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.
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. Noninvasive papillary carcinoma, also called stage 0a, forms long, thin growths into the empty space inside the bladder.
Carcinoma in situ, also called stage 0is bladder cancer, forms flatter growths that tend to be of a wilder grade. It is considered a more aggressive disease and is more likely to spread into the muscular walls of the bladder.
According to the National Cancer Institutes SEER database of cancer statistics, about half of bladder cancers are diagnosed at stage 0.
What Do Different Bladder Cancer Stages Mean
The American Joint Committee on Cancer created a method of staging cancer called the TNM system. Itâs used to describe how far the disease has spread. Itâs based on the following three key pieces of information:
- T — This measures how far the main tumor has grown through the bladder and whether it has spread into nearby tissues.
- N — These are groups of cells that fight disease. âNâ is used to describe whether cancer has spread into lymph nodes near the bladder.
- M — Doctors use this to describe whether the disease has spread into organs or lymph nodes that arenât near the bladder.
Your doctor will assign a number or letter after T, N, and M. The higher the number, the more the cancer has spread.
Once they’ve determined your T, N, and M stages, your doctor will use this information to give you an overall cancer stage. These range from 0 to the Roman numeral IV. Hereâs what each stage means:
Stage 0: The cancer has only grown into the center of your bladder. It hasnât spread into the tissues or muscle of your bladder wall itself. It hasnât spread to your lymph nodes or other organs, either.
Stage I: The cancer has grown through the inner lining of your bladder, but not the muscle of your bladder wall. Nor has it spread to your lymph nodes or distant organs.
Stage II: The cancer has grown through the connective tissue in your bladder and into the muscle layer of the bladder.
Stage IV: This may include any of the following:
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Managing People With Distant Metastases
Most patients who die of bladder cancer will do so with metastatic disease. The main treatment used to prolong life and palliate/alleviate the symptoms is . Most studies on chemotherapy report benefits in terms of response, symptom control and but this comes at the cost of significant treatment related toxicity. Not all patients are able to receive chemotherapy, eg, because of debility, impaired kidney function or over the age for safe use of chemotherapy, and others choose not to have it. There are anecdotal reports of long term survivors, but these are rare. The role of chemotherapy in people who progress or on first line treatment is less clear because their is usually measured in months, so benefits and drawbacks of chemotherapy are very finely balanced.
Pelvic can also be used to treat patients with symptoms of incurable bladder cancer, especially bleeding from the bladder or pain from the bladder or sites of metastatic spread.
Other forms of specialist intervention may be considered for serious complications of advanced bladder including:
Stage Ii Bladder Cancer
Stage II cancer has invaded the muscle of the bladder wall but is still confined to the bladder. Depending on the extent and grade of the cancer, we may recommend a partial or total cystectomy. Some people may need chemotherapy before surgery. We may be able to remove the tumor with TUR followed by radiation and chemotherapy.
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Staging And Grading For Stage 4 Cancer
Most cancers are staged using some form of the TNM system. Doctors may also use the TNM system to help determine the extent of certain cancers in each stage. The TNM system stands for:
- T , or the size of the original tumor
- N , or whether the cancer is present in the lymph nodes
- M , or whether the cancer has spread to other parts of the body
Not all cancers are staged using the TNM system, though. Some cancers, especially liquid cancers, are staged through different established protocols. The Binet and Rai systems, for example, are used to stage certain types of leukemia. Female reproductive system cancers, such as cervical cancer, are staged with a separate staging system created by the International Federation of Gynecology and Obstetrics .
As your care team gathers information about your cancer for the purposes of staging, they may need to order several tests, including:
Your care team may likely also need to perform a biopsy, a procedure that involves removing a sample of cells and analyzing it for signs of cancer. Imaging scans may be able to tell your care team where your cancer is, but looking at the cancer cells specifically tell them how fast they are likely to growor what grade they are.
Grading is different from staging and is done for most, but not all, cancers.
The grade of your cancer is part of how your cancer care team stages your cancer and determines your prognosis, or outlook.
Find The Cause Of Your Hematuria
If you ever notice blood or red discoloration in your urine, its a good idea to schedule an appointment with your doctor especially if it persists for more than a few days. Seeking advice from a trusted medical professional will allow you to determine the cause of your hematuria and begin treatment to restore your health.
In order to rule out bladder cancer as a cause of hematuria, your doctor might have you use Cxbladder, an easy-to-use urine test that can rule out bladder cancer and help narrow down your diagnosis. Cxbladder is an accurate and reliable bladder cancer detection test that can put your mind at ease and increase confidence in your treatment plan. For more information on how Cxbladder can help, reach out to us today.Contact Us Today to Learn More
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Common Symptoms Of Bladder Cancer In Men
If you are a man over the age of 55 and experiencing symptoms like lower back pain and difficulty urinating, it may be easy to dismiss these problems as old age setting in. But these symptoms can be red flags of something more serious, like bladder cancer.
The American Cancer Society estimates that in 2021 more than 83,000 people in the United States will be diagnosed with bladder cancer, the majority of which will be men. Men are three to four times more likely than women to develop bladder cancer. The good news is, bladder cancer has a five-year survival rate of 77%, and catching it early provides the best opportunity for treatment. Were taking a closer look at why men are more susceptible than women to get bladder cancer and sharing common symptoms of bladder cancer in men, so you can spot the signs early.
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Early Warning Signs Of Bladder Cancer
Blood in the urine : This is typically the first sign of bladder cancer. It may be present on a regular basis or disappear and reappear over the course of days or weeks. Sometimes blood is present in such a small amount that it cant be seen with the naked eye, called microscopic hematuria, but a urine test may be able to detect it.
Even a small amount of blood may cause the color of urine to change to orange, pink or, rarely, dark red. When blood causes urines color to change, its called gross hematuria.
Early-stage bladder cancer doesnt usually cause pain or other symptoms besides bleeding. But blood in the urine doesnt always mean theres a tumor in the bladder. Its more likely to be caused by a less serious condition, such as an infection. kidney stones, bladder stones, or noncancerous tumors or kidney diseases.
Its also important to note that blood from menstruation may show up in a womans urine test, which may cause a false-positive test result. In this case, doctors may recommend repeating the test.
Urination changes: Changes in urination are more commonly a sign of a less serious condition, such as a benign tumor, infection, urinary tract infection, bladder stones, an overactive bladder or, in men, an enlarged prostate. But they also may be another early sign of bladder cancer symptoms. These changes may include:
Bladder cancer treatment: The care you need is one call away
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Where Does Metastatic Bladder Cancer Spread To
Bladder cancer spreads when cancerous cells reproduce and invade surrounding healthy tissues. This is known as metastasis. Usually, metastatic bladder cancer refers to cancer that has spread to distant organs, but metastasis can occur locally in the muscles and connective tissues that are directly adjacent to the bladder as well.
Common Factors Causing Red Coloration Of Urine
In some cases, the red coloring in your urine might not actually be blood. Red coloring in urine can come from:
- Food: Certain foods, like beetroot, blackberries, blueberries, and rhubarb, can turn urine red or pink.
- Medication: Some medications can cause the discoloration of urine.
If you think food or medicine might be the cause of discoloration, the red color of your urine could disappear in a few days. However, you should still contact your doctor when you notice discoloration because most people have a difficult time telling the difference between blood and other coloring in urine.
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Strategies To Improve Treatments
As the treatment of stage 4 bladder cancer progresses, more improved treatments have also been discovered. The following are ways to improve the treatment of bladder cancer:
1. Supportive care: means the use of treatments aimed to reduce or control the side effects of cancer drugs. The discomforts experienced by people with stage 4 bladder cancer are caused by the treatments’ side effects, so there should be an optimal therapy delivery. In order to get optimal outcomes from bladder cancer treatment and improvement of life quality, it is good to reduce and control the side effects.
2. Drug resistance inhibitors: since the bladder becomes drug resistant after and during treatment, several drug testings are done to determine if they prevent the cancer from being drug-resistant. These drugs prevent the bladder cancer from becoming multi-drug resistant.
3. Chemotherapy Regimen: the production of a new multi-drug chemotherapy treatment program is under way. It involves the use of new anti-cancer therapies that include an addition of extra drugs such as taxane, carboplatin, and gemcitabine.
4. New cancer therapies: many cancer therapies are being targeted. The new therapies have the ability to interfere with the pathways used in the growth and survivial of cancers cells. The targeted therapies are as follow:
What Is The Five Year Survival Rate For Bladder Cancer
A five-year survival rate is the percentage of people in a study or treatment group who are alive five years after they were diagnosed with or started treatment for a disease such as bladder cancer. Their disease may or may not have recurred during that time.
The American Cancer Society periodically reports on the five-year survival rate for bladder cancer. The most recently period studied was from 2010 to 2016 and that rate was 77%. This means that from the time of diagnosis, 77 out of 100 people diagnosed with bladder cancer were alive in five years. From 1987 1989 , the five-year survival rate was 79% and from 1975 1977, it was 72%. The survival rates are not the same for everyone, however.
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What Are The Symptoms Of Bladder Cancer
Many people with bladder cancer can have blood in their urine but no pain while urinating. There are a number of symptoms that might indicate bladder cancer like fatigue, weight loss, and bone tenderness, and these can indicate more advanced disease. You should pay particular attention to the following symptoms:
Your doctor can rate bladder cancer with a staging system that goes from stages 0 to 4 to identify how far the cancer has spread. The stages of bladder cancer mean the following:
- Stage 0 bladder cancer hasnt spread past the lining of the bladder.
- Stage 1 bladder cancer has spread past the lining of the bladder, but it hasnt reached the layer of muscle in the bladder.
- Stage 2 bladder cancer has spread to the layer of muscle in the bladder.
- Stage 3 bladder cancer has spread into the tissues that surround the bladder.
- Stage 4 bladder cancer has spread past the bladder to the neighboring areas of the body.
Your doctor will work with you to decide what treatment to provide based on the type and stage of your bladder cancer, your symptoms, and your overall health.
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Side Effects Of Treatment For Bladder Cancer
All cancer treatments can have side effects. Your treatment team will discuss these with you before you start treatment. Talk to your doctor or nurse about any side effects you are experiencing. Some side effects can be upsetting and difficult, but there is help if you need it.
or email to speak with a caring cancer nurse for support.
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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.
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.
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Where Do These Numbers Come From
The American Cancer Society relies on information from the SEER* database, maintained by the National Cancer Institute , to provide survival statistics for different types of cancer.
The SEER database tracks 5-year relative survival rates for bladder cancer in the United States, based on how far the cancer has spread. The SEER database, however, does not group cancers by AJCC TNM stages . Instead, it groups cancers into localized, regional, and distant stages:
- Localized: There is no sign that the cancer has spread outside of the bladder.
- Regional: The cancer has spread from the bladder to nearby structures or lymph nodes.
- Distant: The cancer has spread to distant parts of the body such as the lungs, liver or bones.
Other Terms Often Used To Describe Bladder Cancer
Although bladder cancer types are assigned based on the cells that the cancer originates from, several other terms may be used to describe the disease.
- Advanced bladder cancer is another term that may be used to describe metastatic bladder cancer. It means that the cancer has spread to distant parts of the body such as the lungs, bones, liver, or lymph nodes outside the pelvis.
- Locally advanced bladder cancer refers to cancer that has grown through the bladder wall, and possibly into nearby lymph nodes or organs, but has not spread to distant sites in the body.
- Bladder cancer stage describes where the cancer is located within the bladder and any sites of spread. As described above, the TNM staging system assigns a patients bladder cancer to a tumor , lymph node and metastasis category. These categories may also be combined to give an overall stage number: an overall stage of 0 or 1 describes early disease, while stage 4 is the most advanced. For further information regarding staging, see Bladder Cancer Stages.
- Bladder cancer grade is based on the microscopic appearance of cancer cells and suggests how fast a cancer might grow. Low-grade cancer cells appear similar to normal cells and usually grow slowly, whereas high-grade cancer cells have a very abnormal appearance and tend to grow quickly. High-grade cancers are more likely than low-grade cancers to spread.
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