Staging and grade
ancer staging is a term used to refer to describing the tumor's size and whether or not it has spread beyond the area where it began.
Once the doctors know the stage of the bladder cancer, they can decide on the most appropriate treatment for you.
The most commonly used staging system is the TNM system:
- T gives the size of the tumor.
- N refers to whether or not there has been lymph node involvement.
- M indicates whether the cancer has spread to other parts of the body (metastatic).
TX: The primary tumor cannot be evaluated due to a lack of information.
T0: No evidence of a primary tumor.
Ta: Noninvasive papillary carcinoma.
Tis: non-invasive flat carcinoma (flat carcinoma in situ, or CIS).
T1: The tumor has grown from the layer of cells lining the bladder into the connective tissue below. It has not grown into the muscle layer of the bladder.
T2: The tumor has grown into the muscle layer.
T2a: The tumor has grown only into the inner half of the muscle layer.
T2b: The tumor has grown into the outer half of the muscle layer.
T3: The tumor has grown through the muscle layer of the bladder and into the fatty tissue layer that surrounds it.
T3a: The spread into fatty tissue can only be seen using a microscope.
T3b: The spread toward fatty tissue is large enough to be seen on imaging tests or felt by the surgeon.
T4: The tumor has spread outside the fatty tissue and into the nearby organs or structures. It may be growing into any of the following areas: the stroma (main tissue) of the prostate, the seminal vesicles, the uterus, the vagina, the pelvic wall, or the abdominal wall.
T4a: The tumor has spread into the stroma of the prostate (in men) or the uterus, vagina, or both (in women).
T4b: The tumor has spread into the pelvic wall or abdominal wall.
Grading refers to the appearance of the cancer cells under the microscope. This classification provides information on how the cancer cells can behave.
Knowing the grade of cancer helps your medical team decide if you need treatment after surgery.
Grade 1 or low-grade cancer: The cancer cells are very similar to the cells of the bladder, are slow-growing, and are less likely to spread.
Grade 2 or intermediate cancer: The cancer cells are less well differentiated and grow slightly quicker than those that are grade 1.
Grade 3 or high-grade cancer: The cancer cells have a very anomalous appearance and are more likely to grow quickly.