Bladder Cancer : Stages and Grades

TNM staging system

One tool that doctors use to describe the stage is the TNM system. Doctors use the results from diagnostic tests and scans to answer these questions:

The results are combined to determine the stage of cancer for each person. There are 5 stages: stage 0 (zero) and stages I through IV (1 through 4). The stage provides a common way of describing the cancer, so doctors can work together to plan the best treatments.

Staging can be clinical or pathological. Clinical staging is based on the results of tests done before surgery, which may include physical examinations, imaging scans, and biopsies. Pathological staging is based on what is found during surgery, including the results of physical examinations, imaging scans, and biopsies. In general, pathological staging gives the health care team the most amount of information to make a prognosis.

Here are more details on each part of the TNM system for bladder cancer.

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T categories for bladder cancer:

describes how far the main (primary) tumor has grown through the bladder wall and whether it has grown into nearby tissues.

These measurements refer to the primary tumor.

N categories for bladder cancer:

N indicates any cancer spread to lymph nodes near the bladder. Lymph nodes are bean-sized collections of immune system cells, to which cancers often spread first.

M categories for bladder cavity and oropharyngeal cancers:

M indicates if the cancer has spread (metastasized) to distant sites, such as other organs, like the lungs or liver, or lymph nodes that are not near the bladder.

Once the categories have been assigned, the cancer is staged in one of the following ways:

Stage 0: The cancer has only grown into the center of your bladder. It hasn’t spread into the tissues or muscle of your bladder wall itself. It hasn’t spread to your lymph nodes or other organs, either.

Stage I: The cancer has grown through the inner lining of your bladder, but not the muscle of your bladder wall. Nor has it spread to your lymph nodes or distant organs.

Stage II: The cancer has grown through the connective tissue in your bladder and into the muscle layer of the bladder.

Stage III: Cancer is now in the layer of fatty tissue that surrounds your bladder. It may also be in your prostate, uterus, or vagina. But it hasn’t spread to nearby lymph nodes or to distant organs.

Stage IV (stage 4 bladder cancer): In stage IV bladder cancer, one of the following applies:

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