Oxidative Stress and Bladder Cancer Carcinogenesis: Early Detection and Chemoprevention Involving Nrf2—an Integrative Approach

Oxidative stress is a driver of many diseases, including cancer. Nuclear factor (erythroid-derived 2) like 2 (Nrf2 or NFE2L2) provides cellular defense against oxidative stress by regulating antioxidant response element (ARE)-mediated phase II detoxifying/antioxidant enzymes. This protective role is evident from studies on bladder cancer (BCa) pathogenesis. This article reviews the impact of excessive oxidative stress on bladder carcinogenesis, aiming to understand what is happening from an epidemiological perspective concerning its burden and management, as well as to discuss the challenges including high relapse rate. Two measures are proposed for reducing the burden and better management: first, promote early diagnosis of BCa with fluorescence cystoscopy; second, increase dietary intake of nutraceuticals that demonstrate functional antioxidative Nrf2. Such an integrative approach may provide a better prognostic outcome for BCa patients or people who are at higher risk of developing BCa.