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No AccessJournal of Urology1 Jan 1994Megadose Vitamins in Bladder Cancer: A Double-Blind Clinical Trial Donald L. Lamm, Dale R. Riggs, Jackie S. Shriver, Patricia F. vanGilder, Joel F. Rach, and Jean I. DeHaven Donald L. LammDonald L. Lamm More articles by this author , Dale R. RiggsDale R. Riggs More articles by this author , Jackie S. ShriverJackie S. Shriver More articles by this author , Patricia F. vanGilderPatricia F. vanGilder More articles by this author , Joel F. RachJoel F. Rach More articles by this author , and Jean I. DeHavenJean I. DeHaven More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(17)34863-2AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Epidemiological and laboratory studies suggest that vitamin supplements may be helpful in the prevention of some cancers but clinical trials to date have failed to demonstrate protection with naturally occurring vitamins. Without substantiation of the highly touted benefits of vitamins, few physicians who care for cancer patients have recommended their use. A total of 65 patients with biopsy confirmed transitional cell carcinoma of the bladder enrolled in a randomized comparison of intravesical bacillus Calmette-Guerin (BCG) with or without percutaneous administration was also randomized by closed envelope to therapy with multiple vitamins in the recommended daily allowance (RDA) versus RDA multivitamins plus 40,000 units vitamin A, 100 mg. vitamin B6, 2,000 mg. vitamin C, 400 units vitamin E and 90 mg. zinc. The addition of percutaneous BCG did not significantly lessen tumor recurrence but recurrence after 10 months was markedly reduced in patients receiving megadose vitamins. The 5-year estimates of tumor recurrence are 91% in the RDA arm and 41% in the megadose arm (p = 0.0014, Mantel-Cox). Overall recurrence was 24 of 30 patients (80%) in the RDA arm and 14 of 35 (40%) in the high dose arm (p = 0.0011, 2-tailed Fisher’s exact test). Megadose vitamins A, B6, C and E plus zinc decrease bladder tumor recurrence in patients receiving BCG immunotherapy. Further research will be required to identify which ingredient(s) provide this protection. © 1994 by The American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited ByHotaling J, Wright J, Pocobelli G, Bhatti P, Porter M and White E (2018) Long-Term Use of Supplemental Vitamins and Minerals Does Not Reduce the Risk of Urothelial Cell Carcinoma of the Bladder in the VITamins And Lifestyle StudyJournal of Urology, VOL. 185, NO. 4, (1210-1215), Online publication date: 1-Apr-2011.Nepple K, Lightfoot A, Rosevear H, O'Donnell M and Lamm D (2018) Bacillus Calmette-Guérin With or Without Interferon α-2b and Megadose Versus Recommended Daily Allowance Vitamins During Induction and Maintenance Intravesical Treatment of Nonmuscle Invasive Bladder CancerJournal of Urology, VOL. 184, NO. 5, (1915-1919), Online publication date: 1-Nov-2010.Hung R, Zhang Z, Rao J, Pantuck A, Reuter V, Heber D and Lu Q (2018) Protective Effects of Plasma Carotenoids on the Risk of Bladder CancerJournal of Urology, VOL. 176, NO. 3, (1192-1197), Online publication date: 1-Sep-2006.Kassouf W, Highshaw R, Nelkin G, Dinney C and Kamat A (2018) Vitamins C and K3 Sensitize Human Urothelial Tumors to GemcitabineJournal of Urology, VOL. 176, NO. 4, (1642-1647), Online publication date: 1-Oct-2006.Konety B (2018) Bladder Cancer Prevention—Could a Carrot Be the Stick?Journal of Urology, VOL. 176, NO. 3, (864-865), Online publication date: 1-Sep-2006.Busby J and Kamat A (2018) Chemoprevention for Bladder CancerJournal of Urology, VOL. 176, NO. 5, (1914-1920), Online publication date: 1-Nov-2006.OZASA K, ITO Y, SUZUKI K, WATANABE Y, HAYASHI K, MIKAMI K, NAKAO M, MIKI T, MORI M, SAKAUCHI F, WASHIO M, KUBO T, WAKAI K and TAMAKOSHI A (2018) SERUM CAROTENOIDS AND OTHER ANTIOXIDATIVE SUBSTANCES ASSOCIATED WITH UROTHELIAL CANCER RISK IN A NESTED CASE-CONTROL STUDY IN JAPANESE MENJournal of Urology, VOL. 173, NO. 5, (1502-1506), Online publication date: 1-May-2005.NOMURA A, LEE J, STEMMERMANN G and FRANKE A (2018) Serum Vitamins and the Subsequent Risk of Bladder CancerJournal of Urology, VOL. 170, NO. 4 Part 1, (1146-1150), Online publication date: 1-Oct-2003.Pook S, Esuvaranathan K and Mahendran R (2018) N-Acetylcysteine Augments The Cellular Redox Changes and Cytotoxic Activity of Internalized Mycobacterium Bovis in Human Bladder Cancer CellsJournal of Urology, VOL. 168, NO. 2, (780-785), Online publication date: 1-Aug-2002.DUGGAN B, KELLY J, KEANE P and JOHNSTON S (2018) MOLECULAR TARGETS FOR THE THERAPEUTIC MANIPULATION OF APOPTOSIS IN BLADDER CANCERJournal of Urology, VOL. 165, NO. 3, (946-954), Online publication date: 1-Mar-2001.KONETY B, LAVELLE J, PIRTSKALAISHVILI G, DHIR R, MEYERS S, NGUYEN T, HERSHBERGER P, SHURIN M, JOHNSON C, TRUMP D, ZEIDEL M and GETZENBERG R (2018) EFFECTS OF VITAMIN D (CALCITRIOL) ON TRANSITIONAL CELL CARCINOMA OF THE BLADDER IN VITRO AND IN VIVOJournal of Urology, VOL. 165, NO. 1, (253-258), Online publication date: 1-Jan-2001.KAMAT A and LAMM D (2018) CHEMOPREVENTION OF UROLOGICAL CANCERJournal of Urology, VOL. 161, NO. 6, (1748-1760), Online publication date: 1-Jun-1999.Lamm D, Riggs D, Traynelis C and Nseyo U (2018) Apparent Failure of Current Intravesical Chemotherapy Prophylaxis to Influence the Long-Term Course of Superficial Transitional Cell Carcinoma of the BladderJournal of Urology, VOL. 153, NO. 5, (1444-1450), Online publication date: 1-May-1995.Lamm D (2018) Re: Editorial: Bladder Cancer by M. J. Droller J. Urol., 151: 47-48, 1994Journal of Urology, VOL. 152, NO. 4, (1213-1213), Online publication date: 1-Oct-1994. Volume 151Issue 1January 1994Page: 21-26 Advertisement Copyright & Permissions© 1994 by The American Urological Association Education and Research, Inc.Keywordstransitional cellvitaminsBCG vaccinebladder neoplasmscarcinomaMetricsAuthor Information Donald L. Lamm More articles by this author Dale R. Riggs More articles by this author Jackie S. Shriver More articles by this author Patricia F. vanGilder More articles by this author Joel F. Rach More articles by this author Jean I. DeHaven More articles by this author Expand All Advertisement PDF DownloadLoading ...