The Different Types and Stages of Bladder Cancer

According to the American Cancer Society, it is estimated that about 80,470 new cases of bladder cancer will be reported in 2019. Bladder cancer develops when the healthy cells in the bladder lining, mostly the urothelial cells, start transforming and grow uncontrollably. The most common symptom of underlying bladder cancer is the presence of blood in the urine, which is usually painless.

There are three types of bladder cancer, and it depends largely on how far the cancer cells have spread. They are as follows:

1. Urothelial carcinoma (transitional cell carcinoma)

Urothelial carcinoma, also known as transitional cell carcinoma, is the most common type of bladder cancer. In this form of bladder cancer, cancer begins in the urothelial cells that line the inside of the bladder and can even spread to the adjacent areas that are a part of the urinary tract.

2. Squamous cell carcinoma

This is a rare type of bladder cancer and begins when the thin, flat squamous cells form in the bladder due to a long-term infection or irritation in the bladder.

3. Adenocarcinoma

Even this type of bladder cancer is quite rare. It usually begins when the glandular cells form in the bladder due to long-term bladder irritation and inflammation. Moreover, these glandular cells are what form the mucus-secreting glands in the body.

4. Stages of bladder cancer
The American Joint Committee on Cancer (AJCC) devised a method of staging bladder cancer called the TNM system. This method is an effective way of describing how far the disease has spread. The key pieces of information used in this method are:

  • T ( Tumor): It measures how far the main tumor has developed through the bladder and whether it has spread to other sites.
  • N (Lymph Nodes): These are the group of cells that fight diseases. The letter “N” is used to describe whether cancer has spread into the lymph nodes near the bladder.
  • M (Metastasized): This term is used to denote whether the disease has spread into organs or lymph nodes that aren’t anywhere near the bladder.

Once the T, N, M stages are determined, the doctor will use this information to determine the overall cancer stage. It begins from 0 to the Roman numeral IV. This is what each stage of the bladder implies:

Stage 0: In this stage, the cancer is confined into the center of the bladder and hasn’t spread into the tissues or muscles of the bladder wall. In fact, the lymph nodes and other organs remain untouched by cancer.
Stage I: At this stage, cancer has grown through the inner lining of the bladder, but hasn’t affected the bladder wall yet. Even the lymph nodes and distant organs are unaffected by cancer.
Stage II: In stage II, cancer grows through the connective tissue in the bladder into its muscle layer.
Stage III: In this stage, cancer enters the layer of fatty tissue that surrounds the bladder. It can be in the prostate, uterus, or vagina. However, the cancer cells remain confined to the primary site and don’t spread to the nearby lymph nodes or distant organs.
Stage IV: Stage IV implies that cancer has advanced and indicates either of three possible scenarios: cancer has spread from the bladder to the pelvic or abdominal wall, but hasn’t touched the lymph nodes or other organs; or, cancer has spread to nearby lymph nodes, but hasn’t spread to nearby organs; or, it has reached the lymph nodes and distant sites like the liver, lungs, or bones.

Only after determining the stage of bladder cancer can the doctor recommend appropriate bladder cancer treatments.