Bladder Cancer Stages

A cancer’s stage refers to how large the primary tumor is and how far the cancer has spread in the patient’s body. Knowing the stage helps the care team understand the disease and develop an appropriate treatment plan. It also impacts the patient’s prognosis, or chance for a successful treatment.

TNM stages

The TNM staging system is used for most cancers.

TNM staging describes cancer based on three main factors:

• The size of the primary tumor (T) and whether it has invaded nearby tissues.
• The cancer’s spread to nearby lymph nodes (N).
•  Whether the cancer has metastasized (M), or spread, to distant parts of the body.

Each TNM factor is assigned a number that reflects the extent of the cancer. Tumors (T) are scored between 1-4, nodes (N) 1-3, and metastasis (M) 0-1.

After all diagnostic and staging procedures are performed, your doctor should know the TNM stage of your cancer and be able to explain how this stage impacts your treatment and prognosis.

0 to IV stages

Often, TNM staging can be simplified into stages four stages (I-IV). For some cancers, there is also a stage 0. Larger numbers mean the cancer is more advanced and is generally more difficult to treat.

• Stage 0 reflects the presence of abnormal cells that have not spread to tissue that is immediately nearby. Stage 0 is considered precancerous, though it could become cancer in the future. This stage is also called “in-situ,” which means “in its original place.” Not all cancers have a stage 0.
• Stage I cancers are typically small and confined to the area where they began.
• Stage II and Stage III cancers have spread to nearby tissue and/or lymph nodes.
• Stage IV cancer has spread to distant areas of the body. This is also called metastatic cancer. Stage IV cancer often cannot be cured, but frequently can be managed like a chronic disease.

Bladder cancer 0-IV stages

Source: National Cancer Institute

Stage 0 bladder cancer

Stage 0 refers to noninvasive bladder cancer. This means that cancer cells are found in tissue lining the inside of the bladder but have not invaded the bladder wall. Stage 0 is divided into stages 0a and 0is, depending on the type of tumor:

• Stage 0a is also called noninvasive papillary carcinoma, which may look like long, thin growths extending into the bladder lumen (the space where urine collects). Stage 0a can be low grade or high grade, depending on how abnormal the cells look under the microscope (see the section on Bladder cancer grade).
• Stage 0is is also called carcinoma in situ, which is a flat tumor on the tissue lining the inside of the bladder. Stage 0is is always high grade (see the section on Bladder cancer grade).

Stage I bladder cancer

Stage I is a form of non-muscle-invasive bladder cancer that has spread into the connective tissue but has not reached the muscle layers of the bladder.

Stage I bladder cancer (non-muscle-invasive bladder cancer). Cancer has spread into the connective tissue but has not reached the muscle layers of the bladder.

Stage II bladder cancer

Stage II may also be described as muscle-invasive bladder cancer. In stage II, cancer has spread through the connective tissue into the muscle layers of the bladder.Stage III bladder cancer

Stage III may also be described as locally advanced bladder cancer. Stage III is divided into stages IIIA and IIIB.

• In stage IIIA

   

  • cancer has grown all the way through the bladder muscles and bladder wall into the layer of fat surrounding the bladder and may have spread to the reproductive organs (prostate, seminal vesicles, uterus, or vagina) but has not spread to lymph nodes; or
  • cancer has spread to one lymph node in the pelvis that is not near the major arteries in the pelvis, called the common iliac arteries.

     

   

• In stage IIIB, cancer has spread to more than one lymph node in the pelvis that is not near the common iliac arteries or to at least one lymph node that is near the common iliac arteries.

Stage IV bladder cancer

Stage IV is divided into stages IVA and IVB.

• In stage IVA

   

  • cancer has spread to the abdominal wall or pelvic wall; or
  • cancer has spread to lymph nodes that are above the major arteries in the pelvis, called the common iliac arteries.
• In stage IVB, cancer has spread to other parts of the body, such as the lung, bone, or liver.