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The stage of a bladder cancer describes how far it has spread. The stage is important when choosing the best treatment. The stage can also help predict the patient’s outlook (prognosis).

  • The clinical stage of bladder cancer is based the results of the physical exam, imaging tests, and biopsies (described in “How is bladder cancer found?”). The clinical stage is used to help plan treatment.
  • The pathological stage of bladder cancer is based on the results of these tests plus the results of surgery to remove the bladder and nearby lymph nodes. Sometimes the cancer has spread further than the estimate of the clinical stage. Because the pathological stage is based on what was found at surgery, it more accurately predicts the patient’s outlook for survival.

A staging system is a standard way for the cancer care team to describe the extent of the cancer. The most common staging system for bladder cancer is the AJCC staging system, also known as the TNM system. It uses 3 key pieces of information:

  • T is how far the main tumor has grown into the wall of the bladder and into nearby structures.
  • N describes spread to nearby lymph nodes.
  • M tells whether the cancer has spread (metastasized) to other parts of the body.

The T, N, and M categories are combined to get an overall stage, using 0 and the Roman numerals I through IV (1-4). The lower the number, the less the cancer has spread. A higher number, such as stage IV (4), means a more advanced cancer.

Be sure to ask your doctor to explain your stage in a way you understand. This will help you both decide on the best treatment for you.

Last Medical Review: 06/23/2014
Last Revised: 01/21/2016