Vitamins
High-dose multivitamins A, B6, C, E, selenium, and zinc have shown effectiveness in prophylaxing against transitional cell carcinoma recurrence (Lamm et al, J Urol 151:21-26, 1995; Moyad, Urol Clin N Am 29:31-48, 2002). Of interest is the fact that vitamins C and E may be only effective in non-smokers. The combination of these vitamins is marketed commercially as an over-the-counter vitamin preparation called "OncoVite." Along with most of the vitamins shown to have effectiveness in prophylaxis against TCC recurrence, this supplement contains other vitamins and some antioxidants:
The dose of Oncovite is two tabs twice a day, unless one weighs less than 100 lb, in which case three tabs a day are advised. Those with liver disease should take reduced dose (one tablet or less). This supplement can be purchased at most nutrition stores or bought online at sites such as http://www.drugstore.com.
Other Nutritional Supplements
Diet modifications and nutritional supplements that have some evidence to support
their use in patients with a history of bladder tumors and other cancers include soy,
selenium, garlic, green tea, lycopenes (in tomato juice), and a low fat diet.
Fluid intake
Encouraging oral fluids has been shown to decrease cancer recurrences in patients
with on-going exposure to potential carcinogens (Michaud et al, NEJM 340:1390-1397,
1999). It is theorized that this simply dilutes the carcinogens in the urine from
smoking or occupational toxins.
Alkalinization
Alkalinization of the urine to pH>7 has been shown to prevent DNA damage caused by
toxins, such as aromatic amines from cigarette smoking (Rothman et al Cancer Epidemiol
Biomarkers Prev 6: 1039-1042, 1997). Alkalinization should be used with caution in
patients with a history of congestive heart failure since the potential fluid shifts
could be hazardous.