Stages, types and grades
To find the grade of cancer cells, doctors take tissue samples (biopsies) and send them to the laboratory. A specialist doctor, called a pathologist, looks at them using a microscope.
The grade describes whether the cancer cells are similar or very different to normal cells. It gives your doctor some idea of how the cancer might behave.
There are different grading systems for bladder cancer:
number grades (grade 1, 2 and 3)
low grade and high grade
Your doctor may use a combination of these grading systems.
Doctors use the grade as well as other information about the cancer, such as its size, to help plan treatment for non muscle invasive bladder cancer. Grading doesn’t affect treatment decisions for muscle invasive or advanced bladder cancer.
Information about the grade and stage of your cancer can be complicated. Your doctor and specialist nurse will explain what these mean for you and answer any questions you have.
Read about the stages of bladder cancer
Bladder cancer cells can be divided into 3 grades.
The cancer cells look very like normal cells. They are called well differentiated. They tend to grow slowly and generally stay in the lining of the bladder.
The cancer cells look less like normal cells. They are called moderately differentiated. They are more likely to spread into the deeper (muscle) layer of the bladder or to come back after treatment.
The cancer cells look very abnormal. They are called poorly differentiated. They grow more quickly and are more likely to come back after treatment or spread into the deeper (muscle) layer of the bladder.
This grading system divides bladder cancer into:
low grade - this is a slow growing cancer that is unlikely to spread
high grade - this is a quicker growing cancer that is more likely to spread
If you have a high grade non muscle invasive bladder cancer, you're more likely to have further treatment after surgery. This is to reduce the risk of the cancer coming back.
Carcinoma in situ (CIS) is high grade.
Last reviewed: 10 Jul 2026
Next review due: 10 Jul 2029
The type of bladder cancer means the type of cell the cancer started in. Knowing this helps your doctor decide which treatment you need.
There are different ways to stage bladder cancer. Your doctor might use the TNM system or number stages.
In non muscle invasive bladder cancer, the cancer cells are only in the inner lining of the bladder.
Muscle invasive bladder cancer means the cancer has spread into or through the muscle layer of the bladder.
Your treatment options depend on several things, including the stage and type of your bladder cancer. Treatments include surgery, chemotherapy or BCG into your bladder, chemoradiotherapy, radiotherapy, or chemotherapy into your bloodstream.
Bladder cancer starts in the inner lining of the bladder. The bladder stores urine and is in the lower part of your tummy (abdomen).
