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Invasive bladder cancer staging

Invasive bladder cancer means the cancer has spread into or through the muscle layer of the bladder. It is also called muscle invasive bladder cancer.

Doctors might also use the terms locally advanced or advanced bladder cancer to describe some invasive bladder cancers.

Invasive bladder cancer is different to early bladder cancer. In early bladder cancer, the cancer cells are only in the inner lining and haven’t spread into the muscle layer of the bladder wall.

The stages of invasive bladder cancer

Your doctor diagnoses invasive bladder cancer by looking at how far cancer tumours have grown into the bladder. This is called the T stage (T stands for tumour). There are three T stages of invasive bladder cancer:

  • T2 means cancer has grown into the muscle layer of the bladder 
  • T3 means cancer has grown through the muscle layer into the fatty tissue layer
  • T4 means cancer has grown outside the bladder OR into the prostate, womb or vagina, OR into the wall of the pelvis (the area between the hip bones) or tummy (abdomen)
Diagram showing invasive bladder cancer

Your doctor also looks at:

  • whether cancer has spread to any lymph nodes (this is called the N stage)
  • whether or not it has spread (metastasised) to other parts of the body (distant metastasis) like the bones, lungs or liver (this is called the M stage)

Locally advanced bladder cancer

Locally advanced bladder cancer means your cancer has spread:

  • through the bladder and into the nearby tissues including the vagina, womb, ovaries, prostate, and back passage
  • into nearby lymph nodes
Diagram showing stage N1 bladder cancer

Advanced bladder cancer

Advanced bladder cancer means that your cancer has spread to:

  • the wall of the tummy (abdomen) or between the hips (pelvis)
  • distant lymph nodes
  • other parts of the body such as the bones, lungs or liver
Diagram showing advanced bladder cancer

Treatment

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)
  • where the cancer is
  • other health conditions

Treatment may include:

  • surgery
  • chemotherapy
  • radiotherapy
  • radiotherapy with chemotherapy (chemoradiotherapy)
Last reviewed: 
07 Jun 2019
  • AJCC Cancer Staging Manual (8th Edition)
    S Edge and others
    Springer, 2017

  • Bladder cancer: diagnosis and management
    National Institute for Health and Care Excellence (NICE), February 2015

  • BMJ Best Practice. Bladder Cancer
    D Lamm
    BMJ Publishing Group, (Updated June 2018)

  • Bladder cancer: ESMO Practice Guidelines for diagnosis, treatment and follow-up
    J Bellmunt and others
    Annals of Oncology, 2014. Volume 25, Supplement 3, Pages 40 – 48

  • EAU Guidelines on Muscle-invasive and Metastatic Bladder Cancer
    JA Witjes and others
    European Association of Urology, 2017

  • The information on this page is based on literature searches and specialist checking. We used many references and there are too many to list here. Please contact patientinformation@cancer.org.uk with details of the particular issue you are interested in if you need additional references for this information.

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