The prognosis (predicted outlook or chance of survival) of bladder cancer depends on the cancer’s “stage” and “grade.” The stage indicates the extent of the cancer, or how widespread it is in the body. The grade measures how abnormal the cells look under a microscope. The grading and staging systems are combined into another system that allows the physician to discuss the pathology of the tumor in lay terms. These stages include:

• Stage 0. The least serious stage in which bladder cancer is present, but has not invaded the bladder’s muscle or connective tissue, or spread to the lymph nodes or distant sites.
  

  

• Stage I. The cancer has grown into the lining of the urethra, bladder, ureters or kidneys but has not spread to other layers of the bladder wall.
  
  
• Stage II.  The cancer has spread to the main muscle layer of the bladder but has not reached the layer of fatty tissue surrounding the bladder.
  
  
• Stage III.  The cancer has spread through the bladder wall into the surrounding layer of fatty tissue. It may have invaded the prostate, vagina or uterus, but has not spread to the lymph nodes or distant sites.
  
  
• Stage IV. The most advanced stage in which the cancer has spread through the bladder wall to the abdominal or pelvic wall and/or has invaded the lymph nodes and/or distant sites including the bones, lungs or liver.

Physicians use a much more complicated system for staging bladder cancer that was developed by the American Joint Committee on Cancer (AJCC). This system is commonly known as the “TNM” system, where:

• “T” describes the extent of a tumor’s invasion into the wall of the bladder and nearby tissues. Sometimes additional letters will follow the T, such as “Tm,” which indicates the presence of multiple cancers, or “Tis,” which indicates that the cancer is superficial (carcinoma in situ) and has not invaded surrounding tissues.
  
  
• “N” describes whether or not the cancer has spread to surrounding lymph nodes and, if so, the size of the lymph nodes. Lymph nodes are groups of immune system cells that help ward off infections and cancers. They are typically the size of a bean.
  
  
• “M” describes whether or not the cancer has metastasized or spread to distant organs, such as the lungs, or to lymph nodes that do not surround the bladder.

The following chart reflects the relative five-year survival rate of bladder cancer patients by stage. In this case, “relative” refers to deaths from bladder cancer, not from other causes. This distinction is important with bladder cancer because half of patients diagnosed are age 73 or older. It is also important to note that many patients live much longer than five years. Additionally, every patient’s situation is unique and statistics cannot predict the exact outcome of an individual case.