Bladder Cancer

What you do, what you eat, and how you handle stress impact your overall state of well-being.

Nearly 70,000 individuals in the United States will be diagnosed with bladder cancer in 2011, the 5th most common cancer, and almost 15,000 will die of the disease.[1]

It occurs at a rate roughly 3 times higher in the U.S. than in Asian countries.[2]

70% of cases are non-muscle invasive lesions, which recur frequently but do not often affect mortality, and 30% are muscle invasive, which tend to be progressive and have poor survival.[3]

Because most people with bladder cancer have recurrences and survive long-term, lifelong monitoring is required.

Urothelial carcinoma of the bladder is thought to be significantly influenced by environmental factors, particularly cigarette smoking, which accounts for roughly 50% of all cases.[4]

Consume a vegetable rich, Mediterranean-style diet, emphasizing whole foods and cruciferous vegetables (broccoli, cauliflower, kale, brussel sprouts, etc.).[5]

Causes/Contributing Factors

80% of bladder cancer diagnoses occur in those over 60, with a 3x higher occurrence in men than women, and although it is more prevalent in Caucasians, delayed diagnosis leads to worse prognosis in African American individuals.[6]

Smoking is the largest contributor to bladder cancer occurrence, responsible for ½ of all cases, with an increase in risk which persists as long as 20 years after quitting.[7]

Other environmental and occupational toxins have also demonstrated risk, including toxins found commonly in industrial and agricultural settings.

It may also be caused by the infectious agent, Schistosoma haematobium, though this is mainly limited to Africa and the Middle East.

Dietary factors include a higher processed meat intake, while vitamin B12 appears to have a protective effect.[8]

A recent study found that higher intakes of α-linolenic acid content, derived from plant foods, was associated with a 74% lower risk of developing bladder cancer.[9]

Avoid smoking and second-hand smoke, avoid exposure to toxins and make sure drinking water is free of arsenic.[7]

Relevant Diagnostic Testing

Cystoscopy (procedure to see inside bladder and urethra)

Biopsy (sampling of cells collected for further testing)

Imaging (allow the doctor to examine the structures of the urinary tract)

Urine cytology (examination of urine cells under a microscope)

Vitamin D level – Low vitamin D levels have been associated with increased risk for bladder cancer and survival, and the ratio of 25(OH)vitamin D/D binding protein (DBP) may be the most predictive.[10]{11}

Be physically active, every day. Even light intensity exercise has benefit.[12]

Dietary Action Plan


  1. Brightly colored, fresh vegetables, leafy greens and fresh fruits (choose organic if possible)
  2. Cruciferous vegetables, such as broccoli, cauliflower, cabbage, etc., especially raw broccoli
  3. Foods high in alpha linolenic acid, such as flaxseeds, pumpkin seeds, walnuts, brussel sprouts and soybeans, among others
  4. Whole foods (foods that are as close to their natural form as possible)
  5. Low sugar/low glycemic diet (Glycemic index (GI) and glycemic load (GL) are measures of the effect on blood glucose level after a food containing carbohydrates is consumed)
  6. Omega-3 fatty acids, found in cold water fish such as sardines, wild-caught salmon, cod, mackerel, tuna
  7. High fiber, from whole grains, beans, vegetables and fruits
  8. Healthy fats, from avocados, nuts, seeds, olive oil, coconut oil, cold water fish
  9. For animal protein, choose lean poultry and fish over red meat, and aim to view meat as a condiment rather than a staple. Try to choose grass fed and organic meats and eggs whenever possible. Eat no fish larger than a salmon to minimize environmental contaminants, including mercury.


  1. Processed and grilled meats. Also, try to limit intake of red meat
  2. Fast foods, fried foods, baked goods and packaged, processed foods
  3. Sugar, sweeteners  and artificial sweeteners
  4. Vegetable oils, shortening, margarine and anything with hydrogenated or partially hydrogenated oils
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Bladder Cancer Supplement Program

Multiple nutritional supplements have been associated with reduced cancer incidence and/or cancer progression. The list below contains those with the greatest evidence-base and benefit, though it is not necessary that they all be included.

Supplement Info



  • Vitamin D
  • Isothiocyanates
  • Green Tea Extract
  • Vitamin E & mixed tocopherols
  • N-acetylcysteine
  • Curcumin
  • Milk Thistle
  • Diindolylmethane (DIM)
  • Quercetin
  • Vitamin K2
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[1] American Cancer Society Cancer Facts and Figures 2011. American Cancer Society, Atlanta (2011).

[2] Parkin, DM, Bray, F, Ferlay, J, et al. (2005) Global cancer statistics, 2002. CA Cancer J Clin 55, 74–108.

[3] Altekruse, S. F. et al. (Eds). SEER Cancer Statistics Review, 1975–2007 (National Cancer Institute, Bethesda, 2010).

[4] Freedman ND, Silverman DT, Hollenbeck AR, et al. Association between smoking and risk of bladder cancer among men and women. JAMA. 2011 Aug 17;306(7):737-45.

[5] Ros MM, Bueno-de-Mesquita HB, et al. Fruit and vegetable consumption and risk of aggressive and non-aggressive urothelial cell carcinomas in the European Prospective Investigation into Cancer and Nutrition. Eur J Cancer. 2012 Nov;48(17):3267-77.

[6] Sharma S, Ksheersagar P, Sharma P. Diagnosis and treatment of bladder cancer. Am Fam Physician. 2009 Oct 1;80(7):717-23.

[7] S.A. Strope, J.E. Montie. The causal role of cigarette smoking in bladder cancer initiation and progression, and the role of urologists in smoking cessation. J Urol, 180 (2008), pp. 31–37.

[8] Wu JW, Cross AJ, Baris D, et al. Dietary intake of meat, fruits, vegetables, and selective micronutrients and risk of bladder cancer in the New England region of the United States. Br J Cancer. 2012 May 22;106(11):1891-8.

[9] Brinkman MT, Karagas MR, et al. Intake of α-linolenic acid and other fatty acids in relation to the risk of bladder cancer: results from the New Hampshire case-control study. Br J Nutr. 2011 Oct;106(7):1070-7.

[10] Mondul AM, Weinstein SJ, Virtamo J et al. Influence of vitamin D binding protein on the association between circulating vitamin D and risk of bladder cancer. Br J Cancer. 2012 Oct 23;107(9):1589-94.

[11] Peiris AN, Bailey BA, Manning T. Relationship of vitamin D monitoring and status to bladder cancer survival in veterans. South Med J. 2013 Feb;106(2):126-30.

[12] C B, M M, R D, et al. Cross-Sectional & Longitudinal Associations between Light-Intensity Physical Activity & Physical Function Among Cancer Survivors. Cancer Epidemiol Biomarkers Prev. 2013 Mar;22(3):475-6.

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