What Are the Stages of Bladder Cancer?

Medically Reviewed by Minesh Khatri, MD on November 27, 2022
3 min read

Bladder cancer, like other cancers, is measured in stages. The stages describe how far your cancer has spread. This key piece of information will help you and your doctor choose the best treatment for your unique case.

There are two types of stages for bladder cancer -- the clinical stage and the pathologic stage.

The clinical stage is your doctor’s informed opinion of how far your cancer has spread. This is based on results of a number of tests, including physical exams, imaging tests like MRIs or CT scans, and biopsies.

Your doctor will use this information to plan your treatment.

The pathologic stage is something your doctor determines after surgery to remove the cancer. They’ll look at previous test results. They’ll also examine what they found during surgery to give you an idea of how far your cancer has spread.

The American Joint Committee on Cancer (AJCC) created a method of staging cancer called the TNM system. It’s used to describe how far the disease has spread. It’s based on the following three key pieces of information:

  • T (Tumor) -- This measures how far the main tumor has grown through the bladder and whether it has spread into nearby tissues.
  • N (Lymph Nodes) -- These are groups of cells that fight disease. “N” is used to describe whether cancer has spread into lymph nodes near the bladder.
  • M (Metastasized) -- Doctors use this to describe whether the disease has spread into organs or lymph nodes that aren’t 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. Keep in mind that there are stages within stages that show how the disease has progressed, if it has. Here’s what each stage means:

Stage 0: The cancer has only grown into the center of your bladder. It hasn’t spread into the tissues or muscle of your bladder wall itself. It hasn’t 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. It has not reached the fatty tissue around the bladder.

Stage III: Cancer is now in the layer of fatty tissue that surrounds your bladder. It may also be in your prostate, uterus, or vagina. It may have spread to one lymph node in the pelvis, but not to distant organs. 

Stage IV: This may include any of the following:

  • The cancer has spread from your bladder into your pelvic or abdominal wall. But it hasn’t spread to lymph nodes or distant organs.
  • The cancer has spread to nearby lymph nodes. But it hasn’t reached distant organs.
  • Cancer is now in your lymph nodes or distant sites like your bones, liver, or lungs.

The more information you have about the stage of your bladder cancer, the better able you’ll be to choose the right treatment option for you.