Non muscle invasive bladder cancer staging

The stage of cancer describes how far the cancer has grown. This page is about the stages of non muscle invasive bladder cancer.

Read about muscle invasive bladder cancer staging

The stages of non muscle invasive bladder cancer

Doctors find out the stage of bladder cancer by looking at how far ​it has grown into the bladder. This is called the T (tumour) stage. There are 3 T stages for non muscle invasive bladder cancer:

• Tis or CIS (also called ​carcinoma in situ)

• Ta

• T1

Doctors also look at the ​cancer cells​ under a microscope. This tells them the grade. The grade means how much the cells look like normal cells. 

CIS or Tis

Carcinoma in situ (also called CIS or Tis) means there are very early cancer cells in the inner layer of the bladder lining. The cancer cells look very abnormal and are likely to grow quickly. This is called high grade.

CIS can grow in more than one place in the bladder lining. It looks like flat velvety patches through a microscope.

Ta 

The cancer is only in the innermost layer of the bladder lining (Ta). These cancers often look like small mushrooms growing out of the bladder wall.

T1

The cancer has started to grow into the ​connective tissue​ beneath the bladder lining. 

When staging bladder cancer, 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), such as the bones, ​lungs​ or ​liver​ - this is called the M stage

Read more about staging and grading of bladder cancer

Risk groups for non muscle invasive bladder cancer

Doctors put non muscle invasive bladder cancer into 3 risk groups. These groups describe how likely it is that the cancer will spread further, or come back after treatment.

The 3 risk groups are:

• low risk

• intermediate (medium) risk

• high risk

Knowing your risk group helps your doctor decide which tests and treatment are best for you.

Your risk group depends on:​​

• the size of the cancer (T stage)

• what the cells look like under a microscope (grade)

• whether you have any carcinoma in situ (CIS)

• how many tumours there are

• how wide the tumour is (diameter)

• whether this is your first diagnosis, or it has come back (a recurrence)

Treatment

The stage of the 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:

• surgery

• chemotherapy into your bladder

• a vaccine called BCG into your bladder

Find out about treatment for non muscle invasive bladder cancer