Knowing the stage and grade of your tumor helps your doctor decide which methods are most suitable for treating your cancer. It is important to remember that bladder cancer patients must expect to be closely followed by their urologists, with regularly scheduled cystoscopies and urine cytology as bladder tumors often recur. Early detection is crucial to a good long-term prognosis.
Ta papillary tumors are usually low grade (most closely resemble normal cells) and, even though a large majority will recur multiple times after the initial diagnosis and removal, 85-90% will never invade the bladder wall and become life-threatening. Further treatment beyond removal may not be necessary, but regular follow-up is required.
Although CIS is also non-invasive, as the tumor has not grown into the lamina propria (the layer of blood vessels and cells that is situated between the bladder lining and the muscle wall), it is more aggressive than Ta non-invasive tumors and will probably be treated with more aggressive therapies, including intravesicalimmunotherapy (BCG). Once the tumor has invaded the lamina propria, it is considered an invasive tumor with the potential of spreading through the muscle wall and ultimately affecting organs that border the bladder (prostate, uterus, etc.) or other organs such as the lung, bone, and liver. Intravesical therapy and surgery may be considered. If invasion of the muscle is seen on the biopsy, the tumor is at least stage T2, in which case more aggressive treatments (surgery, radiation, and/or chemotherapy) are typically considerations.
There are many lymph nodes that also surround the bladder. Lymph nodes are small glands that store the white blood cells that help to fight disease throughout the body. Cancer cells from invasive bladder tumors may appear in the lymph nodes. Although they can often only be seen with a microscope, they may be seen on scans as enlarged lymph nodes – cancer cells in the lymph nodes indicate that the tumor has spread and will influence the management of the bladder cancer patient. Chemotherapy may be suggested.
Main treatment procedures: