Early Stages of Bladder Cancer
Reviewed by: HU Medical Review Board | Last review date: July 2019. | Last updated: February 2021
To determine a patient’s overall bladder cancer stage, healthcare providers use a combination of information from diagnostic tests and sometimes surgery.1,2 This includes information about the bladder tumor (T), any cancer spread to nearby lymph nodes (N), and any metastasis (M) to other parts of the body more distant from the bladder.
What are the stages of bladder cancer?
Healthcare professionals describe the cancer by assigning numbers and/or letters to each of the three staging categories. This helps to identify the best treatment options for a patient’s specific type of bladder cancer. The five overall stages of bladder cancer are: stage 0, stage I, stage II, stage III, and stage IV.
Stage 0 is the earliest stage of bladder cancer, which involves abnormal cells that have grown in the thin layer of cells that line the inside of the bladder. There are two types of stage 0 bladder cancer: stage 0a and stage 0is.1,2,3
- Stage 0a is classified as [Ta, N0, M0]. This means that the cancer tumor has not grown into the muscle of the bladder wall, but is only located in the inner lining of the bladder, called the urothelium. Stage 0a bladder cancer is also called a noninvasive papillary urothelial carcinoma.
- Stage 0is bladder cancer is classified as [Tis, N0, M0], meaning that it has not spread to nearby lymph nodes or metastasized to other parts of the body. This is a type of flat tumor that has grown only in the inner lining of the bladder and has not grown into the muscular walls of the bladder. This type of bladder cancer may also be referred to as flat, non-invasive carcinoma and carcinoma in situ (CIS).
Stage I bladder cancer means the cancer has been diagnosed at relatively early stage, but not as early as stage 0. It is classified as [T1, N0, M0].1,2 The “T1” category means that the bladder cancer cells have grown into the lamina propria (the connective tissue between the bladder lining and the bladder muscle), but they have not grown into the muscle of the bladder wall. Stage I bladder cancer is N0, which means that the bladder cancer has not spread to lymph nodes near the bladder, and it is M0, which means that the bladder cancer has not spread to other parts of the body that are distant from the bladder.
Treatment for early stages
If you are diagnosed with stage 0 or stage 1 bladder cancer, your healthcare team will discuss the range of available treatment options with you.3 A procedure that is commonly used to treat early stage bladder cancer is called transurethral resection of bladder tumor (TURBT). During this procedure, a surgeon inserts a very thin, flexible instrument into the bladder through the urethra, the hollow tube-like organ that carries urine out of the body from the bladder. The surgeon removes the tumor from the inside of the bladder. After the tumor is removed, the surgeon will often use a procedure called fulguration to try to eliminate any bladder cancer cells that are left in the bladder lining or lamina propria.
A treatment called intravesical chemotherapy is commonly administered after surgery, which involves delivering a special type of chemotherapy medicine directly into the bladder.
Other patients with stage 0 or stage 1 bladder cancer may need to have surgery to remove all or part of the bladder. Some patients may decide to take part in a clinical trial investigating new types of bladder cancer treatment.
The average five-year survival rate for people diagnosed with bladder cancer in situ (sometimes called Stage 0) is around 96% in the United States.4 This means that on average, 96 out of 100 people diagnosed with stage 0 bladder cancer are alive five years after being diagnosed.
Both stage 0a and stage 0is bladder have relatively high rates of recurrence, in which the cancer cells start to grow again after treatment. However, treatment for recurrence that is diagnosed at an early stage tends to be effective.
Among people diagnosed with localized bladder cancer (sometimes called Stage 1) in the United State, the average five-year survival rate is around 70%.4 This five-year survival rate means that on average, around 70 out of 100 people diagnosed at that stage are alive five years after being diagnosed.