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What is Bladder Cancer?

The bladder is an expandable, hollow organ in the pelvis that stores urine (the body's liquid waste) before it leaves the body during urination. The urinary tract, made up of the kidneys, ureters, bladder, and urethra, is lined with a layer of transitional cells called the urothelium. This layer of cells is separated from the bladder muscles (called the muscularis propria) by a thin, fibrous band called the lamina propria. The lamina propria separates tumors that have spread into muscle (called invasive cancer) from those that have not (superficial or non-invasive cancers).

Bladder cancers are malignant tumors that begin in the bladder. Different bladder cancers are described by how deep they grow and if they grow into the bladder or through the muscles around the bladder (superficial or invasive).

There are three types of bladder cancer: transitional cell carcinoma, or TCC (about 90% of bladder cancer cases); squamous cell carcinomas (about 8%); and adenocarcinomas (about 2%). There are other less common types of cancer that arise in the bladder, including sarcomas (which begin in the muscle layers of the bladder) and small cell anaplastic cancers (a rare type very likely to spread to other parts of the body).

All three types can metastasize beyond the bladder. The tumor can grow into the surrounding organs (uterus and vagina in women; prostate in men), called locally advanced disease. It can also spread to the nearby lymph nodes, and/or into the liver, bones, or lungs; this is called distant metastasis. In some cases, it can spread to other parts of the body.

As we well know, there are many kinds of cancer; unfortunately they all come about because of the out-of-control growth of abnormal cells.

Healthy Cells vs. Cancer Cells

Healthy cells are like a cat. They need structure to determine the size of bones and shape of the body, tail and whiskers. The DNA in genes and chromosomes determine this. They need energy to play and prowl and sustain life. This is derived from chemicals in food. Cats need a system to deliver chemicals (food nutrients like amino acids, carbohydrates, fats, vitamins and minerals) to all parts of their body. These are the blood vessels. Growth factors take a kitten into a lazy old cat, all the while helping it to function normally.

The body and its cells are mostly made up of protein. The building blocks of proteins are substances called amino acids that in the form of enzymes and hormones literally control every chemical reaction within the cells. When these are modified, different messages are sent to a complex control system that can alter their function. There are twenty different kinds of amino acids that are essential to life. Twelve of these can be synthesized within the body however; eight must be supplied by the daily diet.


Normal Cells

Cancer Cells

DNA in genes and chromosomes go about their business in a normal way.

Cancer cells develop a different DNA or gene structure or acquire abnormal numbers of chromosomes.

Cells divide in an orderly way to produce more cells only when the body needs them.

Cells continue to be created without control or order.  If not needed, a mass of tissue is formed which is called a tumor.


Normal Cells

Cancer Cells

Cells derive 70% of their energy from a system called the “Krebs Cycle.”

Cells have a defective “Krebs Cycle” and derive little or no energy from it.

Cells derive only 20% of their energy from a system called “Glycolosis.”

Cancer cells derive almost all their energy from “Glycolosis.”

Cells derive most of their energy with the use of oxygen.

Cells derive most of their energy in the absence of oxygen.

Blood Vessels

Normal Cells

Cancer Cells

Cells have a built-in blood vessel system.

Cells do not have a built-in blood vessel system.  They require more of certain amino acids to grow.


Growth Factors

Normal Cells

Cancer Cells

While similar to cancer cells, the amount of them is more in balance to produce a more normal level of activity.

These cells have over produced, require more chemicals (food) and are over active.


Normal Cells

Cancer Cells

The enzymes and hormones go about business in a normal balanced manner.

The enzymes and hormones are either over active or under active.

Tumors are Different



Benign tumors are not cancerous.  They do not invade nearby tissues nor spread to other parts of the body.  They can be removed and are not a threat to life.

Malignant tumors are cancerous.  They can invade and damage nearby tissues and organs and they can break away and enter the blood stream to form new tumors in other parts of the body. The spread of cancer is called metastasis.


Treatment for bladder cancer depends on what type it is, how big the tumor is, and if it has spread to other parts of the body. Early stage cancers can often be treated locally (treatments that just involve the bladder) without removing the whole bladder. More advanced cancers often need systemic chemotherapy, or drugs that circulate through the whole body to kill cancer cells. In advanced cancer, it may or may not be possible to save the bladder during surgery.

When appropriate we support surgery, chemotherapy and/or radiation, for cancers that are operable, combined with our integrative biological protocol Controlled Amino Acid Therapy (CAAT).

  • Surgery

Transurethral resection of the bladder (TURB) with fulguration for early stage cancers). The surgeon inserts a tube and light (cystoscope) through the urethra into the bladder, and removes the cancer using a tool with a small wire loop or burns the tumor with a laser or high-energy electricity (fulguration). This is done under anesthetic so that it is not painful.

Cystectomy (usually used in more advanced cancer, or recurrent cancer). In a radical cystectomy, a surgeon removes the whole bladder, and may also remove nearby tissue and organs. In men, the prostate and urethra are removed. In women, the uterus, fallopian tubes, ovaries, and part of the vagina are removed. In men or women, lymph nodes in the pelvis may also be removed. This is called a pelvic lymph node dissection (PLND).

If possible, sometimes the surgeon will remove just part of the bladder, called a partial cystectomy. Advances in chemotherapy are making this option more common, and new surgical techniques to preserve part of the bladder can help make patients more comfortable.

Ostomy/urostomy. If the bladder is removed, the doctor will make a new way for the body to store urine by using a section of the small intestine to pass urine through an opening (stoma) to the outside of the body. The patient wears a bag attached to the stoma to collect and drain urine.

Sometimes surgeons can make a continent reservoir, a storage pouch that sits inside the body. They create this using a part of the small intestine. In this case, the patient will not need a stoma because the pouch stays connected to part of the urethra, which can still drain the body’s urine.

  • Radiation Therapy

Radiation therapy uses high-energy X-rays to stop cancer cells from reproducing. Radiation may treat a tumor from a machine outside the body (external radiation therapy) or from a small pellet of radioactive material placed inside or near the tumor (internal radiation therapy).

Doctors use radiation therapy to treat bladder cancer at all stages: a) Before surgery, to shrink a tumor; b) After surgery, to destroy any tumor left behind; c) To relieve symptoms such as pain, bleeding or blockage.

  • Chemotherapy

Chemotherapy is the use of drugs to destroy cancer cells by stopping them from growing or reproducing. For bladder cancer, doctors may decide to use one of two types of chemotherapy: local (intravesical) or whole body (systemic) treatment. In general, earlier cancers are more likely to be treated with local chemotherapy, and more advanced cancers with systemic chemotherapy.

Local (intravesical) chemotherapy. Drugs are placed into the bladder through a thin tube (catheter) inserted through the urethra. Local treatment kills only superficial tumor cells. It cannot reach tumor cells in the bladder wall or growths that have spread to other organs. The most common drug that is given in intravesical treatment is an immune therapy drug called BCG (described below). Intravesical therapy can cause bladder irritation, bladder infections, inability to urinate, or blood in the urine. Rarely, patients experience fevers or chills.

Systemic chemotherapy. Patients receive drugs orally or intravenously (IV). The drugs enter the bloodstream and travel to all parts of the body.

In bladder cancer, most chemotherapy drugs are still being tested in clinical trials to help determine which ones, or which combinations, work the best in treating bladder cancer. Of the known drugs, usually a combination of drugs works better than one drug alone.

A combination of drugs called MVAC (pronounced emm-vack) is now used as the standard treatment for bladder cancer. It has been useful in bladder cancer in delaying recurrence and extending life, but it has severe side effects. Other drugs are now in clinical trials to see if there is a combination of drugs that works better and has fewer side effects. MVAC uses four drugs: Methotrexate, Vinblastine, doxorubicin (brand name "Adriamycin"), and Cisplatin.

  • Immunotherapy

Immunotherapy uses materials made by the body or in a laboratory to boost patients' natural defenses against cancer. It is also called biological therapy or biological response modifier (BRM) therapy. Immunotherapy drugs are given in the same way chemotherapy drugs are given: by mouth, or through an IV.

The most common immunotherapy is a weakened bacterium called bacillus Calmette-Guerin (BCG), which is similar to a weak form of the germ that causes tuberculosis. It is placed into the bladder through a catheter. BCG irritates the inside of the bladder, attracting the patient's immune cells to the bladder to fight the tumor.

Controlled Amino Acid Therapy (CAAT)

The objective of CAAT is to alter or impair the development of cancer cells by interfering with the five basic requirements of cell formation (structure, energy, blood vessels, growth hormones and functions). This is accomplished by controlling the intake of the 20 different amino acids, the building blocks of proteins and cells, which the cancer cell requires for formation, growth and function. In essence, amino acids in the form of enzymes and hormones, control literally every chemical reaction that takes place in the cells of the body. (Source, text book, Practical Physiological Chemistry: authors; Harper, Rodwell and Mayes.) Thus, the name, Controlled Amino Acid Therapy (CAAT).

THE SCIENTIFICALLY FORMULATED AMINO ACID THERAPY CAAT is an amino acid and carbohydrate deprivation protocol. It is a three-phase program, lasting six to nine months, to control a patient’s amino acid intake. This is achieved by removing certain foods from a person’s food plan for a short time and by replacing them with particular amino acids. It is important to emphasize that patients needn’t abandon their conventional cancer treatment, nor is it recommended that they do so unless it has already failed them. Furthermore, CAAT works synergistically with chemotherapy and/or radiation, not only to enhance their benefits but also to lessen their toxic side effects. CAAT has also been proven to work successfully alone. The patient’s oncologist determines which drugs will be used. Oncologists and the patients in several U.S. states and other countries are now using CAAT.

Phase 1: CAAT Formulation

The crucial component of CAAT is the scientifically formulated amino acids. It is the core of the treatment because it replaces regular protein foods, which meats, fish, cheese, fowl, nuts, and beans normally occupy. The remainder of the regimen consists primarily of vegetables, limited amounts of grits or rice, certain fruits, small amounts of dairy, and vegetable and fish oils, if the patient’s cancer type allows. Patients usually take the formulation twice a day, at lunch and dinner.

Phase 2: Daily Food Intake

(DISCLAIMER: The food program described below SHOULD NOT be consumed without the amino acid (CAAT) formula and without consent from your doctor and our institute.)

Patients are allowed to eat vegetables and salads (depending on the type of cancer, medical information, and their blood work). Vegetables are generally low in carbohydrates, proteins, and especially in certain amino acids that are already reduced in the daily diet. CAAT’s amino acid formula (depending on the type of cancer) is designed to replace most animal protein in the diet.


½ grapefruit or 1 orange or 6 ounces of fresh orange juice. Whey Enhanced Protein (vanilla flavor--Vitamin Shoppe brand) [approximately 10-12 grams of protein--read label carefully]
Grits or Cream of Wheat cereal or 1 slice of white toast or ½ plain bagel or ½ English muffin. (Butter is okay.)                        
1 cup of green or black tea (artificially sweetened if desired).

Explanation: ½ grapefruit or 1 orange or 6 ounces of fresh orange juice are rich in natural nutrients called limonene and citric acid. Limonene helps de-activate the Ras cancer gene, which is overactive in 90 percent of all cancers. Citric acid helps reduce the process of Glycolosis, which then helps starve cancer cells to death.

Whey Enhanced Protein (vanilla flavor--Vitamin Shoppe brand) [approximately 10-12 grams of protein-- read label carefully]. Whey protein helps protect health of normal cells, maintain normal appetite, and fight edema (swelling or water build-up in legs or other sites in the body). Whey proteins are low in phosphorus, a nutrient that cancer cells must utilize in order to grow and reproduce.

Whey protein is included in the menu of all advanced or metastatic cancer patients. When treating cancers that are stable or have regressed in size, patients then may include other protein foods at their breakfast meals, such as cottage cheese, yogurt, or soy foods. Eggs are allowed in diets of patients with lymphoma and brain cancers. Grits or Cream of Wheat cereal or 1 slice of white toast or ½ plain bagel or ½ English muffin. (Butter is okay.) Grits is the preferred carbohydrate food at each meal. The other choices are options once the cancer is stable or reduced in size. Certain bland carbohydrates are included in the CAAT menu, instead of whole grains, to deprive cancer cells of a B-complex vitamin called pyridoxine (vitamin B-6). Cancer cells require this vitamin to manufacture certain amino acids that we avoid through CAAT’s amino acid deprivation formula and diet. Grits is the preferred food at breakfast, lunch, and supper instead of rice because it helps deplete the body’s tryptophan, one of several amino acids that we reduce in the diets of all cancer patients.

1 cup of green or black tea (artificially sweetened if desired). These teas are rich sources of several compounds that help reduce Glycolosis and therefore the energy supply to cancer cells. Green or regular teas also help prevent certain hormones and tumor growth factors from stimulating cancer cells to grow and metastasize to other parts of the body.


Amino Acid Formula (3 1/2 level plastic scoops) with diet ginger ale soda or water, or lemonade artificially sweetened, or chicken or beef broth or V8 Juice
Two cooked vegetables (except peas, lentils, or beans of any type)
1 serving of grits or white rice
8 to 10 black or green olives
1 cup of green or black tea (artificially sweetened if desired)

Explanation: Amino Acid Formula (3 1/2 level plastic scoops) with diet ginger ale soda or water, or lemonade artificially sweetened, or chicken or beef broth or V8 Juice. This CAAT formula, combined with the special diet, allows the CAAT Protocol to reduce certain amino acids in the daily diet of cancer patients. To synthesize DNA, build new blood vessels, or duplicate their entire protein content, cancer cells require the amino acids called glycine, serine, glutamic acid, and aspartic acid. In addition, cancer cells require further amino acids in order to synthesize other proteins that act as growth-promoting hormones or tumor growth factors. CAAT also impairs the synthesis of a protein called elastin, which is essential to the manufacture of new blood vessels. CAAT’s amino acid deprivation formula, diet, certain phytochemicals, and herbs work efficaciously because, when combined, they become powerful forces that attack cancer cells on various biological fronts.

Two cooked vegetables (except peas, lentils, or beans of any type). The latter three foods are very high in either carbohydrates and/or proteins and when consumed, provide energy to cancer cells that prevents their self-destructing. This would thus counteract the benefits of CAAT’s deprivation protocol. Almost all other vegetables are low in carbohydrates and high in phytochemicals, compounds that help fight cancer.

1 serving of grits or white rice. These complex carbohydrate foods provide calories for normal cells and help regulate body weight. In the body, grits helps deplete the amino acid called tryptophan, which is one of several amino acids that the CAAT formula also reduces in cancer patients’ diets. Without sufficient tryptophan, cancer cells cannot duplicate the protein content necessary for them to divide and spread within the body. Grits or white rice can be seasoned with favorite spices and butter.

8 to 10 black or green olives. Olives are rich in squalene and oleic acid nutrients that have been reported to help fight cancer. The calories in olives also help control body weight and increase ketones in the blood. Ketones help fight cancer by impairing Glycolosis--the process on which cancer cells depend almost exclusively for their daily energy.

3 p.m. Snack:

2 ounces of chicken or turkey breast, 1 slice of white bread (no mayo)
1 cup of green or black tea (artificially sweetened if desired)


2 ounces of salmon or tuna, 1 slice of white bread (no mayo)
1 cup of green or black tea (artificially sweetened if desired).

Explanation: If the patient is underweight or has an albumin level below normal, s/he is allowed this meal. It should be eaten a minimum of 3 hours before or after the Amino Acid Formula. CAAT provides sufficient protein to maintain the health of normal cells and adequate amounts of calories to maintain desired body weight. Any proteins taken in excess of amounts recommended will counteract the benefits of our CAAT protocol.


Amino Acid Formula (4 level plastic scoops) with diet ginger ale soda or water, or lemonade artificially sweetened, or chicken or beef broth or V8 Juice.
Two cooked vegetables (except peas, lentils, or beans of any type)
½ avocado salad with lettuce, tomatoes, celery, garlic, and onions with lemon juice and olive oil.   
1 serving of grits or white rice
1 cup of green or black tea (artificially sweetened if desired)

Mid-evening Snack:

1 serving of sugar-free Jello or 1 plum or one 6-ounce glass of orange juice

Explanation: 1 serving of sugar-free Jello or 1 plum or 6-ounce glass of orange juice. Jello helps appease appetite. Plums contain quinlic acid, which is converted to benzoic acid in the body and helps deplete the supply of the amino acid glycine (essential to the synthesis of DNA) and the proteins that cancer cells require to build new blood vessels and tumor-growth factors. Orange juice contains citric acid that fights cancer by helping to reduce Glycolosis and the energy supply to cancer cells. If underweight, take one ounce of light cream and one ounce of olive oil.

Carbohydrate Deprivation Diet: CAAT’s formulation provides approximately 20 percent of its calories as carbohydrates. Calories need not be a focal point or counted daily. It is recommended that all patients combat their cancer by keeping their body weight at normal to slightly below normal levels. Patients’ desired body weight is regulated by their rate of metabolism, which in turn is regulated by their blood levels of thyroxine, cortisone, and insulin, plus the amount of oils and fats in the diet. Studies with human cancer patients and laboratory animals show that reducing the calories from carbohydrates in the diet by only 10 percent actually shrank cancerous tumors. When the carbohydrate calories were reduced by 40 percent, the cancers disappeared. To increase the efficiency of the CAAT treatment, it is recommended that obese patients gradually and systematically lose excess weight. Those patients who are underweight shouldn’t gain weight, unless they are more than 15 pounds under normal levels. When a patient is underweight due to anorexia or cachexia, such illnesses must be addressed before treatment can begin.

We suggest that any patient considering enrolling into CAAT make a three-month commitment, in order to give CAAT the time it needs to fight your cancer. If scans or tests then show CAAT is helping, we would suggest following CAAT for an additional 3 to 6 months. The total time on CAAT should be only 6 to 9 months.

Phase 3: Nutritional Supplements

Nutritional supplements are based on each unique situation. For example, slow-growing cancers produce low levels of toxic free radicals. Tumor cells that grow aggressively produce large amounts of toxic free radicals. The patient will be instructed whether or not to take anti-oxidants (in a nutritional supplement), and at what dosage, according to the levels of toxic free radicals produced in the cancerous cells.

An example of how nutritional supplements can help manipulate cancer cells involves vitamin B-6 (pyridoxine). There are four amino acids essential to the synthesis of DNA. However, those amino acids cannot be synthesized without a certain enzyme, which includes vitamin B-6 among various components. CAAT patients are forbidden from taking any supplement that contains vitamin B-6 during the first two months of treatment.

The patient will be instructed about which nutritional supplements to purchase and at which dosage strength. Keep in mind that each supplement alone provides only minimal benefits. However, when combined, they augment the therapeutic benefits of the CAAT Protocol.

Superoxide dismutase: Taken sublingually (under the tongue), this enzyme can reduce or de-activate Ras, the growth-promoting cancer gene. It is also crucial in causing cancer cells to self-destruct.

Curcumin: Helps reduce activity of the enzymes called tyrosine kinase and protein kinase, which otherwise stimulate the growth and spread of cancer. In this respect, curcumin complements CAAT, which inhibits the production of these enzymes.

Parsley: Contains ingredients that can help reduce activity of enzymes called epithelial growth factors, which also stimulate the growth and spread of cancer. CAAT’s amino acid deprivation diet works similarly.

Quercetin: Like parsley, this herb can also help retard activity of the enzymes that cause cancer growth and spread.

Lycopene: Also decreases activities of cancer-promoting enzymes.

Vitamin D: Helps promote production of enzymes called phosphotases, which help de-activate other enzymes called kinases, essential to growth and reproduction of cancer cells.

Green tea extract: Phytochemicals in tea reduce Glycolosis (cancer cells’ main energy supply), thereby helping starve cancer cells to death. These effects complement CAAT’ s carbohydrate deprivation diet.

Anti-oxidants: The controversy about whether to treat cancer with anti-oxidants is slowly resolving with the newer understanding of how they affect the activity of genes and enzymes in cancer cells. The prevailing data shows that the benefits, or lack of benefits, depend upon the oxidative state the cancer cells are in. Anti-oxidants taken when the cells are in a very high oxidative state may prevent them from entering apoptosis or from committing suicide. When oxidative stress in cancer cells is only slightly above normal, however, then anti-oxidants are expected to stop their growth and reproduction.

Blood chemistry: Blood tests are usually done each every 6 to 8 weeks, depending upon the results of each test. Not only is it important to monitor the tumor markers but equally important to evaluate the overall health of normal tissues and organs. For example, it is crucial to determine the health of kidneys and liver and see whether the body is producing sufficient red and white blood cells, etc. Low albumin levels often indicate insufficient intake of proteins, which requires some change in diet.

CAAT is designed to attack cancer, while keeping normal cells and tissues functioning harmoniously.

* When considering any type of complementary cancer treatment or alternative cancer treatment, always consult with your physician first, as possible interactions could reduce your regimen’s efficacy.

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