What are the grades and stages of bladder cancer?


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What are the grades of bladder cancer?

Grading describes how quickly the cancer may grow and spread.

  • Low-grade bladder cancer: The cancer cells look only slightly abnormal, much like normal bladder cells. The cancer is usually slow-growing and less likely to spread than high grade bladder cancer.
  • High-grade bladder cancer: The cancer cells look fairly or very abnormal and are more likely to grow quickly. Carcinoma in situ (CIS) is always classed as high grade.

Read more about types of bladder cancer.

Grading describes the cancer cells – what they look like and how they might grow

Staging describes where the cancer is in your body

What are the stages of bladder cancer?

Staging means finding out how deeply the cancer has grown into the bladder and if it has spread to other parts of your body. Staging will help your doctor to plan the best treatment for you.

The staging system normally used in bladder cancer is called TNM. This stands for:

  • Tumour (T): How deeply has the tumour has grown into the bladder?
  • Node (N): Is there cancer in your lymph nodes?
  • Metastasis (M): Has the cancer has spread to other parts of your body?

Your doctor often uses this information to give your cancer a number stage – from 1 to 4.

A higher number, such as stage 4, means a more serious cancer. Some stages are further divided into stage A and B. 

Stages of bladdr cancer

Staging can be hard to understand, so ask your doctor and nurse for more information if you need it.

More about staging bladder cancer

Tumour (T):

CIS / Ta / T1: Non-muscle invasive bladder cancers

  • Carcinoma in situ (CIS): This appears as flat, red areas in your bladder. This type of bladder cancer is more likely to come back after treatment, often as another non-invasive cancer in the bladder. CIS can grow more quickly and can become invasive. This means it may need different treatment to other non-muscle invasive bladder cancers.
  • Ta: Here the tumour is found as a mushroom-like growth (papillary cancer) growing only in the innermost lining of your bladder.
  • T1: The tumour has started to grow into the connective tissue just below the bladder lining.

T2 / T3: Muscle invasive bladder cancers

  • T2: The tumour has grown into the muscle layer in your bladder.
  • T3: The tumour has spread through the muscle layer to the outer fat layer around your bladder.

T4: locally advanced / metastatic bladder cancer

  • T4: The cancer has spread outside your bladder to other organs. For example, the abdominal wall, the pelvic wall, the prostate in men, or the womb and vagina in women.

Nodes (N)

  • N0: No cancer is found in any of your lymph nodes.
  • N1: Cancer is found in one lymph node and is smaller than 2 cm.
  • N2: Cancer is found in one lymph node and is bigger than 2 cm but less than 5 cm or the cancer has spread to more than one lymph node, but is smaller than 5 cm.
  • N3: Cancer is found in at least one lymph node and is 5 cm in size.

Metastasis (M)

  • M0: The cancer has not spread to other parts of your body.
  • M1: The cancer has spread to other parts of your body. This is also known as secondary, metastatic or advanced bladder cancer. The organs likely to be affected are your bones, liver or lungs.

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