Different stages of bladder cancer
Bladder cancer is staged according to the TNM classification. TNM stands for
- T (tumor): It refers to the size of the original tumor.
- N (node): It describes whether cancer is present in the lymph nodes.
- M (metastasis): It refers to cancer spread to other parts of the body.
A number (0-4) or the letter X is allocated to each factor. A higher number indicates increasing severity. For instance, a T1 score refers to a smaller tumor than a T2 score. The letter X indicates that information could not be assessed. Cancer that is a flat, noninvasive carcinoma (Tis) is also known as flat carcinoma in situ (CIS).
First, the physician would assign categories that are as follows:
| Stages | T Category | N | M |
|---|---|---|---|
| X | Primary tumor cannot be assessed | Lymph nodes cannot be assessed | - |
| 0 | No evidence of a primary tumor | Cancer has not spread to the nearby lymph nodes | No distant spread |
| 0a | No evidence of a primary tumor | - | - |
| 0is | Cancer is still localized (in situ) | - | - |
| I | The tumor has grown from the layer of the cells lining the bladder into the connective tissue below. It has not grown into the muscle layer of the bladder | Cancer has spread to one lymph node in the true pelvis. No distant spread | Cancer has spread to the lymph nodes that lie along the common iliac artery |
| II | The tumor has grown into the inner (T2a) or outer (T2b) muscle layer of the bladder wall | Cancer has spread to two or more lymph nodes in the true pelvis | - |
| III | Cancer has grown through the muscle layer of the bladder and into the layer of the fatty tissue that surrounds the bladder (T3a or T3b) | Cancer has spread to the lymph nodes that lie along the common iliac artery | - |
| IV | The tumor has spread into the nearby organs or structures such as the seminal vesicle, uterus, vagina, and pelvic wall | - |
After assigning the category, cancer is staged as follows:
- Stage 0: It is again subdivided into two categories.
- Stage 0a: It indicates early cancer found on the surface of the inner lining of the bladder.
- Stage 0is: Also known as a flat tumor or CIS, it is found in the inner lining of the bladder and hasn’t invaded the connective tissue or muscle layer.
- Stage I: Cancer has grown from the layer of the cells lining the bladder into the connective tissues below.
- Stage II: Cancer has spread to the thick muscle wall of the bladder.
- Stage III: Cancer has reached the layer of the fatty tissue surrounding the bladder. It may also be in the prostate, uterus, or vagina. However, it hasn’t invaded the nearby lymph nodes or distant organs.
- Stage IV: The tumor has spread into the pelvic wall or cancer has spread to the lymph nodes outside the pelvis or to other parts of the body. One of the three may be applicable in stage IV cancer.
References
https://www.webmd.com/cancer/bladder-cancer/the-stages-of-bladder-cancer
https://www.cancer.org/cancer/bladder-cancer/detection-diagnosis-staging/staging.html
https://www.cancer.org/cancer/bladder-cancer/detection-diagnosis-staging/staging.html
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