Nutraceuticals in Human Urinary Bladder Cancer Prevention and Treatment

Abstract

Bladder cancer is a major public health burden. Tumor resection with possible intravesical treatments for superficial disease, and cystectomy or chemotherapy with radiation protocols for invasive bladder cancer have associated limitations and large costs. In addition, exposure to carcinogens contributes to the majority of bladder cancer risk. All of these represent profound opportunities to use nutraceuticals for improvement of current bladder cancer prevention and treatment. We discuss the clinical opportunities for use of nutraceuticals in bladder cancer prevention and treatment, including preventing the first occurrence of bladder cancer in high risk populations, delaying progression of the disease, use in combination with existing intravesical agents, and delaying or preventing radical cystectomy. We review randomized controlled trials of nutraceuticals in bladder cancer, current promising chemopreventive agents under preclinical development for bladder cancer prevention, and future directions of bladder cancer chemoprevention, including the concept of individualized bladder cancer chemoprevention. Abbreviations 4HRPN-4-hydroxyphenylretinamide 5-ALA 5-aminolevulinic acid ATBC alpha-Tocopherol Beta-Carotene CIS carcinoma in situ CPS-II cancer prevention study II EMT epithelial-to-mesenchymal transformation NMIBC non-muscle-invasive bladder cancers RDA recommended daily allowance RTK the receptor tyrosine kinases TCC transitional cell carcinoma TURBT transurethral resection of bladder tumor UC urothelial carcinoma UVB ultraviolet B