Nutrition

On this page: dietary bladder irritantsMemorial Sloan Kettering patient info over dietary mattersvegetables for bladder cancerIs raw better? genesteinapples! Links New: Dietary vitamin E prevents bladder cancer
Cranberry for prevention of urinary tract infections/cystis Carrot compound fights cancer in animal tests

Nutrition Recommendations Can Be Different for Cancer Patients! For an excellent booklet online please see: Eating Hints for Cancer Patients, Before, During and After Treatment, http://www.cancer.gov/cancerinfo/eatinghints

Bladder cancer warriors undergoing BCG or other treatments may find that certain foods can aggravate symptoms such as urgency, frequency and burning. Some common dietary bladder irritants: alcoholic beverages, carbonated beverages (with or without caffeine), milk or milk products, coffee or tea (even decaffeinated), medicines with caffeine, high acid, citrus fruits and citrus juices*, tomatoes and tomato-based products, highly spiced/hot foods, sugar, honey, chocolate, corn syrup, artificial sweetener. *Low acid fruits include: pears, apricots, papaya and watermelon

If bladder symptoms are related to dietary factors, strict adherence to a diet which eliminates the above food products should bring significant relief in ten days. The proof is resuming your old dietary habits followed by the return of symptom complex. Once you are feeling better, you can begin to add these things back into your diet, one thing at a time. This way, if something does cause your symptoms, you will be able to identify what it is. When you do begin to add foods back into your diet, it is crucial that you maintain a significant water intake. Water should be the majority of what you drink every day.
http://www.mybladdermd.com/dietirritants.htm

Diet and cancer studies have shown that, in general, vegetables and fruits, dietary fiber, and certain nutrients seem to be protective against cancer, whereas fat, excessive calories, and alcohol are linked to increased risk.

Although individual factors could contribute to inconsistencies in interpretation of dietary factors and their role in cancer prevention, there is definitely enough data to warrant the serious attention being given to the role that food plays in the fight against cancer.

Comprehensive reviews of case control and prospective cohort studies found that the relationship between high vegetable and fruit intake and reduced cancer risk appears to be strongest for cancers of the alimentary and respiratory tracts (cancers of the colon, lung, esophagus, and oral cavity) and weakest for hormone-related cancers (cancers of the breast, ovary, cervix, endometrium, and prostate).However, new data coming in is suggesting that the lycopene found in cooked tomatoes can fight prostate cancer (see below).

Reduced cancer risk has been linked primarily to consumption of raw vegetables and fresh fruits (citrus, carrots, green leafy vegetables, and cruciferous vegetables), soy products, and whole grain wheat products. The beneficial effect of vegetables, fruits, and whole grains may be due to either individual or combined effects of their constituents, including fiber, micro nutrients, and phytochemicals. The latter are naturally occurring and mostly non nutritive compounds found in plants. Although specific constituents have been the focus of numerous studies, the relative cancer-protective contributions of the nutrients and no nutrients that are “packaged” in fruits, vegetables, and whole grains are difficult to separate.1

Phytochemicals are the biologically active substances in plants that are responsible for giving them color, flavor, and natural disease resistance. The phytochemicals in fruits and vegetables are not generally destroyed in cooking. The main phytochemicals in soybeans, for example, are not destroyed by heat, and the lycopene in tomatoes appears to become more available to the body after heating. Heat destroys the phytochemical found in raw garlic, but if the garlic has been chopped and exposed to air for 10 minutes before cooking, the original phycochemical is converted to the substance that appears to be responsible for garlic’s cancer-prevention benefits and this substance is not destroyed by heat. Some of the phytochemicals in certain fruits, however, do not seem to be heat-stable.2

MSK Info
Antioxidant Vitamins — Are They the Only Cancer-Phyters?
from Memorial Sloane Kettering’s patient’s info:

Eating the vegetables and fruits that contains vitamin E, C, and A, beta carotene and Folic acid, as well as other protective substances, does appear to lower the risk for most cancers. This has been confirmed in study after study, which show, in general, that people whose diets are low in fruits and vegetables experience twice the risk of those with high intake. Dr. Hans Prochaska, of the Molecular Pharmacology and Therapeutics Department at MSKCC, believes there are a number of reasons for this. First, consuming generous quantities of fruits and vegetables generally replaces eating large amounts of animal fats. Studies have found high rates of many cancers in countries where consumption of animal fat is also high. Dr. Prochaska recommends cutting back on eating meat, particularly avoiding overcooked charcoal-broiled red meat. The second important cancer-fighting property of vegetables and fruit is fiber, which is particularly effective against colon and rectal cancers.Third, most fruits and vegetables contain not only the valuable antioxidant vitamins but also important compounds known as phytochemicals. (Phyto comes from the Greek word for plant.) These compounds fight cancer in a number of different ways. Some, such as the carotenoids and flavonoids, serve as antioxidants. Although dark green and yellow-orange vegetables are usually recommended for their abundance of carotenoids, one recent study has found that the carotenoid lycopene, a pigment that is responsible for the color of tomatoes and other red fruits and vegetables, is a very potent antioxidant and may protect against colon and bladder cancer. Flavonoids are present in onions, apples, and wine. Other phytochemicals known as isothiocyanates both stimulate the manufacture of enzymes that render carcinogens harmless and block other enzymes that activate carcinogens. (One of these phytochemicals, phenethylisothiocyanate, is currently being studied for blocking the effects of carcinogens in cigarette smoke.) Dark green vegetables are a particularly good source of isothiocyanates. The phytochemical limonene, found in the peels of citrus fruits, blocks a protein that stimulates cell growth and proliferation and may inhibit a type of carcinogenic protein from entering healthy cells. Another important phytochemical under investigation is genistein, which is found in soy products. This substance helps to block estrogen and so, theoretically, might play a role in preventing breast cancer.

Experts advise eating five to nine servings of vegetables and fruit a day. In addition to vitamins, there are many complex phytochemical agents in fruits and vegetables that may not be cancer-protective individually but that may act together to produce benefits.

So what about those vitamin supplements? People at high risk for cancer, such as smokers, may want to take supplements of vitamin E, which is not easily obtained in the diet. Taking a multiple vitamin, folic acid, and some extra vitamin C probably won’t hurt either. But the fact is, the path to health is lined with delicious, succulent fruits and vegetables, and eating them is much more fun than simply popping pills.

Note: For additional information, order The AICR Vitamin and Mineral Guide, which is available without charge, from the American Institute for Cancer Research, 1759 R Street NW, Washington DC 20009. MSKCC Website; http://www.mskcc.org/index.cfm

Vegetables for bladder cancer
In a 1999 study from Harvard, Dr. Michaud and colleagues reported that high cruciferous vegetable consumption may reduce bladder cancer risk, but other vegetables and fruits may not confer appreciable benefits against this cancer. Dr. Machaud has also determined that high fluid intake lowers the risk for bladder cancer in men (see fluids).3
 
Dr.Giovannucci, another Harvard researcher in the field of cancer and it’s relationship to nutrition, published findings in Feb. 1999 which discusses the consistently lower risk of cancer for a variety of anatomic sites that is associated with higher consumption of tomatoes and tomato-based products, which he postulates may add further support for current dietary recommendations to increase fruit and vegetable consumption. However, the benefits derived from the lycopene in tomatoes has not yet been shown to proffer an advantage to bladder cancer patients, though there has been an advantage observed for those with prostate cancer.4

Given that that prostate involvement is not uncommon with invasive bladder cancer, eating more tomato sauce products is a simple form of prevention worth considering.

As discussed in an article by Dr. John Anderson;
Dr. Giovannucci’s study, which was done on  47,894 men, age 40 to 75 and free of any diagnosed cancer, over a six-year period, assessed the dietary preferences and consumption frequency for 131 foods and beverages, providing researchers a detailed picture of the yearly nutrient intake of each man.  Between 1986 and 1992, the participants were surveyed for cancer incidence. In that time period, 812 new cases of prostate cancer developed. The cancer incidence was then compared with dietary intake of any of 46 fruits, vegetables, and related products to see if any of these foods had a protective effect against prostate cancer.

Of the 46 foods, tomato sauce, tomatoes, pizza, and strawberries were associated with a reduced risk of prostate cancer. The researchers learned that the first three of these foods were the primary dietary sources of lycopene, accounting for 82% of the lycopene intake for the men. (While strawberries were associated with a reduced prostate cancer risk, they are not a significant source of lycopene.) Those who consumed ten or more servings of these three tomato-based foods per week had a 35% reduced chance of developing prostate cancer.

The lycopene in these foods is one of five groups of carotenoids: No measurable protective effect against prostate cancer was noted among the four other primary carotenoids: alpha carotene (found in carrots), beta carotene (in yams, sweet potatoes, yellow squash), lutein (found in dark green, leafy vegetables), and beta-cryptoxanthin (in oranges).

Men of southern European descent, from regions where tomato-based foods are consumed more frequently (as part of the well-publicized “Mediterranean diet”), have a lower incidence of prostate cancer than African-American or Asian-American men who, typically, eat fewer tomato-based items. Even a preexisting family history of prostate cancer did not change lycopene’s protective effect, researchers report.

“Tomato-based foods may be especially beneficial regarding prostate cancer risk,” reported Dr. Giovannucci. “These findings suggest that intake of lycopene or other compounds in tomatoes may reduce prostate cancer risk,” while other carotenoids appear unrelated to reducing the risk, said Dr. Giovannucci.

Lycopene from tomato juice is not easily absorbed, but when it’s cooked with oil (as in making a sauce), this substantially increases intestinal absorption of its nutrients. In other words, cooked tomato sauce is a more efficient way of delivering lycopene to the body than raw tomato juice, according to this study. Researchers declared that, based on a mini-study of blood samples and dietary patterns of 121 men, those who consumed the most tomato sauce were the most likely to have high blood levels of lycopene. Consuming tomato sauce cooked with oil raised the blood level of lycopene by a factor of 2 to 3 times, as measured 24 hours after consumption; in comparison, uncooked tomato juice produced no measurable increase.

However, lycopene from raw tomatoes may be able to protect against gastrointestinal cancers, according to an Italian study conducted between 1985 and 1991 involving 2,879 controls and 2,706 cases of cancer in the oral cavity and pharynx, esophagus, stomach, colon, or rectum. Among the controls, lycopene intake (from the traditional tomato-rich Mediterranean diet of northern Italy) was strongly associated with “a pattern of protection for all sites and most notably for gastrointestinal neoplasms [cancers],” the researchers wrote.

Scientists at the University of Illinois in Chicago correlated consumption of lycopene-rich foods with a significantly reduced incidence of the earliest precancerous signs of cervical cancer.

Lycopene is the predominant carotenoid found in the blood, in various tissues (such as liver, kidney, adrenal glands, testes, and ovaries), and in the prostate gland itself. Research suggests that lycopene is an essential part of the body’s natural defense against harmful oxidizing agents such as free radicals. Lycopene is now being touted as a highly capable antioxidant; Dr. Giovannucci pointed out that “lycopene is the most efficient scavenger of singlet oxygen [free radicals] among the common carotenoids.” 2

Raw is not necessarily better:

Researchers led by Dr. Luke Howard at the University of Arkansas have now found that cooking carrots increases their antioxidant content by 34 percent. In fact, storing them for a week or two only increased their potency. This is similar to the observations concerning lycopene, the active antioxidant in tomatoes.

Many consumers think that fresh vegetables are always superior in nutritional quality than processed vegetables but this does not appear to be true for carrots,” Dr. Luke Howard, the Arkansas study author, said. Leaving the carrots unpeeled is another way of increasing their antioxidant power. “Numerous phenolic compounds are located in the skin of fruits and vegetables, many of which are removed by peeling steps prior to processing,” he notes. Cooking and storing breaks down the tough cells walls of the vegetables and frees the phenolic compounds that provide most of their antioxidant power.

Genestein

A recent US study stated that the Asian diet, particularly the role of the phytochemical genistein-found in soy products-plays a direct role in Asia’s lower incidence of invasive bladder cancer; “A significantly higher dietary consumption of soy products exists in Asia and has led to the notion that the isoflavones present in this diet may contribute to a reduction in the number of invasive transitional cell bladder cancers. In this regard, we sought to determine the effect of genistein, a naturally occurring dietary protein tyrosine kinase (PTK) inhibitor, on the growth and motility of human bladder cancer cell lines with diverse EGFR and p21ras expression phenotypes and corresponding invasive behaviors. These effects were compared with those of tyrphostin, a pure synthetic EGFR inhibitor. Our results indicate that both genistein and tyrphostin are effective inhibitors of bladder cancer motility and growth, key factors in the development of muscle invasive disease. In addition, the growth and motility inhibitory effects of genistein and tyrphostin are observed preferentially in cells that over express the EGFR. Cells that have a mutated p21ras but do not over express the EGFR are less inhibited by these 2 compounds, suggesting that their effect is primarily directed at the EGFR signal transduction pathways proximal to the p21ras gene. Our results would seem to corroborate the notion that a high dietary intake of isoflavones is a likely explanation for the decreased incidence of invasive bladder cancer5

NEWS FLASH: Chemicals in apples slow cancer growth in lab tests, scientists report
An apple a day may keep the oncologist away. Naturally occurring chemicals in apples slow the growth rate of human colon-cancer cells and liver-cancer cells, laboratory tests at Cornell University have demonstrated. The stronger the concentration of apple extract, the slower the rate of reproduction among the cancer cells, the Cornell scientists reported in a recent edition of the journal Nature. The researchers said the relatively large amounts of antioxidants found in apple extract may help to explain the cancer protection provided by a diet that includes five servings of fruits and vegetables a day. The anti-cancer effect, a spokesman said, was strongest in extracts made from unpeeled apples, which contain more antioxidant phytochemicals. These are plant chemicals containing substances that prevent or delay deterioration caused by oxygen. 6

Some helpful links to get you further in your search:

http://www.thedietchannel.com/dietandcancer.htm#Phytochemicals

http://www.nlm.nih.gov/medlineplus/nutrition.html A wealth of articles on nutrition and cancer including a recent article from the FDA: Soy: Health Claims for Soy Protein, Questions About Other Components http://www.fda.gov/fdac/features/2000/300_soy.html

http://www.wellweb.com/ Lots of useful information on this excellent site. Links to get you further on your search for reliable info on nutrition, vitamins, supplements, herbs, and both mainstream and complimentary medicine.

http://www.dianadyermsrd.com/ A site set up by cancer survivor Diana Dyer, MS, RD, a dietician who has written an award winning book. Many useful links can be found here as well.

Dietary Vitamin E Against Bladder Cancer

A recent study suggests that vitamin E protects against bladder cancer. Food, said the researchers, rather than supplements, is the best way to get the vital nutrient.

The study -largely funded by the state of Texas- was based on questionnaires of the eating habits of about 1,000 Houston residents.

Those people who either ate the most vitamin E – containing food or had the highest levels of it in the blood were the least likely to have cancer. Of the several different forms of vitamin E it was found that alpha tocopherol was key for cancer-preventative health benefit. Alpha tocopherol is found in foods such as sunflower seeds, spinach, almonds, mustard greens and green and red sweet peppers, but not in supplements.

The study was presented at the 2004 annual meeting of the American Association of Cancer Research in Orlando, by Dr. Xifeng Wu of the University of Texas M.D. Anderson Cancer Center, John Radcliffe of Texas Woman’s University in Houston and colleagues:
"… those with the highest intake of alpha tocopherol from food had a 42 percent reduced risk of bladder cancer, and those who had a vitamin E-rich diet and took supplements too had a 44 percent lower risk."

It was the opinion of Dr. Radcliffe that people would do well to try and meet the dietary allowance of vitamin E, which is about 50 milligrams a day. Current average U.S. intake of E is only 8 mg a day.

One of the best sources, said Radcliffe, a dietician, is a handful of sunflower seeds. Many E supplements contain both active and inactive forms of E and may not be the best source. Plus, he said, sunflower seeds are high in selenium, another key nutrient and cancer-fighter.

Source: American Association of Cancer Research
Intake of vitamin E (2-R isomers of á:-tocopherol) and ã:-tocopherol in a case-control study and bladder cancer risk: Abstract No. 3921 Xifeng Wu, M.D., Ph.D., M.S., University of Texas M.D. Anderson Cancer Center in collaboration with researchers at Texas Woman’s University, Houston
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Cranberries and UTI Prevention
Ingestion of cranberry juice has been shown to be effective in decreasing bacteria in the urine with pyuria [pus], but not bacteriuria alone or symptomatic urinary tract infection (UTI), in an elderly population. When combined with lingonberry, cranberry juice was demonstrated to reduce the rate of recurrent UTI in younger women. A randomized trial compared placebo, cranberry juice, and cranberry tablets for the prevention of UTIs in sexually active women aged 21 to 72 years. In this study, 32% of the women taking placebo experienced at least one symptomatic UTI over a period of 1 year; for the women taking cranberry juice or cranberry tablets, the rates were 20% and 18%, respectively.[7] Thus, although the efficacy of cranberry juice for the prevention of UTI needs further evaluation, there is mounting evidence that it may be effective in young, otherwise healthy women.[8]

Carrot compound fights cancer in animal tests
9th Feb 2005 – A compound found in carrots that acts as a natural pesticide reduced the risk of cancer in rats by a third, report UK and Danish researchers today.

Their findings offer new insight into how carrot consumption may protect against cancer, as previously demonstrated in epidemiological studies. Falcarinol protects carrots and other vegetables in the same family from fungal diseases. Previous research on the compound, which is toxic to humans in large doses, has concentrated on its actions on plant disease defense."It was simply not considered interesting for humans because it is toxic in high amounts," explained study author Dr Kirsten Brandt, a senior lecturer with Newcastle University’s School of Agriculture, Food and Rural Development.

However falcarinol is also present in ginseng, a long-established medicinal plant, and initial findings showing that it could protect against cancer led a team from Newcastle University in the UK, the University of Southern Denmark and the Danish Institute of Agricultural Sciences to look more closely at the compound. Their results, published today in the Journal of Agricultural and Food Chemistry (10.1021/jf04519s), show that after 18 weeks, rats with pre-cancerous tumors who ate a popular variety of carrots along with their ordinary feed, and another group that consumed falcarinol in a quantity equal to that in the carrots, were one third less likely to develop full-scale tumors than the rats in the control group. "We already know that carrots are good for us and can reduce the risk of cancer but until now we have not known which element of the vegetable has these special properties," said Dr Brandt.

The researcher told NutraIngredients.com that the findings lead to a potential explanation for the confusion surrounding the widely researched carotenoid beta-carotene, another important component in carrots. "Beta-carotene has been widely investigated in extensive intervention studies. One of the big conundrums was that beta-carotene alone was found to raise risk of cancer yet people who ate a lot of carrots did not experience this elevated risk," she said. "This led to a simple explanation that it must be something else in the carrot that has a protective effect as it can’t be the beta-carotene." The mechanism for the anti-cancer action is unclear at this stage. "We have some vague ideas, such as the theory that it could stimulate the immune system. Greenhouse workers exposed to falcarinol on their skin can become allergic to the compound as the immune system becomes over stimulated," said Dr Brandt. "This shows that there is some kind of chemical reaction, and it might also stimulate the immune system in a positive way," she said.

The researchers also need to find out how much falcarinol is needed to prevent the development of cancer and if certain types of carrot are better than others. But Dr Brandt noted that extracting the compound for use in supplements would present significant safety issues, likely to prevent its launch on the market. "You could in principle isolate it and let people take it in a pill. But I don’t see this as an option. It can kill you in high doses, and while people would never be able to eat the 200 carrots required to reach these fatal doses, they may overdose on pills." Further research will instead seek to pinpoint the optimal dose needed to fight off cancer, while Dr Brandt will focus on implications for industry, such as whether processing conditions like boiling carrots or making juice changes the levels of this compound. The current study used raw carrots. "We could also expand our research to include other vegetables. For consumers, it may soon no longer be a case of advising them to eat five portions of fruit and vegetables per day but to eat particular types of these in certain quantities," added Dr Brandt. The research may lead to more tailored advice for growers. The Newcastle team will shortly study whether organic carrots have higher levels of the compound.

References

1. Peter Greenwald, MD, DrPH, Sharon S. McDonald, MS, Division of Cancer Prevention and Control at the National Cancer Institute, Bethesda, Md (PG) and The Scientific Consulting Group, Inc, Gaithersburg, Md (SSM
Cancer Prevention: the Roles of Diet and Chemo Prevention http://www.moffitt.usf.edu/pubs/ccj/v4n2/toc.html
Article also found on: www.medscape.com
CREDIT AND/OR COPYRIGHT NOTICE
Reproduced by Permission from Cancer Control: Journal of the Moffitt Cancer
Center http://www.moffitt.usf.edu/pubs/ccj/

2. John Anderson, M.D., article; http://www.alternativemedicine.com/
Used with permission.

3. Michaud DS; Spiegelman D; Clinton SK; Rimm EB; Willett WC; Giovannucci EL
Department of Nutrition, Harvard School of Public Health, Boston, MA 02115, USA. 
J Natl Cancer Inst 1999 Apr 7;91(7):605-13 PMID: 10203279 UI: 99217942

4.Tomatoes, tomato-based products, lycopene, and cancer: review of the epidemiologic literature. Giovannucci E Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA 02115, USA. JNatl Cancer Inst 1999 Feb 17;91(4):317-31 PMID: 10050865 UI: 99158152

5. Inhibition of human bladder cancer cell motility by genistein is dependent on epidermal growth factor receptor but not p21ras gene expression Theodorescu D; Laderoute KR; Calaoagan JM; Guilding KM    Department of Urology, University of Virginia Health Sciences Center, Charlottesville 22908, USA. Int J Cancer 1998 Dec 9;78(6):775-82  PMID: 9833772 UI: 99049518

6 Antioxidant activity of fresh apples. Eberhardt MV, Lee CY, Liu RH Department of Food Science, Cornell University, Ithaca, New York 14853-7201, USA. PMID: 10879522 .Nature 2000 Jun 22;405(6789):903-4

7.Stothers L: A randomized trial to evaluate effectiveness and cost effectiveness of naturopathic cranberry products as prophylaxis against urinary tract infection in women. Can J Urol 9:1558, 2002 [PMID 12121581]

8. Jepson RG, Mihaljevic L, Craig J: Cranberries for preventing urinary tract infections. Cochrane Database Syst Rev (1):CD0013213, 2004 [PMID 14973968]