If bladder cancer is diagnosed, your doctor needs to learn the extent (stage) of the disease to help you choose the best treatment.
Staging is a careful attempt to find out the following:
- Whether the tumor has invaded the muscle layer of the bladder
- Whether the tumor has invaded nearby tissues
- Whether the cancer has spread, and if so, to what parts of the body
Your doctor may order these tests:
- Blood tests: Blood tests can show how well the liver and kidneys are working.
- Chest x-ray: An x-ray of the chest can show a tumor in the lung.
- IVP: A dye that shows up on x-rays is injected into your blood vessel. The dye collects in your urine, which makes the bladder and the rest of the urinary tract show up on x-rays.
- CT scan: An x-ray machine linked to a computer takes a series of detailed pictures of your abdomen. You may receive an injection of contrast material so your urinary tract and lymph nodes show up clearly in the pictures. The CT scan can show cancer in the bladder, lymph nodes, or elsewhere in the abdomen.
- MRI: A large machine with a strong magnet linked to a computer is used to make detailed pictures of your urinary tract and lymph nodes. You may receive an injection of contrast material. MRI can show cancer in the bladder, lymph nodes, or other tissues in the abdomen.
- Ultrasound: The ultrasound device uses sound waves that can’t be heard by humans. The sound waves make a pattern of echoes as they bounce off internal organs. The echoes create a picture of your kidneys and other organs in the abdomen. The picture can show a tumor or blockage in the urinary tract.
When cancer spreads from its original place to another part of the body, the new tumor has the same kind of abnormal cells and the same name as the original (primary) tumor. For example, if bladder cancer spreads to the liver, the cancer cells in the liver are actually bladder cancer cells. The disease is metastatic bladder cancer, not liver cancer. It’s treated as bladder cancer, not as liver cancer. Doctors sometimes call the new tumor in the liver “distant” disease.
These are the stages of bladder cancer:
- Stage 0: The cancer cells are found only on the surface of the inner lining of the bladder. The doctor may call this carcinoma in situ.
- Stage I: The tumor has grown deeper into the inner lining of the bladder. But it hasn’t invaded the muscle layer of the bladder.
- Stage II: The tumor has invaded the muscle layer of the bladder.
- Stage III: The tumor has grown through the muscle layer to reach tissues near the bladder, such as the prostate, uterus, or vagina.
- Stage IV: The tumor has invaded the wall of the pelvis or abdomen, but cancer is not found in any lymph nodes. Or, the cancer cells have spread to at least one lymph node or to parts of the body far away from the bladder, such as the liver, lungs, or bones.