Evidence-based Anticancer Materia Medica for Bladder Cancer

  • Dawei Ye
  • Pingping Gu
  • Hongyu Zhao
  • Michelle Chow
  • Xiaoqing Guo
  • Jianyu Rao
Part of the Evidence-based Anticancer Complementary and Alternative Medicine book series (ACAM, volume 2)


Bladder cancer is a relatively common urinary tract carcinoma. There are in general two categories of bladder cancer, low grade and high grade, which develop through distinct molecular pathways, have different clinical presentations and therefore require different management schemes. Regardless of tumor grade, most bladder cancers have high recurrence rate. Conventional treatments such as surgery, radiotherapy, and chemotherapy, though quite effective in managing the tumor burden itself, may not be effective enough to cure the disease. Herbal medicines, such as Zhuling, garlic, green tea, astragalus, triptolide, and Ganoderma lucidum, provide potential alternatives for the management of this disease. This chapter provides an overview of the scientific research studying the efficacy and potential mechanisms of action of these herbal remedies in the treatment of bladder cancer. Some of the active ingredients in the herbs have been shown to be effective in inhibiting tumor growth in vitro and in vivo. Animal models and cell line studies provide experimental evidence demonstrating the potential therapeutic effects of these herbs. Obviously, definitive clinical trials are needed to evaluate the safety and efficacy of herbal ­management of bladder cancer. In this chapter, we also discuss the relationship of nutrition and diet with bladder cancer.


Bladder Cancer Transitional Cell Carcinoma Bladder Cancer Risk Partial Cystectomy Aged Garlic Extract 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. Aben KK, Kiemeney LA (1999) Epidemiology of bladder cancer. Eur Urol 36:660–672PubMedCrossRefGoogle Scholar
  2. Amaral AF, Cantor KP, Silverman DT, Malats N (2010) Selenium and bladder cancer risk: a meta-analysis. Cancer Epidemiol Biomarkers Prev 19:2407–2415PubMedCrossRefGoogle Scholar
  3. Bakkar AA, Wallerand H, Radvanyi F et al (2003) FGFR3 and TP53 gene mutations define two distinct pathways in urothelial cell carcinoma of the bladder. Cancer Res 63:8108–8112PubMedGoogle Scholar
  4. Bane BL, Rao J, Hemstreet GP (1996) Pathology and staging of bladder cancer. Semin Oncol Bladder Cancer 23:546–570Google Scholar
  5. Billerey C, Chopin D, Aubriot-Lorton MH et al (2001) Frequent FGFR3 mutations in papillary non-invasive bladder (pTa) tumors. Am J Pathol 158:1955–1959PubMedCrossRefGoogle Scholar
  6. Bjurlin MA, Goble SM, Hollowell CM (2010) Smoking cessation assistance for patients with bladder cancer: a national survey of American urologists. J Urol 184:1901–1906PubMedCrossRefGoogle Scholar
  7. Botteman MF, Pashos CL, Redaelli A, Laskin B, Hauser R (2003) The health economics of ­bladder cancer: a comprehensive review of the published literature. Pharmacoeconomics 21:1315–1330PubMedCrossRefGoogle Scholar
  8. Brinkman MT, Karagas MR, Zens MS, Schned A, Reulen RC, Zeegers MP (2010) Minerals and vitamins and the risk of bladder cancer: results from the New Hampshire study. Cancer Causes Control 21:609–619PubMedCrossRefGoogle Scholar
  9. Cassidy A, Wang W, Lin J (2009) Risk of urinary bladder cancer: a case-control analysis of industry and occupation. BMC Cancer 9:443PubMedCrossRefGoogle Scholar
  10. Cheng L, Zhang S, MacLennan GT, Williamson SR, Lopez-Beltran A, Montironi R (2011) Bladder cancer: translating molecular genetic insights into clinical practice. Human Pathol 42:455–481.Google Scholar
  11. Cheung E, Quinn D, Tsao-Wei D, Groshen SG Aparicio A, Twardowski P et al (2008) Phase II study of vorinostat (Suberoylanilide Hydroxamic Acid, SAHA) in patients with advanced transitional cell urothelial cancer (TCC) after platinum-based therapy. California Cancer Consortium/University of Pittsburgh NCI/CTEP sponsored trial. J Clin Oncol 26:abstract 16058Google Scholar
  12. Chow N, Chan S, Tzai T, Ho C, Liu H (2001) Expression profiles of ErbB family receptors and prognosis in primary transitional cell carcinoma of the urinary bladder. Clin Cancer Res 7:1957–1962PubMedGoogle Scholar
  13. Dreicer R, Li H, Stein MN, DiPaola RP, Eleff M, Roth BJ et al (2008) Phase II trial of sorafenib in advanced carcinoma of the urothelium: a trial of the Eastern Cooperative Oncology Group. J Clin Oncol 26:abstract 5083Google Scholar
  14. Feldman A, Kirley S, McDougal WS, Zukerberg LR, Wu CL (2003) Expression of cables, a cell cycle regulatory gene is lost in human prostate cancer and suppresses prostate cancer cell growth. J Urol 169:188 (American Urological Association, Abstract 727)Google Scholar
  15. Gallagher D, Milowsky M, Gerst S, Iasonos A, Boyle M, Trout A et al (2008) Final results of a phase ii study of sunitinib in patients with relapsed or refractory urothelial carcinoma. J Clin Oncol 26:abstract 5082Google Scholar
  16. Gloeckler Ries L, Reichman M, Lewis D, Hankey B, Edwards B (2003) Cancer survival and incidence from the Surveillance, Epidemiology, and End Results (SEER) program. Oncologist 8:541–552PubMedCrossRefGoogle Scholar
  17. Habuchi T, Marberger M, Droller MJ, Hemstreet GP 3rd, Grossman HB, Schalken JA et al (2005) Prognostic markers for bladder cancer: International Consensus Panel on bladder tumor markers. Urology 66:64–74PubMedCrossRefGoogle Scholar
  18. Hernandez L, Wu X, Lin J, Radcliffe J (2004) Intake of vitamin E (2-R isomers of alpha-tocopherol) and gamma-tocopherol in a case-control study and bladder cancer risk. Proc Am Assoc Cancer Res 45:abstract #3921Google Scholar
  19. Hirao Y, Kim WJ, Fujimoto K (2009) Environmental factors promoting bladder cancer. Curr Opin Urol 19:494–499PubMedCrossRefGoogle Scholar
  20. Jaye M, Schlessinger J, Dionne CA (1992) Fibroblast growth factor receptor tyrosine kinases: molecular analysis and signal transduction. Biochim Biophys Acta 1135:185–199PubMedCrossRefGoogle Scholar
  21. Jemal A, Siegal R, Ward E (2010) Cancer statistics, 2010. CA Cancer J Clin 60:277–300PubMedCrossRefGoogle Scholar
  22. Junttila T, Laato M, Vahlberg T, Söderström K, Visakorpi T, Isola J et al (2003) Identification of patients with transitional cell carcinoma of the bladder overexpressing ErbB2, ErbB3, or specific ErbB4 isoforms: real-time reverse transcription-PCR analysis in estimation of ErbB receptor status from cancer patients. Clin Cancer Res 9:5346–5357PubMedGoogle Scholar
  23. Kohlmeier L, Weterings KG, Steck S, Kok FJ (1997) Tea and cancer prevention: an evaluation of the epidemiologic literature. Nutr Cancer 27:1–13PubMedCrossRefGoogle Scholar
  24. Kurashige S, Akuzawa Y, Endo F (1999) Effects of astragali radix extract on carcinogenesis, cytokine production, and cytotoxicity in mice treated with a carcinogen, N-butyl-N’-butanolnitrosoamine. Cancer Invest 17:30–35PubMedGoogle Scholar
  25. Lamm D, Riggs D (2000) The potential application of Allium sativum (garlic) for the treatment of bladder cancer. Urol Clin North Am 27:157–162PubMedCrossRefGoogle Scholar
  26. Lau BHS, Woolley JL, Marsh CL et al (1986) Superiority of intralesional immunotherapy with Corynebacterium parvum and Allium sativum in control of murine transitional cell carcinoma. J Urol 136:701–705PubMedGoogle Scholar
  27. Lu QY, Jin YS, Zhang Q, Zhang ZF, Heber D, Go VL et al (2004) Ganoderma lucidum extracts inhibit growth and induce actin polymerization in bladder cancer cells in vitro. Cancer Lett 216:9–20PubMedCrossRefGoogle Scholar
  28. Lu QY, Jin YS, Pantuck A, Zhang ZF, Heber D, Belldegrun A (2005) Green tea extract modulates actin remodeling via Rho activity in an in vitro multistep carcinogenic model. Clin Cancer Res 11:1675–1683PubMedCrossRefGoogle Scholar
  29. Mhawech-Fauceglia P, Cheney RT, Schwaller J (2006) Genetic alterations in urothelial bladder carcinoma: an updated review. Cancer 106:1205–1216PubMedCrossRefGoogle Scholar
  30. Michaud DS, Spiegelman D, Clinton SK, Rimm EB, Curhan GC, Willett WC (1999) Fluid intake and the risk of bladder cancer in men. N Engl J Med 340:1390–1397PubMedCrossRefGoogle Scholar
  31. Mondul A, Weinstein S, Männistö S, Snyder K, Horst R, Virtamo J et al (2010) Serum vitamin D and risk of bladder cancer. Cancer Res 70:9218–9223PubMedCrossRefGoogle Scholar
  32. Mueller C, Caporaso N, Greene M (2008) Familial and genetic risk of transitional cell carcinoma of the urinary tract. Urol Oncol 26:451–464PubMedCrossRefGoogle Scholar
  33. Naito S, Tanaka K, Koga H, Kotoh S, Hirohata T, Kumazawa J (1995) Cancer occurrence among dyestuff workers exposed to aromatic amines. A long term follow-up study. Cancer 76:1445–1452PubMedCrossRefGoogle Scholar
  34. NCI/NIH. Bladder cancer. Accessed 12 Sep 2011
  35. Primdahl H, von der Maase H, Sørensen FB, Wolf H, Ørntoft T (2002) Immunohistochemical study of the expression of cell cycle regulating proteins at different stages of bladder cancer. J Cancer Res Clin Oncol 128:295–301PubMedCrossRefGoogle Scholar
  36. Radosavljević V, Janković S, Marinković J, Dokić M (2005) Diet and bladder cancer: a case-control study. Int Urol Nephrol 37:283–289PubMedCrossRefGoogle Scholar
  37. Santos L, Amaro T, Pereira SA, Lameiras CR, Lopes P, Bento M et al (2003) Expression of cell-cycle regulatory proteins and their prognostic value in superficial low-grade urothelial cell carcinoma of the bladder. Eur J Surg Oncol 29:74–80PubMedCrossRefGoogle Scholar
  38. Sato D (1999) Inhibition of urinary bladder tumors induced by N-butyl-N-(4 -hydroxybutyl)-nitrosamine in rats by green tea. Int J Urol 6:93–99PubMedCrossRefGoogle Scholar
  39. Scosyrev E, Noyes K, Feng C, Messing E (2009) Sex and racial differences in bladder cancer presentation and mortality in the US. Cancer 115:68–74PubMedCrossRefGoogle Scholar
  40. Sgambato A, Migaldi M, Faraglia B, De Aloysio G, Ferrari P, Ardito R et al (2002) Cyclin D1 expression in papillary superficial bladder cancer: its association with other cell cycle-associated proteins, cell proliferation and clinical outcome. Int J Cancer 97:671–678PubMedCrossRefGoogle Scholar
  41. Shinohara N, Koyanagi T (2002) Ras signal transduction in carcinogenesis and progression of bladder cancer: molecular target for treatment? Urol Res 30:273–281PubMedCrossRefGoogle Scholar
  42. Urist M, Di Como C, Lu M, Charytonowicz E, Verbel D, Crum CP et al (2002) Loss of p63 expression is associated with tumor progression in bladder cancer. Am J Pathol 161:1199–1206PubMedCrossRefGoogle Scholar
  43. van Rhijn B, van der Kwast T, Vis A et al (2004) FGFR3 and P53 characterize alternative genetic pathways in the pathogenesis of urothelial cell carcinoma. Cancer Res 64:1911–1914PubMedCrossRefGoogle Scholar
  44. Vecchione A, Sevignani C, Giarnieri E, Zanesi N, Ishii H, Cesari R et al (2004) Inactivation of the FHIT gene favors bladder cancer development. Clin Cancer Res 10:7607–7612PubMedCrossRefGoogle Scholar
  45. Yang D (1991) Inhibitory effect of Chinese herb medicine zhuling on urinary bladder cancer. An experimental and clinical study. Zhonghua Wai Ke Za Zhi 29:393–395, 399Google Scholar
  46. Yang D, Li S, Wang H, Li X, Liu S, Han W et al (1999) Prevention of postoperative recurrence of bladder cancer: a clinical study. Zhonghua Wai Ke Za Zhi 37:464–465PubMedGoogle Scholar
  47. Yang C, Wang X, Lu G, Picinich S (2009) Cancer prevention by tea: animal studies, molecular mechanisms and human relevance. Nat Rev Cancer 9:429–439PubMedCrossRefGoogle Scholar
  48. Yang S, Chen J, Guo Z, Xu XM, Wang L, Pei XF et al (2003) Triptolide inhibits the growth and metastasis of solid tumors. Mol Cancer Ther 2:65–72PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2012

Authors and Affiliations

  • Dawei Ye
    • 1
  • Pingping Gu
    • 2
  • Hongyu Zhao
    • 1
  • Michelle Chow
    • 1
  • Xiaoqing Guo
    • 3
  • Jianyu Rao
    • 1
  1. 1.Department of Pathology and Laboratory Medicine, David Geffen School of MedicineUniversity of CaliforniaLos AngelesUSA
  2. 2.Department of Epidemiology, School of Public HealthUniversity of CaliforniaLos AngelesUSA
  3. 3.Department of OncologyGanzhou City People’s HospitalJiangxiPR China

Personalised recommendations