Early bladder cancer means the cancer cells are only in the inner lining of the bladder. They have not grown through the inner lining and into the deeper muscle layer of the bladder. It is early in its development.
Early bladder cancer is also called superficial bladder cancer, or non muscle invasive bladder cancer.
The stages of early bladder cancer
Doctors diagnose early bladder cancer by looking at how far tumours have grown into the bladder. This is called the T stage. There are 3 T stages of early bladder cancer - Tis, Ta and T1.
Carcinoma in situ (CIS or Tis)
Carcinoma in situ (also called CIS or Tis) means very early, high grade cancer cells that are only in the innermost layer of the bladder lining.
It is a non invasive cancer of the flat urothelial or transitional cells. These cells make up all the moist tissues that line your body organs.
They can grow in more than one place in the bladder lining and look like flat velvety patches through a microscope.
Ta and T1
The cancer is only in the innermost layer of the bladder lining (Ta) OR has started to grow into the connective tissue beneath the bladder lining (T1).
These tumours often look like small mushrooms growing out of the bladder wall.
Doctors also look at whether the cancer has spread to:
- any lymph nodes (this is called the N stage)
- other parts of the body (distant metastasis) like the bones, lungs or liver (this is called the M stage)
Early bladder cancer has not spread to the lymph nodes (N0) or to distant parts of the body (M0).
Risk groups for early bladder cancer
Doctors put early bladder cancer into 3 risk groups. These groups describe how likely it is that your cancer will spread further, or come back after treatment.
The 3 risk groups are:
- low risk
- intermediate (medium) risk
- high risk
Your doctor tells you whether your cancer is low risk, intermediate (medium) risk or high risk. Knowing your risk group helps them decide which tests and treatment are best for you.
Your risk group depends on:
- the size of your tumour (T stage)
- what the cells look like under a microscope (grade)
- how many tumours there are
- the type of bladder tumour
- whether you have had treatment in the last year for early bladder cancer
The stage of your cancer helps your doctor to decide which treatment you need. Treatment also depends on:
- your type of cancer (the type of cells the cancer started in)
- your risk group (low, intermediate or high)
- where the cancer is
- other health conditions
Treatment may include:
- chemotherapy into your bladder
- a vaccine called BCG into your bladder