The bladder cancer staging and grading processes help your doctors make treatment decisions and estimate your chance of recovery.
These assessments are used to determine cancers stage (0 to IV) and grade.
Doctors use the staging information to comparetreatment optionsand patient outcomes.
Verywell / Laura Porter
Staging and grading also important in determining your eligibility for cancer treatment clinical trials.
Early Detection
If cancers are caught early, they are easier to treat and cure.
A specialist doctor called a pathologist analyzes the tumor samplesunder the microscope.
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The grades go from grade 1 (mostly normal) to grade 3 (very abnormal).
The most common symptom of bladder cancer is reddish or brownish-colored urine from blood in the urine.
When cancer spreads, its called metastatic cancer or a metastatic tumor.
This spreading can happen between tissues, or through the fluids of the blood or lymphatic systems.
T scoring is from 0 to 4, and also special categories of Ta and Tis.
N is scored from 0 to 3.
M is either 0 or 1.
An X means that that characteristic couldn’t be measured.
Stage Never Changes
A cancer stage never changes from when it was first diagnosed.
If cancer improves or worsens, it will be the same stage cancer.
Stage 0 Bladder Cancer
Stage zero bladder cancers are called noninvasive papillary carcinoma and carcinoma in situ.
Theyre precancerous lesions that could develop into more serious cancers if not treated.
These growths develop on the inner lining of the bladder.
The surgery uses a lighted camera that is threaded up theurethrathe tube through which urine usually exits the body.
Surgery is typically followed up with chemotherapy inside the bladder or an immunotherapy calledBacillus Calmette-Guerin (BCG) therapy.
When treatment is given into the bladder, it’s called intravesically administered treatment.
If BCG therapy is unsuccessful, another treatment option includes Adstiladrin (nadofaragene firadenovec-vncg).
These tumors havent yet reached the muscular layers of the bladder, so theyre often called non-muscle-invasive bladder cancer.
Some cases of non-muscle-invasive bladder cancer progress to muscle-invasive bladder cancer, which is more serious.
This treatment is usually followed by chemotherapy orBCG therapyinside the bladder.
In some cases, a more extensive surgery called a radical cystectomy is recommended.
This surgery removes the bladder and any nearby cancerous lymph nodes or tissues.
Stage II Bladder Cancer
Stage II bladder cancer is also known as muscle-invasive bladder cancer.
These tumors have spread into the muscular walls of the bladder.
Stage II cancers are more likely to spread to other parts of the body.
Approximately 20% of newly diagnosed bladder cancer cases are muscle-invasive.
Cancers that have grown into the bladder wall (muscle-invasive tumors) generally have poorer outcomes.
The same applies to having larger tumors or numerous tumors.
Some patients may only need a partial removal of the bladder or TUR and fulguration.
Sometimes treatments like chemotherapy and external-beam radiation therapy are also used.
If chemotherapy is recommended to shrink the bladder tumors before surgery, its referred to asneoadjuvant therapy.
Its divided into stage IIIA and stage IIIB.
Stage IIIA bladder cancer has either:
Stage IIIB cancer has also spread.
This is often called metastatic cancer.
Stage IV bladder cancer is divided into stage IVA and IVB.
Coping
Late-stage bladder cancer doesn’t have very good outcomes.
New types and combinations of treatment for bladder cancer are being tested in clinical trials.
Summary
When you are diagnosed with bladder cancer, it will be graded and staged.
The grade and stage help guide treatment options.
This rate has improved over the past several years.
When bladder cancer has become metastatic, it spreads to the lungs, bones, or liver.
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National Cancer Institute.Bladder cancer treatment (adult) (PDQ)patient version.
Centers for Disease Control and Prevention.Bladder cancer basics.
American Society of Clinical Oncology.Bladder cancer stages.
National Cancer Institute.Cancercancer stat facts.
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