Vitamin E Reduces Superficial Bladder Cancer Recurrence: A Randomized Controlled Trial

Background: Most patients with superficial bladder cancer who undergo transurethral resection of bladder tumor show recurrence of the disease. So far, there have been numerous studies on ways to decrease bladder cancer recurrence, including the intake of vitamins and antioxidants. The goal of this study was to investigate the effect of vitamin E on the recurrence of non?invasive bladder cancer. Methods: In this randomized controlled trial, 46 patients with a single, low?grade, superficial bladder cancer, less than 3 cm in diameter, were randomly divided into two groups of vitamin E intake (400 IU daily) and no intake of vitamin E. Ultrasound and urinalysis were performed every three months to detect bladder cancer recurrence. Results: There was no significant difference between the groups in age, tumor size, mean time to recurrence, and follow?up time. There recurrence rate was 28.3% throughout the follow?up period (19% in the study group and 36% in the controls) (CI=0.19 – 0.92, RR=0.53, CI=0.11 – 0.94, OR=0.42, P=0.04). In both groups, most (69.2%) of the recurrences occurred during the first year. The rate of recurrence decreased in smokers from 50% in the study group to 25% in the control group (P=0.06) and from 26.7% to 15.4% in the non?smokers in the control and study groups, respectively (P=0.15). Conclusion: Intake of vitamin E significantly decreased bladder cancer recurrence, especially among smokers, possibly due to higher levels of oxidants, which vitamin E may target in smokers. The trial registry code: IRCT201105235527N2