Stage Iii Bladder Cancer
Stage III bladder cancers have started to spread away from the bladder itself into either local or regional organs or into lymph nodes in the pelvis. Its divided into stage IIIA and stage IIIB.
Stage IIIA bladder cancer has either:
- Spread into the fat around the bladder or into the reproductive organs, but not to the lymph nodes
- Spread from the bladder to one lymph node in the pelvis
Stage IIIB cancer has also spread. To be defined as stage IIIB, cancer needs to be found in either:
- More than one lymph node far from major arteries
- One or more lymph nodes near the major arteries
According to SEER, 7% of bladder cancer cases are diagnosed when theyve reached stage III, or regional stage.
Prognosis And Survival Rates For Bladder Cancer
When someone is diagnosed with bladder cancer, their doctor will give them a prognosis. A prognosis is the doctors opinion of how likely the cancer will spread and the chances of getting better. A prognosis depends on the type and stage of cancer, as well as the persons age and general health.
Bladder cancer can usually be effectively treated if it is found before it spreads outside the bladder.
If you have bladder cancer, your doctor will talk to you about your individual situation when working out your prognosis. Every persons experience is different, and there is support available to you.
Treating Stage I Bladder Cancer
Stage I bladder cancers have grown into the connective tissue layer of the bladder wall , but have not reached the muscle layer.
Transurethral resection with fulguration is usually the first treatment for these cancers. But it’s done to help determine the extent of the cancer rather than to try to cure it. If no other treatment is given, many people will later get a new bladder cancer, which often will be more advanced. This is more likely to happen if the first cancer is high-grade .
Even if the cancer is found to be low grade , a second TURBT is often recommended several weeks later. If the doctor then feels that all of the cancer has been removed, intravesical BCG or intravesical chemo is usually given. If all of the cancer wasn’t removed, options are intravesical BCG or cystectomy .
If the cancer is high grade, if many tumors are present, or if the tumor is very large when it’s first found, radical cystectomy may be recommended.
For people who arent healthy enough for a cystectomy, radiation therapy might be an option, but the chances for cure are not as good.
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Bladder Cancer Stage Grouping
The results are combined to determine the stage of bladder cancer for each person. There are 5 stages: stage 0 and stages I through IV .
- Stage 0, called Papillary Carcinoma and Carcinoma in Situ, is divided into stage 0a and stage 0is, depending on the type of the tumor:
- Stage 0a : Abnormal cells are found in tissue lining the inside of the bladder. These abnormal cells, which may look like tiny mushrooms growing from the lining of the bladder, may become cancer and spread into nearby normal tissue .
- Stage 0is : A flat tumor on the tissue lining the inside of the bladder. It has not grown in toward the hollow part of the bladder, and it has not spread to the thick layer of muscle or connective tissue of the bladder .
What Is Bladder Cancer In Dogs
Bladder cancer in dogs is a tumor that develops due to the abnormal growth of cells in the urinary bladder. This type of tumor of the urinary tract is relatively rare in dogs and accounts for about 1% or less of all canine tumors.
Bladder cancer is usually diagnosed in the late stages. This is because the obvious symptoms and signs of bladder cancer in dogs are similar to those of urinary tract infections . Plus, invasive transitional cell carcinoma, as the most common type of bladder cancer in dogs, develops really quickly and aggressively.
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What Is Cancer Staging
Staging is a way of describing where the cancer is located, if or where it has invaded or spread, and whether it is affecting other parts of the body.
Doctors use diagnostic tests to find out the cancers stage, so staging may not be complete until all of the tests are finished. Knowing the stage helps the doctor recommend the best kind of treatment, and it can help predict a patient’s prognosis, which is the chance of recovery. There are different stage descriptions for different types of cancer.
For bladder cancer, the stage is determined based on examining the sample removed during a transurethral resection of bladder tumor and finding out whether the cancer has spread to other parts of the body.
This page provides detailed information about the system used to find the stage of bladder cancer and the stage groups for bladder cancer, such as stage II or stage IV.
What Is Cancer Restaging
The stage of a cancer given at the time of diagnosis and initial treatments does not change. This is so doctors can understand a person’s medical progress, help understand the prognosis, and learn how treatment affects many people.
However, if the cancer comes back or spreads, restaging can be done. This is described with a small “r.” For example, rN1 is restaging of the lymph nodes. Usually some of the same tests that were done when the cancer was first diagnosed will be done again. After this, the doctor can assign the cancer a restage or “r stage.”
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Doctor Visits And Tests
Your schedule of exams and tests will depend on the stage and grade of the cancer, what treatments youve had, and other factors. Be sure to follow your doctors advice about follow-up tests.
Most experts recommend repeat exams every 3 to 6 months for people who have no signs of cancer after treatment. These are done to see if the cancer is growing back or if theres a new cancer in the bladder or urinary system. Your follow-up plan might include urine tests, physical exams, imaging tests , and blood tests. These doctor visits and tests will be done less often as time goes by and no new cancers are found.
- If your bladder hasnt been removed, regular cystoscopy exams will also be done every 3 months for at least the first 2 years.
- If you have a urinary diversion, you will be checked for signs of infection and changes in the health of your kidneys. Urine tests, blood tests, and x-rays might be used to do this. Your vitamin B12 will be checked at least once a year because urinary diversions made with your intestine can affect B12 absorption. Your doctor will also talk to you about how well youre able to control your urine. Tests will be done to look for signs of cancer in other parts of your urinary tract, too.
Some doctors recommend other lab tests as well, such as the urine tumor marker tests discussed in Can Bladder Cancer Be Found Early? Many of these tests can be used to help see if the cancer has come back, but so far none of these can take the place of cystoscopy.
Bladder Cancer In Men Vs Women
Bladder cancer is 3 to 4 times more common in people assigned male at birth than in people assigned female at birth.
Researchers believe the increased prevalence of bladder cancer in those assigned male at birth may be due to differences in how carcinogens are metabolized before they pass through the bladder . Or it may be that male sex hormones promote tumor formation in the bladder, whereas female sex hormones inhibit this progression.
In contrast, people assigned female at birth tend to be diagnosed at later stages of the disease, do not respond as well to treatment, and have a higher cancer-specific mortality rate, so it’s especially important for those assigned female at birth to be aware of early symptoms and seek prompt evaluation.
One study looked at the prevalence of the early cancer symptoms in both sexes, concluding that:
- Visible hematuria was present in 65% of men and 68% of women.
- Dysuria was present in 32% of men and 44% of women.
- Urgency was present in 61% of men and 47% of women.
- Nocturia was present in 57% of men and 66% of women.
Painful urination is often dismissed as due to a bladder infection or friction and may be less likely to be investigated, particularly in women. One study found that 47% of female bladder cancer patients were treated for symptoms up to a year before a diagnosis was made, without receiving any further evaluation. A lower percentage of females than males saw a urologist as well.
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Treatment Of Stage Iv Bladder Cancer
For information about the treatments listed below, see the Treatment Option Overview section.
Treatment of stage IV bladder cancer that has not spread to other parts of the body may include the following:
- Urinary diversion or cystectomy as palliative therapy to relieve symptoms and improve quality of life.
Treatment of stage IV bladder cancer that has spread to other parts of the body, such as the lung, bone, or liver, may include the following:
- External radiation therapy as palliative therapy to relieve symptoms and improve quality of life.
- Urinary diversion or cystectomy as palliative therapy to relieve symptoms and improve quality of life.
- A clinical trial of new anticancer drugs.
Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available.
Bladder Cancer Is A Disease In Which Malignant Cells Form In The Tissues Of The Bladder
The bladder is a hollow organ in the lower part of the abdomen. It is shaped like a small balloon and has a muscular wall that allows it to get larger or smaller to store urine made by the kidneys. There are two kidneys, one on each side of the backbone, above the waist. Tiny tubules in the kidneys filter and clean the blood. They take out waste products and make urine. The urine passes from each kidney through a long tube called a ureter into the bladder. The bladder holds the urine until it passes through the urethra and leaves the body.
There are three types of bladder cancer that begin in cells in the lining of the bladder. These cancers are named for the type of cells that become malignant :
- Transitional cell carcinoma: Cancer that begins in cells in the innermost tissue layer of the bladder. These cells are able to stretch when the bladder is full and shrink when it is emptied. Most bladder cancers begin in the transitional cells. Transitional cell carcinoma can be low-grade or high-grade:
- Low-grade transitional cell carcinoma often recurs after treatment, but rarely spreads into the muscle layer of the bladder or to other parts of the body.
- High-grade transitional cell carcinoma often recurs after treatment and often spreads into the muscle layer of the bladder, to other parts of the body, and to lymph nodes. Almost all deaths from bladder cancer are due to high-grade disease.
See the following PDQ summaries for more information:
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Understanding Your Bladder Cancer Stage
A staging system is a standard way for the cancer care team to describe how far a cancer has spread. The staging system most often used for bladder cancer is the American Joint Committee on Cancer TNM system, which is based on 3 key pieces of information:
- T describes how far the main tumor has grown through the bladder wall and whether it has grown into nearby tissues.
- N indicates any cancer spread to lymph nodes near the bladder. Lymph nodes are bean-sized collections of immune system cells, to which cancers often spread first.
- M indicates if the cancer has spread to distant sites, such as other organs, like the lungs or liver, or lymph nodes that are not near the bladder.
Numbers or letters after T, N, and M provide more details about each of these factors. Higher numbers mean the cancer is more advanced. Once a persons T, N, and M categories have been determined, usually after surgery, this information is combined in a process called stage grouping to assign an overall stage.
The earliest stage cancers are called stage 0 , and then range from stages I through IV .
As a rule, the lower the number, the less the cancer has spread. A higher number, such as stage IV, means a more advanced cancer. And within a stage, an earlier letter means a lower stage. Cancers with similar stages tend to have a similar outlook and are often treated in much the same way.
Treatment Of Stages Ii And Iii Bladder Cancer
For information about the treatments listed below, see the Treatment Option Overview section.
- Transurethral resection with fulguration.
- A clinical trial of a new treatment.
Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available.
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Questions To Ask The Doctor
- What treatment do you think is best for me?
- Whats the goal of this treatment? Do you think it could cure the cancer?
- Will treatment include surgery? If so, who will do the surgery?
- What will the surgery be like?
- How will I pee after surgery?
- Will I have other types of treatment, too?
- Whats the goal of these treatments?
- What side effects could I have from these treatments?
- Is there a clinical trial that might be right for me?
- What about treatments like special vitamins or diets that friends tell me about? How will I know if they are safe?
- What should I do to be ready for treatment?
- Is there anything I can do to help the treatment work better?
- Whats the next step?
Treatment For Advanced Bladder Cancer
If bladder cancer has spread to other parts of the body, it is known as advanced or metastatic bladder cancer. You may be offered one or a combination of the following treatments to help control the cancer and ease symptoms:
- systemic chemotherapy
- radiation therapy.
Immunotherapy uses the bodys own immune system to fight cancer. BCG is a type of immunotherapy treatment that has been used for many years to treat non-muscle-invasive bladder cancer.
A new group of immunotherapy drugs called checkpoint inhibitors work by helping the immune system to recognise and attack the cancer. A checkpoint immunotherapy drug called pembrolizumab is now available in Australia for some people with urothelial cancer that has spread beyond the bladder. The drug is given directly into a vein through a drip, and the treatment may be repeated every 2 to 4 weeks for up to 2 years.
Other types of checkpoint immunotherapy drugs may become available soon.
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Bladder Cancer Stages And Survival Rates
Cancer survival rates are also categorized according to the stage of the cancer when it was diagnosed. The stage of cancer generally refers to how far it has progressed, and whether it has spread to other parts of the body. For bladder cancer, the 5-year survival rate for people with:2,3
- Bladder cancer in situ is around 96 percent
- Localized bladder cancer is around 70 percent
- Bladder cancer that has spread to the regional lymph nodes is 35 percent
- Distant or metastasized bladder cancer is 5 percent
If you would like to learn more about bladder cancer statistics, consider speaking with someone on your health care team. They will be able to explain more about how these statistics apply to your cancer. Tell us about your experience in the comments below, or with the community.
What Are The Complications
At this stage, treatment will likely involve removing your bladder.
Without treatment, or if treatment fails, stage 3 bladder cancer can progress to invade distant tissues and organs.
When theres no sign of cancer, youre in a state of remission. Even if youve finished treatment, youll need plenty of follow-up care. Your doctor will provide a plan for recovery, which may include:
- information about late or long-term side effects
- diet, exercise, and self-care recommendations
- schedule for regular checkups
- schedule for bladder cancer tests and screening tests for other types of cancer
- information about signs of recurrence
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