Staging and Grading Bladder Cancer

What is meant by “staging and grading” a tumor?
What are the different “stages” for a bladder cancer tumor?
What are the different “grades” for a bladder cancer tumor?

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For more information about these and other questions, see our Ask the Doctor Archive

What is meant by “staging and grading” a tumor?
If bladder cancer is diagnosed, the doctor needs to know the stage, or extent, of the disease to plan the best treatment. Staging is a careful attempt to find out whether the cancer has invaded the bladder wall, whether the disease has spread, and if so, to what parts of the body. Grade refers to what the cancer cells look like under the microscope, and how many cells are multiplying. The higher the grade, the more uneven the cells are and the more cells are multiplying. Knowing the grade can help your doctor predict how fast the cancer will grow and spread.

Urologists typically send a sample of the cancer tissue to a pathologist, a doctor who specializes in examining tissue to determine the stage and grade of the cancer.  The pathologist writes a report with a diagnosis, and then sends it to your urologist.

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What are the different “stages” for a bladder cancer tumor?
Stage suggests the location of the tumor in relation to the inner lining of the bladder. The higher the stage the further the tumor has grown away from its original site on the surface. The following are the stages for bladder tumors:

T0: No tumor
Ta: Papillary tumor without invasion of the bladder wall
TIS (CIS): Carcinoma in situ (non-invasive flat high-grade (G3) cancer)
T1: Tumor invades the connective tissue under the surface lining
T2: Tumor invades the muscle layer
T3: Tumor penetrates the bladder wall and invades the
surrounding fat layer
T4 Tumor invades other organs (i.e., prostate, uterus, vagina, pelvic wall)
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What are the different “grades” for a bladder cancer tumor?
Grade is expressed as a number between 1 (low) and 3 (high, i.e. G3); the higher the number the less the tumor resembles a normal cell. In lieu of numbers to grade a bladder cancer tumor, your doctor may refer to the tumor simply as low or high grade.

Learn more about the terminology used when diagnosing and identifying bladder cancer from pathologist Dr. Donna Hansel MD, PhD, who answers questions about nomenclature from the “Ask The Doctor” portion of our Fall 2008 newsletter.
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The information and services provides by the Bladder Cancer Advocacy Network (BCAN) are for informational purposes only. The information and services are not intended to be substitutes for professional medical advice, diagnosis or treatment. If you are ill, or suspect that you are ill, seek professional medical attention immediately! BCAN does not recommend or endorse any specific physicians, treatments, procedures or products even though they may be mentioned on this site