Probiotics are touted for so many medical conditions— digestive health, colds, weight loss, autoimmune disorders—but what you never hear “experts” telling the public is that the strongest area of clinical research with probiotics in medicine is for bladder cancer (during and after conventional treatment), where they have been used for several decades.
If you’ve been diagnosed with bladder cancer, you should have a mandatory discussion with your physician about including probiotics in your treatment regimen. In my experience, very few doctors who treat bladder cancer have been educated about the benefits of probiotics in this situation, but no other supplements have anywhere near the data that probiotics do for this condition.
What is Bladder Cancer?
Each year almost 400,000 people worldwide are diagnosed with bladder cancer, and about 75,000 of those are in the United States. Blood in the urine (hematuria) is the most common symptom that leads to testing and a diagnosis. Nonmuscle invasive (or superficial) bladder cancer accounts for 80 percent of cases. In general, this type has a good prognosis because it usually stays localized (it doesn’t leave the bladder), although bladder cancer does have a reputation for coming back over and over again. When you’re diagnosed, your doctor will tell you if your cancer is low grade (not that aggressive), high grade (more aggressive), or muscle invasive (very aggressive, needing surgery as well as chemo or radiation in most cases).
Besides tobacco use, other risk factors for bladder cancer include a family history, previous pelvic radiation to the bladder, a history of inflammation of the bladder, occupational exposure to chemicals (such as in the synthetic dye manufacturing industry), and contaminated drinking water (including high arsenic levels in well water).
Natural Treatment For Bladder Cancer
1. Lactobacillus casei Shirota probiotic 3,000 milligrams a day
for at least 1 year following conventional treatment, or Yakult drink for prevention or treatment Researchers are not positive, but they think this probiotic appears to improve the body’s immune response to bladder tumors, possibly by activating so-called natural killer cells within the immune system and inducing cancer cell death. There’s a milklike product called Yakult that contains a high concentration of this probiotic strain, and it may also be associated with a reduced risk of bladder cancer (meaning it may help prevent cancer).
Researchers believe the probiotic may detoxify carcinogens or other toxins when they hit the bladder, preventing them from taking up residence there. Drinking a serving (approximately 3 ounces) of Yakult several times a week if you’re at high risk is a good preventive strategy, or if you don’t want to take the lactobacillus pills posttreatment, this is an adequate replacement.
So let’s talk research: Randomized trials with this probiotic strain were first completed more than 25 years ago. Two older trials were conducted in individuals with superficial localized transitional cell cancer of the bladder to determine the effect of taking 3 grams of oral L. casei Shirota (biolactis powder) daily.
Researchers specifically hoped to determine whether the cancer would return after being removed. Both trials showed a significant reduction in the risk of bladder cancer recurrence 1 to 2 years posttreatment. (Mild diarrhea was the primary side effect in 5 percent of the study subjects.)
Another trial with patients who had surgery for superficial bladder cancer compared recurrence rates with the drug epirubicin (an intravesical chemotherapy treatment) alone and with the drug along with L. casei Shirota. The combination group had a significantly greater chance (75 percent) of going 3 years posttreatment without recurrence versus the drug-alone group (60 percent).
You can purchase the same probiotic agent used in these patients in capsule form (although it’s easier to just use the Yakult; one 2.7-ounce serving is one dose). Each dose, which may be one to two capsules, contains about 1 x 1010 cells of L. casei Shirota strain per gram (the dosage used in the research is 3,000 milligrams or 3 grams per day).
The capsule form has been tested in several clinical trials now with positive results, and side effects have been similar to a placebo. It has been used as an “add on” (during or after conventional treatment) for bladder cancer in Japan for 25 to 30 years, so I’m comfortable with the benefit-to-risk ratio here. You should definitely talk to your doctor about this one. Again, the research appears to show a benefit for low-grade bladder cancers treated by resection only (not tested with BCG treatment) and in some cases chemotherapy.
2. Centrum Silver or an equivalent multivitamin one capsule daily for prevention and after conventional treatment
I know multivitamins have been under a lot of scrutiny in the last few years, and it’s partly deserved because some companies have made them so complicated (you have to take multiple pills and they’re expensive) without having research to back them up. Low-dose multivitamins, such as Centrum Silver, have very good research and safety records and deserve more respect.
In fact, Centrum Silver was tested in one of the largest and best studies in the history of dietary supplement medicine to determine if it could reduce the risk of cancer. This study, known as the Physicians’ Healthy Study II (a.k.a. PHS II), was a randomized, double-blind, placebo-controlled trial with more than 14,000 super- healthy male doctors ages 50 or older at baseline (some had a history of cancer).
The study began in 1997 and follow-up was completed in 2011. At that point, 2,669 men had been diagnosed with cancer. Men who took a daily multivitamin had a statistically significant (8 percent) reduction in the risk of cancer, but those men who had a baseline history of cancer, meaning they had a higher risk of getting cancer, experienced a 27 percent decrease in the risk of being diagnosed with cancer.
There was also a statistically nonsignificant (12 percent) reduction in cancer deaths in the multivitamin group compared to the placebo. Researchers did see a large (28 percent), albeit statistically insignificant, reduction in bladder cancer risk compared to other cancers and a reduction in bladder cancer deaths. If the trial had been allowed to go a bit longer, I believe these stats would have reached significance (it was close).
The side effects were similar to a placebo, except for a higher number of rashes in the supplement group. This is exciting! A basic low-dose adult multivitamin daily may reduce the risk of bladder cancer by providing enough nutrients to allow for optimal immune function, keeping bladder cancer as well as other types from forming. No supplements have been tested for this long and have shown this kind of safety and efficacy against cancer, especially bladder cancer.
Selenium is currently being tested in a large clinical trial called SELEBLAT (Selenium and Bladder Cancer Trial) that is testing a dose of 200 micrograms of selenium (from a yeast source) a day to determine if it can reduce the risk of bladder cancer returning after conventional treatment.
It’s being conducted at 18 hospitals in Belgium. In other studies, such high dosages of selenium have shown some scary side effects, including increased risk of diabetes and recurrence of skin cancer. I don’t recommend going this route until the results of the SELEBLAT study are in. Even then, will it be worth the risk? I’m skeptical, but we shall know soon enough.
What Are Useless For Treating Bladder Cancer?
High doses of vitamins and minerals
A multi appears to work, so wouldn’t a “turbocharged” multi work even better? No! But this is how the thinking got started: In 1994, a small (67 patients) trial published in the Journal of Urology found bladder cancer patients appeared to have a reduced risk of recurrence after conventional treatment when taking large doses of certain supplements.
This study obviously required larger randomized trials to confirm its findings, but the initial result was so promising that many patients started taking the supplement that was tested (a product called Oncovit). Megadoses of nutrients were used with conventional bladder cancer treatment (BCG).
Finally, a larger, more definitive study (670 patients from 75 medical centers) was published in 2010 in the same journal showing the large doses below did not work better than a standard multivitamin supplement.
- Vitamin A (36,000 IU per day)
- Vitamin B6 (100 milligrams per day)
- Vitamin C (2,000 milligrams per day)
- Vitamin D3 (1,600 IU per day)
- Folic acid (1,600 micrograms or 1.6 milligrams per day)
- Vitamin E (400 IU per day)
- Zinc (30.4 milligrams per day)
My guess is that the original study subjects had a variety of vitamin and mineral deficiencies, so the megadoses probably did reduce the risk of recurrence. But today, most patients are not deficient. We’re getting oversupplemented with antioxidants from foods, beverages, and supplements. And as we all know, too much of a good thing isn’t always good. In some cases —like vitamin E—it can increase cancer growth.
This important vitamin impacts the metabolism of numerous compounds in the body, and there used to be some research suggesting that it could favorably reduce the amount of toxic compounds affecting the bladder.
But a large study known as EORTC (European Organization for Research and Treatment of Cancer), done by the Genitourinary Tract Cancer Cooperative Group, found no significant difference in recurrence rates between vitamin B6 and a placebo. This study, published in 1995, shows just how long bladder cancer researchers have been doing large studies on dietary supplements.
Exotic herbal products with no quality control
I will never understand why some people are willing to take the risk on products like these. For instance, some herbal supplements contain a compound called aristolochic acid that occurs naturally in specific plants. But it belongs to a family of carcinogenic compounds, and it can increase the risk of permanent kidney damage and bladder cancer!
Even herbalists who’ve handled it in Asia have a higher risk of getting these medical conditions. It’s illegal in the United States, but we all know that you can buy products from all over the world these days. Know what you’re buying and whom you’re buying it from. You have to do your research!
What Lifestyle Changes Can Help With Bladder Cancer?
Heart healthy = bladder healthy
Some factors that are associated with an increased risk of heart disease are also associated with a higher risk of bladder cancer, especially smoking and tobacco use. (Some preliminary studies suggest — and I agree with them—that smokeless tobacco also increases risk.) Other factors, such as weight gain, have not been linked to bladder cancer, but controlling your weight and adopting heart-healthy habits—such as eating a healthy diet and maintaining normal cholesterol, blood sugar, and blood pressure levels—is a nobrainer since not doing so contributes to so many other diseases and conditions.
Hydrate—but not too much
Here’s the rule: Clear colored urine is healthy urine. Fluid consumption may reduce the risk of bladder cancer by reducing the ability of carcinogens to attach for long periods to the inside of the bladder, but it does not appear to treat bladder cancer or benefit conventional treatment. In fact, drinking too much water reduces blood sodium levels and can be life threatening, but this is rare.
Check your water supply
Inorganic arsenic in drinking water has been found to be a potential carcinogen to the skin and lungs, and I am convinced it increases the risk of bladder cancer as well. Arsenic occurs naturally throughout the environment, and it’s primarily transported through water. Municipal water systems routinely check for arsenic (you can request the testing results) and are generally safe, but private water supplies are at risk and should be tested.
What? No, chomping on a stick of gum does not prevent or treat bladder cancer, but it may speed recovery after surgery: Recent evidence suggests that patients who chew gum several times a day after bladder cancer– removal surgery are more likely to get their bowels moving again, which speeds recovery time. Chewing sends a message to the gastrointestinal tract to get ready for food, so the bowels begin their natural movement. Get your doctor’s permission though, and only do it if you’re sitting upright.
Get more omega-3s from plants
An interesting US study found that people who regularly consumed omega-3 fatty acids (alpha-linolenic acid or ALA) from plants had an almost 75 percent reduction in the risk of bladder cancer. Certain foods—such as walnuts, canola oil, flaxseed, and chia seeds—are loaded with ALA and have been shown to potentially reduce the risk of heart disease as well.
Load up on veggies
Cruciferous veggies (broccoli, cauliflower, Brussels sprouts, kale, cabbage, and bok choy, to name a handful) reduce the risk of bladder cancer. They’re also low in calories and high in fiber and nutrients.