Stages 0-4

Bladder cancer is categorized into stages based on how deeply it has spread, ranging from Stage 0 (non-invasive, confined to the bladder lining) to Stage IV (advanced cancer that has spread to distant organs). Staging helps determine treatment options, with early-stage cancers often treatable with surgery, while advanced stages may require chemotherapy, immunotherapy, or other aggressive treatments.

Low or High Grades

Bladder cancer is classified into low-grade (slow-growing, less likely to spread) and high-grade (fast-growing, more aggressive) tumors. High-grade cancers are more likely to recur and spread, requiring more intensive treatment and close monitoring.

Invasive or Non-invasive

Non-invasive bladder cancer remains within the inner lining of the bladder, making it easier to treat with procedures like surgery or immunotherapy. Invasive bladder cancer, however, penetrates deeper into the bladder wall or beyond, posing a higher risk of spreading and often requiring more aggressive treatment.

Tests That Help Find and Understand Your Cancer

• Cystoscopy: Your urologist uses a thin tube with a camera to look inside your bladder.
• Urine tests: A lab checks your urine for cancer cells or other signs of cancer.
• Imaging scans: CT, MRI, or PET scans take pictures inside your body to see if cancer has spread.
• Pathology report: Tissue removed during surgery goes to a lab. The report tells you the type, grade, and stage of your cancer.
• Biomarker testing: The lab checks your tumor for specific changes that help match you to certain medicines.

Watching and Follow-Up

• Surveillance cystoscopy: Your urologist looks inside your bladder on a set schedule to catch cancer that comes back.
• Follow-up scans and urine tests: Repeat tests over time keep an eye on your bladder and the rest of your body.

Surgery

• TURBT: The surgeon removes the tumor through the urethra, so there is no outside cut.
• Partial cystectomy: The surgeon removes only part of your bladder.
• Radical cystectomy: The surgeon removes your whole bladder and nearby lymph nodes.
• Urinary diversion: After the bladder is removed, your surgeon creates a new way for urine to leave your body. This can be a pouch worn outside the body or a new bladder made from part of your intestine.

Treatments Placed Inside the Bladder

• BCG: A weakened germ placed in your bladder through a catheter. It gets your immune system to attack cancer cells.
• Bladder chemo: Chemo medicine placed in your bladder through a catheter to kill leftover cancer cells after surgery.
• Newer bladder treatments: Gene therapy, immune boosters, and small devices that release medicine slowly inside the bladder. These are often used when BCG stops working.

Treatments That Travel Through Your Body

• Chemotherapy: Medicine given through an IV that travels through your whole body. It is often used before surgery or for cancer that has spread.
• Immunotherapy: Medicine that helps your immune system find and fight cancer cells.
• Targeted therapy: Medicine that goes after specific changes inside cancer cells.

Radiation

• Radiation therapy: High-energy beams aimed at the cancer. When paired with chemo, it helps some people keep their bladder. It can also ease pain or bleeding.

Clinical Trials

• Clinical trials: Research studies that test new treatments or new ways to use current ones. They are open to people at every stage.
  • Search the NCI Trial Finder
  • Search ClinicalTrials.gov
  • Search J&J Clinical Trials