Carolinas HealthCare System

After bladder cancer has been diagnosed, your healthcare team will need to determine how far the cancer has progressed—for example, is it confined to the bladder or has it spread to other organs? This information is used to "stage" the cancer. What stage your cancer is will help determine treatment. Computed tomography (CT) scan, magnetic resonance imaging (MRI), X-ray and bone scans may be used to help determine stage.

Bladder cancer staging uses a scale system that was established by the American Joint Committee on Cancer—called the TNM scale—to help classify these cancers using three key pieces of information:

  • T (tumor location and extent of spread within bladder)
  • N (whether cancer has spread to lymph nodes)
  • M (metastasis, or whether cancer has spread to other parts of the body)

Once the categories have been established, this information is used to assign an overall stage, which is expressed using the following numerals:

  • Stage 0 tumors have not invaded the bladder wall and are considered noninvasive. This is the earliest stage of cancer.
  • Stage I tumors have invaded the first part of the bladder wall, or connective tissue.
  • Stage II tumors have spread into the muscle part of the bladder.
  • Stage III tumors have spread to the outer portion the bladder wall and in some cases into nearby organs, such as the prostate or uterus.
  • Stage IV tumors have spread into the abdominal wall or pelvis, lymph nodes or other parts of the body, such as the lung, bone or liver. This is the most advanced stage of cancer.