His liver and kidney functions are considered to be normal based on blood chemistry tests. This index case suggests that BSGRH may have cancer chemopreventive effects on UCC.

Although residual confounding by smoking or other factors cannot be excluded, higher concentrations of plasma carotenoids may reduce risk of urothelial cell carcinoma, in particular aggressive UCC. Higher plasma lutein concentrations may reduce risk of nonaggressive urothelial cell carcinoma.

Curcumin and turmeric
Are Curcumin longa / Tumeric and Wasabi powder and Frankinsense useful to prevent or treat bladder cancer? And if so, what would be the optimal amount dosage to take and in what form?
   A. Here are a few studies that I found:

Anticancer Drugs. 2006. Apoptosis-inducing effects of curcumin derivatives in human bladder cancer cells.

Cancer Res. 2009. Curcumin potentiates the antitumor effects of Bacillus Calmette-Guerin against bladder cancer through the downregulation of NF-kappaB and upregulation of TRAIL receptors.

Biomed Res Int. 2014. Bladder cancer and urothelial impairment: the role of TRPV1 as potential drug target. Curcumin, reported to potentiate the effects of the chemotherapeutic agents used in the management of recurrent urothelial cancer in vitro and also identified as one of several compounds to own the vanillyl structure required to work like a TRPV1 agonist, could be thought as complementary in the clinical management of both the recurrences and the inflammatory effects caused by the endoscopic resection or intravesical chemotherapy administration or could be combined with adjuvant agents to potentiate their antitumoral effect.

Eur Rev Med Pharmacol Sci. 2017. The effect of curcumin on bladder tumor in rat model. Curcumin can inhibit the growth and invasion of rat bladder cancer cells, possibly through the arresting of G1/S transition and subsequently increased apoptosis.

J Drug Target. 2017. Curcumin inhibits urothelial tumor development by suppressing IGF2 and IGF2-mediated PI3K/AKT/mTOR signaling pathway. We report that curcumin inhibits urothelial tumor development by suppressing IGF2 and IGF2-mediated PI3K/AKT/mTOR signaling pathway.

Oncol Lett. 2017. Antitumor effects of curcumin in human bladder cancer in vitro. We tested the effects of curcumin on cell growth, apoptosis and migration of bladder cancer cell lines. The present study confirmed that curcumin is able to inhibit cell migration and promote apoptosis of bladder cancer through suppression of matrix metalloproteinase signaling pathways in vitro. The anticancer effects of curcumin on bladder cancer cells may benefit clinical practice in the future.

Biochem Biophys Res Commun. 2017. Curcumin inhibits bladder cancer stem cells by suppressing Sonic Hedgehog pathway.

Tumour Biol. 2017. Curcumin inhibits bladder cancer progression via regulation of β-catenin expression.

Diindoylmethane or DIM
Pathol Oncol Res. 2016. Diindolylmethane and Lupeol Modulate Apoptosis and Cell Proliferation in N-Butyl-N-(4-Hydroxybutyl) Nitrosamine Initiated and Dimethylarsinic Acid Promoted rat Bladder Carcinogenesis.

Flavonoids and bladder Cancer
Flavonoid phytochemicals are being studied for both prevent ion and therapy of various human malignancies including bladder cancer. One such naturally occurring flavonoid is silibinin isolated from milk thistle.
Cigarette smoking is confirmed as a risk factor for bladder cancer.

Expert Rev Clin Pharmacol. 2016. Silibinin: a potential old drug for cancer therapy. Silibinin is mixture of flavonolignans extracted from milk thistle and often has been used in the treatment of acute and chronic liver disorders caused by toxins, drug, alcohol and hepatitis and gall bladder disorders for its antioxidant and hepatoprotective properties. Silymarin may function diversely and may serve as a novel therapy for cancer therapy, such as lung cancer, prostatic cancer, colon cancer, breast cancer, bladder cancer and hepatocellular carcinoma by regulating cancer cells growth, proliferation, apoptosis, angiogenesis and many other mechanism.

Garlic could be of benefit
Environ Toxicol Pharmacol. 2014. Diallyl trisulfide-induced apoptosis of bladder cancer cells is caspase-dependent. Diallyl trisulfide is one of the major organosulfur components of garlic (Allium sativum), which inhibits the proliferation of various cancer cells.

Grape seed extract with proanthocyanidins
J Cancer. 2012. Additively enhanced antiproliferative effect of interferon combined with proanthocyanidin on bladder cancer cells. Our findings support the notion that combination of IFN-α(2b) and grape seed extract is capable of additively enhancing antiproliferative effect on T24 cells with a G(1) cell cycle arrest, implying an adjuvant therapeutic modality for superficial bladder cancer.

Eur Rev Med Pharmacol Sci. 2016. Induction of cell cycle arrest and apoptosis by grape seed procyanidin extract in human bladder cancer BIU87 cells.

Green tea may be of benefit
Green Tea Extract
may interfere with a process that helps early bladder cancer to spread throughout the body. The findings bolster ongoing studies into green tea extract as a cancer treatment -- and may give green tea drinkers more reason to savor every cup. The investigators found that when they exposed human bladder cells to both a cancer-causing chemical and green tea extract, the extract interfered with a particular process by which early cancer cells become invasive and spread throughout body tissue. This process involves the "remodeling" of actin, a structural protein in cells that is essential for cell movement. Actin remodeling allows cancer cells to move and invade nearby healthy tissue. Based on the new findings, green tea extract may get in the way of this process by activating a protein known as Rho, which helps regulate actin's organization in cells and has been implicated in tumor development and progression.

Exp Ther Med. 2017. Epigallocatechin gallate inhibits the growth and promotes the apoptosis of bladder cancer cells.

Curr Urol. 2013. In vitro regulation of cell growth and angiogenesis by inositol hexaphosphate in bladder cancer. In vitro treatment of bladder cancer with the common dietary polyphosphorylated carbohydrate IP6 significantly decreased cellular growth by anti-angiogenic mechanisms.

Nutr Cancer. 2013. The effect of gartanin, a naturally occurring xanthone in mangosteen juice, on the mTOR pathway, autophagy, apoptosis, and the growth of human urinary bladder cancer cell lines. We demonstrate that mangosteen xanthones (i.e., gartanin and α-mangostin) at pharmacologically achievable concentrations inhibit the growth of cancer cell lines from different stages of human urinary bladder cancer.

Melatonin, pineal gland hormone
Int J Oncol. 2017. Melatonin potentiates the antitumor effect of curcumin by inhibiting IKKβ/NF-κB/COX-2 signaling pathway. Melatonin synergized the inhibitory effect of curcumin against the growth of bladder cancer by enhancing the anti-proliferation, anti-migration, and pro-apoptotic activities. Combined treatment with curcumin and melatonin might exhibit an effective therapeutic option in bladder cancer therapy.

Mistletoe extract
Perm J. 2015. High-Dose Viscum album Extract Treatment in the Prevention of Recurrent Bladder Cancer: A Retrospective Case Series. High-dose Viscum album treatment may have interrupted frequently recurring tumors in individual patients with recurrent bladder cancer. Prospective studies are needed to assess whether this treatment offers an additional, bladder-sparing preventive option for patients with intermediate- to high-risk nonmuscle-invasive bladder cancer. Treatment was generally well tolerated and no patient stopped treatment because of side effects.

After surgery for superficial bladder cancer, treatment with a mistletoe extract appears to be effective at reducing tumor recurrence. Mistletoe extracts have been shown to act favorably on proteins that affect cancer and have been widely used for many years as alternative therapy in patients with malignancies. In the current study, 30 patients with superficial bladder carcinoma received six weekly instillations of a standardized water-based mistletoe extract beginning about 4 weeks after surgery. The treatment was well tolerated at all concentrations and there were no reports of side effects. At 12 months, nine tumors had recurred. In the 24 patients with so-called pTa G2 and pT1 G2 tumors, the recurrence rate was 33 percent, comparable to the recurrence rate in similar historical controls treated with BCG, the investigators point out.

Mushrooms and extracts
Altern Med Rev. 2007. Effect of various natural products on growth of bladder cancer cells: two promising mushroom extracts. Eight commercially available natural products were tested for possible effects on the growth of human bladder cancer T24 cells. This study demonstrated that two maitake mushroom extracts, GD- and PL-fractions, induced a significant (>90 percent) growth reduction in 72 hours, whereas the remaining six products had no effect. Interestingly, non-toxic concentrations of the GD- or PL-fractions, when combined with a non-toxic concentration of vitamin C, became highly cytotoxic, resulting in >90-percent cell death. Thus, vitamin C appears to act synergistically with these fractions to potentiate their bioactivity (cytotoxicity). No other products tested demonstrated such a synergistic potentiation with vitamin C. The present study indicates that GD- and PL-fractions appear to have the most potent cytotoxic effect on human bladder cancer T24 cells. It is thus plausible that these substances could be used, solely or combined with conventional modalities, for the treatment of superficial bladder cancer.

BJU Int. 2010. Synergistic potentiation of interferon activity with maitake mushroom d-fraction on bladder cancer cells.

Int J Gen Med. 2009. Possible disease remission in patient with invasive bladder cancer with D-fraction regimen. Superficial bladder tumors are the most prevalent form of bladder cancers and transurethral resection is the primary surgical modality for those tumors. However, nearly 65% of patients will have tumor recurrence in five years while about 15% will have progression to muscle invasion. The primary therapeutic aim is to prevent multiple recurrences and progression to a more advanced disease. We report an 87-year-old white male patient with invasive bladder cancer who received an unconventional oral regimen of D-fraction, the bioactive extract of Maitake mushroom (Grifola frondosa), following endoscopic transurethral resection of bladder tumor. Despite a high risk for disease recurrence, follow-up yet indicated no clinical evidence of progression of residual disease or recurrence of invasive cancer. It has been nearly two years but the patient remains remarkably well and appears to be in remission. To our knowledge, this is the first and only case report of possible disease remission in a bladder cancer patient after the two-year follow-up of D-fraction regimen

Cancer Lett. 2004 Ganoderma lucidum extracts (Reishi) inhibit growth and induce actin polymerization in bladder cancer cells in vitro.

Pomegranate fruit or extract
BMC Complement Altern Med. 2013. Suppression of urinary bladder urothelial carcinoma cell by the ethanol extract of pomegranate fruit through cell cycle arrest and apoptosis.

Phytother Res. 2015. Anti-proliferative effects of polyphenols from pomegranate rind (Punica granatum) on EJ bladder cancer cells via regulation of p53/miR-34a axis.

J Environ Sci Health A Tox Hazard Subst Environ Eng. 2016. Chemotherapeutic potential of quercetin on human bladder cancer cells. Our study suggests that quercetin could inhibit cell proliferation and colony formation of human bladder cancer cells by inducing DNA damage and that quercetin may be an effective chemopreventive and chemotherapeutic agent for papillary urothelial bladder cancer after transurethral resection.

Oncol Lett. 2018. Anticancer effect of salidroside reduces viability through autophagy/PI3K/Akt and MMP-9 signaling pathways in human bladder cancer cells. Salidroside, found in the herb rhodiola, reduced the viability and induced the apoptosis of bladder cancer cells through the autophagy/PI3K/Akt and MMP-9 signaling pathways.

Soy isoflavones
Cancer Epidemiol Biomarkers Prev. 2018. Soy isoflavone intake and bladder cancer risk in Japan: From the Takayama study. A significant decreased risk of bladder cancer was observed among men who had higher intakes of total soy and isoflavones.

Vitamin C
Clin Epigenetics. 2018. Vitamin C increases 5-hydroxymethylcytosine level and inhibits the growth of bladder cancer.

Vitamin D
Low vitamin D levels may increase the risk of bladder cancer, the study was presented November 2016 at the annual meeting of the Society for Endocrinology, in Brighton, England.

Dermatoendocrinol. 2016. Solar radiation and the incidence and mortality of leading invasive cancers in the United States. Cancer mortality for all invasive cancers was not significantly associated with solar radiation, but for 7 of 22 leading cancers, including cancers of the uterus, leukemias, lung, ovary, and urinary bladder, increased solar radiation predicted decreased mortality.

Korean herbal medicine
Case Rep Oncol. 2014. A case of metastatic bladder cancer in both lungs treated with korean medicine therapy alone.Lee DH1, Kim SS1, Seong S1, Woo CR1, Han JB2.Author informationAbstractThis case report is aimed to investigate the effects of Korean medicine therapy (KMT) including oral herbal medicine and herb nebulizer therapy in treating metastatic bladder cancer in the lungs. A 74-year-old man was diagnosed with metastatic bladder cancer in both lungs in August 2013. He refused any chemotherapy and was admitted to our hospital in a much progressed state on January 11, 2014. Since then, he was treated with KMT until May 17, 2014. The main oral herbal medicines were Hyunamdan made of heat-processed ginseng, Hangamdan S made of Cordyceps militaris, Panax ginseng radix, Commiphora myrrha, calculus bovis, margarita, Boswellia carteri, Panax notoginseng radix and Cremastra appendiculata tuber, and nebulizer therapy with Soram nebulizer solution made of wild ginseng and Cordyceps sinensis distillate. Their effect was evaluated considering the change of the main symptoms and using serial chest X-ray. The size and number of multiple metastatic nodules in both lungs were markedly decreased and the symptoms had disappeared. These results suggest that KMT can be an effective method to treat metastatic bladder cancer in the lungs.

The symptoms for bladder cancer are not specific. Many other diseases, including inflammatory conditions, involving the bladder and kidney may cause similar symptoms. However, early detection is important in curing bladder cancer. The most common first symptom of bladder cancer is blood in the urine called hematuria, either visible or microscopic. Gross hematuria describes urine that appears red or brown and can be seen with the naked eye. Microscopic hematuria means the red blood cells are visible if a urine sample is examined under a microscope. Other symptoms and signs of of bladder cancer include pain and burning on urination, a sense of incomplete emptying of the bladder after urination and having to urinate more frequently or at shorter intervals. These symptoms could also indicate problems (less serious) other than bladder cancer such as an infection.

Bladder Cancer Urine test
A urine test can detect bladder cancer early and may be especially useful for smokers and others prone to the disease. The test for the enzyme telomerase in urine was found to be accurate 90 percent of the time in men, after the cancer diagnoses were confirmed with standard invasive examinations of the bladder and urinary tract. The test also detected the disease in early stages.

Cause of Bladder Cancer
Eur J Epidemiol. 2016. Modifiable risk factors for the prevention of bladder cancer: a systematic review of meta-analyses. Note: if RR is higher than one, then there is more risk. If the RR is less than one, then it is protective. Statistically significant associations were found for current (RR 3.14) or former (RR 1.83) cigarette smoking, pipe (1.9) or cigar (2.3) smoking, antioxidant supplementation (1.52), obesity (1.10), higher physical activity levels (0.86), higher body levels of selenium (0.61) and vitamin D (0.75), and higher intakes of: processed meat (1.22), vitamin A (0.82), vitamin E (0.82), folate (0.84), fruit (0.77), vegetables (0.83), citrus fruit (0.85), and cruciferous vegetables (0.84). Finally, three occupations with the highest risk were tobacco workers (1.72), dye workers (1.58), and chimney sweeps (1.53). The combined probability of causation was 81.8 %. Modification of lifestyle and occupational exposures can considerably reduce the bladder cancer burden. While smoking remains one of the key risk factors, also several diet-related and occupational factors are very relevant.

Marijuana has been shown to potentially cause bladder cancer if used in high doses on a regular basis.

Studies have found higher rates among people in various occupations, including hairdressers, textile workers, truck drivers and workers in the rubber, leather and chemical industries. It's thought that long-term chemical exposures are to blame.

Chlorinated water exposure through drinking, swimming pools or baths can increase the risk for bladder cancer.

When bladder cancer occurs in patients previously diagnosed with prostate cancer, it tends to be of higher grade among patients who were treated with radiation compared to those not treated with radiation.

EU regulators said in 2006 they would ban 22 substances from use in hair dyes in the European Union. The EU's Scientific Committee on Consumer Products (SCCP) said at the end of 2002 that there was epidemiological evidence indicating that the regular and long-term use of hair dyes by women may be associated with the development of bladder cancer. The SCCP called for an overall safety assessment strategy for hair dyes including testing hair dye cosmetic ingredients for their potential genotoxicity or mutagenicity. The European Commission therefore asked hair dye producers to prove the substances they used did not pose bladder cancer risk or other health risk and the industry submitted such safety files on 115 substances in use. The ban by the Commission, the EU's executive, concerns 22 hair dye substances for which industry has not submitted any safety files.

Gonorrhea, a common sexually transmitted infection, can increase the risk of bladder cancer in men.

Women who are relatively young when they go through menopause seem to be at increased risk of developing bladder cancer.

Nitrosamines are chemical compounds which are cancer causing. The same chemicals that paint your hot dogs pink and keep botulism out of your bologna could also raise your risk. Cancer, 2010.

Smoking, and Hormones
Menopausal status as well as age at menopause may modify the risk of women developing bladder cancer. The risk in men is greater than that in women. Hormonal factors may be involved because gender differences in cigarette smoking patterns, occupational exposures and other differences in known risk factor distributions cannot explain the excess bladder cancer observed for males. There is a significant increase in bladder cancer risk with earlier menopause (age 45 years or less) compared with later menopause (age 50 years or more). The drop in estrogen levels with menopause has been associated with bladder dysfunction and frequent urinary tract infections. It may be that women who experience early menopause are at an increased risk of bladder cancer because they have recurrent urinary tract infections and concurrent inflammation starting at an earlier age. Because inflammation and cigarette smoking are likely to act together to increase risk, this hypothesis would also explain the strong interaction with smoking. Source: American Journal of Epidemiology, 2006.

Medical and surgical treatment
Patients who get more intensive treatment for early bladder cancer do not improve any better than patients who get less treatment. Medicare spent more than twice as much on the intensively managed patients without improving their survival rates. Dr. Brent Hollenbeck of the University of Michigan used federal data on 20,700 Medicare patients diagnosed with early bladder cancer between 1992 and 2002 by different doctors, mostly urologists. Treatment can include surgery, chemotherapy, radiation therapy and infusion of BCG, the bacteria used to vaccinate against tuberculosis. The doctors in the group that gave most care also spent the most -- $7,000 on average. Those who gave the least care billed only $2,800 on average. "Simply put, urologists who treat aggressively early are likely to provide aggressive treatment in all aspects of bladder cancer care, and vice versa," Dr. Brent Hollenbeck and his fellow researchers wrote. "More intensive treatment was not associated with better overall survival. Patients who underwent more intensive early treatment were more likely to undergo major interventions later," they added. Journal of the National Cancer Institute, 2009.

Chemotherapy for bladder cancer
The standard treatment is MVAC given every two or three weeks. MVAC stands for Methotrexate, Vincristine, Adriamycin, and Cisplatin. The day after chemo many oncologists recommend giving a white blood cell stimulating drug called Zarxio or Neupogen. Common side effects with Zargio include increased body temperature and bone pain. Some people claim that taking Claritin a couple of hours before the Zarxio injection reduces the side effects.

Cancer Radiother. 2018. Trimodalities for bladder cancer in elderly: Transurethral resection, hypofractionated radiotherapy and gemcitabine. Thirty-one patients were enrolled, age ≥65years, diagnosed with transitional cell carcinoma of the urinary bladder, after a maximum safe transurethral resection of a bladder tumour. They received 52.5Gy in 20 fractions using 3D conformal radiotherapy with concurrent 100mg/m2 gemcitabine weekly as a radiosensitizer. Twenty-five patients (80%) achieved a complete response. At 2-years, overall survival was 94% and disease-free survival was 72%. T3 and residual after transurethral resection are factors that adversely affect disease-free survival. Hypofractionated radiotherapy and gemcitabine as a radiosensitizer in elderly as organ preservation for transitional cell carcinoma bladder cancer have acceptable toxicity profile with good response rate and disease-free survival, keeping salvage cystectomy for persistence or recurrence of invasive cancer.

Onco Targets Ther. 2018. The efficacy and safety of intravesical gemcitabine vs Bacille Calmette-Guérin for adjuvant treatment of non-muscle invasive bladder cancer: a meta-analysis. Intravesicular gemcitabine may have similar efficacy and lower incidence of dysuria and hematuria compared with BCG.

Send to Biomed Pharmacother. 2018. Synergistic antitumour effects of triptolide plus gemcitabine in bladder cancer.

Mol Immunol. 2018. Physical exercise contributes to cisplatin-induced nephrotoxicity protection with decreased CD4+ T cells activation.

Diagnosis of lymph node metastases
World J Urol. 2018. Comparative sensitivity and specificity of imaging modalities in staging bladder cancer prior to radical cystectomy: a systematic review and meta-analysis. The detection of lymph node metastases in bladder cancer has a significant impact on treatment decisions. Multiple imaging modalities are available to clinicians including magnetic resonance imaging, computed tomography and positron emission tomography. MRI and PET/CT provide superior sensitivity compared to CT for detection of positive lymph nodes in bladder cancer prior to cystectomy.

Urine Ph, acidic or alkaline foods
Can J Urol. 2018. Urinary pH and the risk of recurrence in patients with non-muscle invasive bladder cancer. There was no association between urine pH and risk of tumor recurrence, regardless of smoking status.

Q. My Brother-in-law has Stage IV bladder cancer. I would like to get more information about natural treatment. Currently he is under treatment at Kaiser – Walnut Creek, California.
   A. I will update this article over time.

In 2008 my urologist removed a tumor via laser, prognosis was transitional cell carcinoma of the bladder, grade 3. I will be 89 years of age in November 2010. The tumor which was relatively small was in a diverticular of which I have three of in my bladder. March, 2009, first intravesical treatment with mitomycin c, April 2009 second intravesical treatment with mitomyin c May, 2009, third intravesical treatment with mitiomycin c, July, 2009, fourth, intravesical treatment with mitiomycin c, August 2009, fifth intravesical treatment with mitomycin c, October, 2009 sixth, intravesical treatment with mitio Asmycin c, I experienced a great deal of fatigue and some irritation during and after the therapy. My urologist claimed that the chemotherapy was not that invasive. I feel differently. I can only play nine holes of golf because fatigue sets in fast. I get very tired just doing things around the house. I do 20 minutes on the NordicTrack four times a week plus other exercises. I quit smoking 25 years ago. No further treatments until February of 2010 at which time I received another treatment and experienced much irritation in the bladder which was verified by a cystoscope examination. No further chemo has been administered since then. Scope examination in May revealed no evidence of a tumor but the he recommended additional treatment commencing in August, I have some reservations about doing so, especially after reading her book and reading the opinions of so many doctors she consulted in the book. My diet is exceptionally good and has been for many years, 80 ounces of water a day, juicing three times a week, salmon or other fish most of the time, with plenty of vegetables. breakfast consists of oatmeal with raw wheat germ and flax with 4 fresh fruits. I do take a myriad of vitamins. I would really appreciate hearing from you , as I would like to prevent the re-occurrence of the tumor with out chemotherapy. I just started using sun chlorella hoping that additional supplements and a strict good diet would prevent the re-occurrence of the tumor.