Cruciferous Vegetable Intervention to Reduce the Risk of Cancer Recurrence in Non–Muscle-Invasive Bladder Cancer Survivors: Development Using a Systematic Process

Abstract

Background Bladder cancer is one of the top 10 most common cancers in the United States. Most bladder cancers (70%-80%) are diagnosed at early stages as non–muscle-invasive bladder cancer (NMIBC), which can be removed surgically. However, 50% to 80% of NMIBC cases recur within 5 years, and 15% to 30% progress with poor survival. Current treatments are limited and expensive. A wealth of preclinical and epidemiological evidence suggests that dietary isothiocyanates in cruciferous vegetables (Cruciferae) could be a novel, noninvasive, and cost-effective strategy to control NMIBC recurrence and progression. Objective The aim of this study is to develop a scalable dietary intervention that increases isothiocyanate exposure through Cruciferae intake in NMIBC survivors. Methods We worked with a community advisory board (N=8) to identify relevant factors, evidence-based behavior change techniques, and behavioral theory constructs used to increase Cruciferae intake in NMIBC survivors; use the PEN-3 Model focused on incorporating cultural factors salient to the group’s shared experiences to review the intervention components (eg, the saliency of behavioral messages); administer the revised intervention to community partners for their feedback; and refine the intervention. Results We developed a multicomponent intervention for NMIBC survivors consisting of a magazine, tracking book, live telephone call script, and interactive voice messages. Entitled POW-R Health: Power to Redefine Your Health, the intervention incorporated findings from our adaptation process to ensure saliency to NMIBC survivors. Conclusions This is the first evidence-based, theoretically grounded dietary intervention developed to reduce bladder cancer recurrence in NMIBC survivors using a systematic process for community adaptation. This study provides a model for others who aim to develop behavioral, community-relevant interventions for cancer prevention and control with the overall goal of wide-scale implementation and dissemination.

Allyl-, Butyl- and Phenylethyl-Isothiocyanate Modulate Akt–mTOR and Cyclin–CDK Signaling in Gemcitabine- and Cisplatin-Resistant Bladder Cancer Cell Lines

“…In vivo and in vitro data have already demonstrated that ITCs may suppress oncogenesis and tumor progression [ 12 ]. There is also epidemiological evidence that ITCs may diminish the risk of bladder cancer recurrence [ 13 ]. However, information about AITC, BITC and PEITC is sparse, and no reports are available dealing with the influence of these compounds on drug-resistant bladder cancer.…”

Allyl isothiocyanate induces DNA damage and inhibits DNA repair‐associated proteins in a human gastric cancer cells in vitro

“…17 ITCs may suppress oncogenesis and tumor progression 18 and it may diminish the risk of bladder cancer recurrence. 19 Numerous preclinical studies have shown that AITC has pharmacological activities such as antimicrobial, 20 antioxidant, 21 chemoprevention, [22][23][24] antiobesity, 25,26 anti-inflammatory, 27,28 and anticancer 29,30 activities.…”