I recently emailed Dr Lamm to ask what I could be doing to help beat Bladder Cancer, besides BCG and a general healthy diet. I am always surprised and elated that he takes time from his very busy life to answer emails. He gave me some great advise and I thought by sharing it, other patients would gain from his vast knowledge and research with Bladder Cancer:
[i]I routinely take a diet history and, on
average, I find that our patients take only 2 servings of fruit or
vegetables a day.
I am very, very impressed by work at UCLA, MD Anderson Cancer Center, the
University of Wisconsin, Columbia and many other prestigeous institutions
that shows that phytochemicals (organic compounds synthesized by plants
after millions of years of evolution) can protect agains DNA damage, the
route cause of cancer. Below is my "short list" of dietary
recommendations for bladder cancer patients. The three items on the top,
I believe, are most important.
Thanks for asking,
Don Lamm, MD
Diet and Lifestyle Considerations for Bladder Cancer Patients
Nutrition plays an important role in the development of cancer. Dietary
factors such as increased fat and animal protein, especially when broiled,
can promote development of cancer, but many foods such as soy, garlic,
cruciferous vegetables, fruits, tea, and even some chocolates have
beneficial ingredients such as antioxidants that may reduce the risk of
cancer. With a healthy diet and life style, which includes regular
exercise and avoidance of carcinogens including tobacco, supplemental
vitamins may not be needed. Many of us, however, may benefit from
supplemental vitamins. Oncovite, two tablets twice a day, is now
recommended for all bladder tumor patients. Diet and lifestyle can also
play a significant role. Here are some suggestions:
I recommend increasing fruit and vegetable consumption to a minimum of 6
servings a day. The vegetarian diet is optimal for reduction of
carcinogens. Some fruits and vegetables may contain more phytochemicals
that protect against cancer than others. Beneficial effects have been
reported for tea, soy, cruciferous vegetables (broccoli, cauliflower,
brussel sprouts), citrus, berries, tomatoes and other red/orange
vegetables, and garlic. Studies show that carcinogenic DNA adducts in the
urine (chemicals that combine with genes to promote cancer) are
significantly reduced with high intake of fruit and vegetables.
Epidemiologic studies suggest that fruit may be especially beneficial in
the prevention of bladder cancer. It is true that cranberry juice can
protect against bladder infection, one of the causes of bladder cancer.
Cranberries and other small dark berries are very high in antioxidants.
Pomegranate juice appears to be very promising in studies of prostate and
other cancers, and may have a role in bladder cancer. There is some
suggestion that green tea, soy and garlic may reduce the risk of bladder
cancer. Many are unable to change their diet and get enough of the
beneficial chemicals (phytochemicals) in plants. A list of health food
supplements is available to help guide your nutritional therapy.
Additional life style/dietary changes may be beneficial in the prevention
of bladder cancer:
It is important to avoid any carcinogen exposure. While epidemiologic
studies have not confirmed the carcinogenicity of artificial sweeteners, I
would recommend avoiding excess use. Anecdotally, some patients with a
history intractable tumor recurrence report remaining tumor free after
discontinuing soft drinks. Second hand smoke, pesticides, diesel fuel and
organic chemical exposure, as well as excessive exposure to dyes should
also be avoided.
Increased intake of water that is free of arsenic, pesticides and other
bladder carcinogens appears to be helpful. Studies by Dr. Michaud and
others show that increased fluid intake reduces the risk of bladder
cancer, but we have not demonstrated an effect yet in reducing recurrence.
We have demonstrated in an animal model that garlic can actually reduce
the growth of bladder cancer and even prolong survival. If interested in
such alternative approaches, garlic supplementation such as Aged Garlic
Extract (Kyolic), can be used . Other supplements that may be beneficial
include: Cox 2 inhibitors such as Celebrex (Ibuprophen and similar drugs,
which inhibit both Cox 1 and 2 may be equally effective) and selenium, 200
ug daily.
Exercise in moderation stimulates the immune system, so take a walk with
friend or lover. A little sunshine is also good for you, as is a good
laugh. Don't take any of this too seriously, but do be involved in your
own care- people who are live longer. Be sure to be happy and enjoy your
extra time!
Lamm DL and Riggs DR: The potential application of Allium sativum
(garlic) for the treatment of bladder cancer. Urol Clin North Am 27(1):
157-162, 2000.
Health Food Store (e.g. GNC) options for phytochemical treatment of
bladder cancer
1. Sulforophane, the main phytochemical in Broccoli and other cruciferous
vegetables. Only 3 servings a month reduced bladder cancer risk by 50%,
an effect now confirmed by 3 independent studies. Recommendation: 2-3
servings of raw or lightly steamed broccoli a week. An alternative would
be 100mcg sulforophane twice a day (Nature's Way or other, cruciferous
vegetable extract softgel).
2. S-allyl cysteine, the aqueous extract of garlic and other allium
vegetables. Aged Garlic Extract (Kyolic, by Wakanaga laboratories, Japan)
was confirmed in our laboratory to reduce the incidence, growth and
mortality of transplanted bladder cancer in mice. The human dose from
these experiments would be 8ml a day, but we recommend 2-4 ml a day (1/2
to one teaspoon) of the liquid preparation. It can be added to vegetable
juice such as V-8. Alternatively 4 garlic cloves a day can be taken.
Garlic should be crushed and let stand for 10 minutes before cooking to
permit enzymatic activation.
3. Genistein, the main phytochemical in soy, is excreted into the urine in
active form and kills 7/8 human bladder cancer cell lines in tissue
culture. We recommend 50mg twice a day (e.g. Natural Brand or other soy
isoflavone concentrate) or 4 ounces of soy beans a day.
It is recommended to add these supplements to your diet one at a time each
week. That way if you have any side effects you will know what is causing
the symptom. The above three are thought to be most beneficial, but
several others appear to have excellent activity as well, and can be taken
as tolerated:
1. Resveratrol, a phytochemical in grapes and peanuts, has beneficial
effects on the cardiovascular system and prolongs life span of yeast and
many animals. It also has anti-tumor activity. We recommend 4mg twice a
day. 10 ounces of red wine, grape juice, or a comparable number of
raisens has 2 mg.
2. Ellagic acid, the primary phytochemical in pomegranates and berries,
inhibits prostate and bladder cancer cells. We recommend 20mg twice a
day, or 12 ounces of pomegranate juice.
3. Quercetin, a phytochemical in apples and many plants, has been
associated with a reduced risk of breast and lung cancer in some studies,
and it inhibits cancer cell growth in culture. 200 to 500mg daily appears
to be a reasonable dose.
4. Curcumin, a phytochemical in curry, has antitumor activity. 200mg
twice a day, or a hefty dose of the spice, may be beneficial.
5. Lycopene, a phytochemical in tomatoes and red vegetables, reduces
cancer cell growth and increases cancer cell death. Preliminary studies
suggest it may be beneficial in prostate cancer. We suggest 40mg a day,
the amount in a cup of marinara sauce. Cooking, surprisingly, appears to
increase lycopene.
Nix
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