Stage and Grade

Bladder Cancer The stage of the cancer refers to whether it is superficial or invasive bladder cancer, and whether it has spread to other places in the body. Bladder cancer in the early stages can often be cured.

The type of bladder cancer cells and how they look under a microscope is called the grade of the cancer. Typically bladder cancers are referred to as High Grade or Low Grade. Most invasive bladder cancers are High Grade.

Treatment options depend on the stage of bladder cancer

Your stage of bladder cancer is determined by several tests.

  1. Cystoscopy and transurethral resection of the tumor. This is a biopsy of the tumor and will help to determine the stage (how deep the cancer is penetrating) and the grade (how aggressive the tumor is).
  2. Additionally, the bladder cancer surgeons may perform Blue-light cystoscopy, a novel method of detecting tumors not seen by the naked eye. 
  3. A CT scan will determine if the cancer has spread outside the bladder or to any other organs.
  4. A bone scan may be used if the tumor is larger or appears very aggressive or if the CT scan detects cancer outside of the bladder. 
  5. PET scans are occasionally used and may be discussed by your physician.

The following stages are used for bladder cancer:

Stage 0 (Papillary Carcinoma and Carcinoma in Situ) In stage 0abnormal cells are found in tissue lining the inside of the bladder. These abnormal cells may become cancer and spread into nearby normal tissue. Stage 0 is divided into stage 0a and stage 0is, depending on the type of the tumor:
Stage I: In stage Icancer has formed and spread to the layer of tissue under the inner lining of the bladder.

Stage II: In stage II, cancer has spread to either the inner half or outer half of the muscle wall of the bladder.

Stage III: In stage IIIcancer has spread from the bladder to the fatty layer of tissue surrounding it and may have spread to the reproductive organs (prostate, seminal vesicles, uterus or vagina).

Stage IV: In stage IVcancer has spread from the bladder to the wall of the abdomen or pelvis. Cancer may have spread to one or more lymph nodes or to other parts of the body.