One of the most important recent developments in the management of superficial bladder cancer has been the unequivocal demonstration that intravesical immunotherapy can prevent progression of the disease to muscle-invasive cancer, whereas intravesical chemotherapy apparently cannot. Toxicity for these two forms of therapy still remains a major problem and attempts at reducing the dosage of immunotherapeutic agents are underway. The promise that various simple natural agents, taken by mouth, can have a significant effect on bladder cancer prophylaxis is being energetically explored at the present time.