Bladder Cancer Types, Stages and Grades

What You Need to Know

Bladder cancer can appear in different forms—papillary, sessile, or carcinoma in situ—and may range from non-muscle invasive (early stage) to muscle invasive or advanced disease. Doctors use staging to describe how far the tumor has grown and grading to show how abnormal and aggressive the cancer cells are. Early-stage, low-grade tumors are often more treatable, while higher-stage or higher-grade cancers carry greater risks of spreading. Understanding tumor type, stage, and grade helps guide treatment decisions and predict outcomes.

Bladder Cancer Stages

After a bladder cancer diagnosis, doctors determine the stage of the cancer to plan the most effective treatment. The stage describes how far the tumor has spread in relation to the bladder’s inner lining. The stage and grade of the cancer are typically determined by examining a tissue sample. A urologist collects this sample, which is then analyzed by a pathologist.

Staging helps assess whether the cancer has invaded the bladder wall, spread to other areas, and if so, which parts of the body are affected. Bladder cancer stages range from 0 to 4—with higher stages indicating that the tumor has grown further from its original location.

Stage 0 Bladder Cancer

T0: No tumor

A T0 bladder tumor means that doctors did not find any cancer in the bladder after testing. It shows that there are no visible signs of a tumor in the bladder lining. T0 is part of a system doctors use to describe how far cancer has grown. In this case, it means the bladder looks clear of cancer at the time of the exam.

Ta: Papillary tumor without invading the bladder wall

A papillary tumor without invading the bladder wall is called a Ta bladder tumor. This means the tumor is growing in small, finger-like shapes on the surface lining of the bladder but has not spread deeper into the bladder wall. Ta tumors are considered non-muscle invasive.

T1S (CIS): Carcinoma in situ

Carcinoma in situ is a cancerous patch of bladder lining, often referred to as a “flat tumor.” The patch may look almost normal or may look red and inflamed. CIS is a type of non-muscle invasive bladder cancer that is of higher grade and increases the risk of recurrence and progression. At diagnosis, approximately 10% of patients with bladder cancer present with CIS.

Stage 1 Bladder Cancer

T1: Tumor invades the connective tissue under the surface lining

A T1 bladder tumor means the cancer has grown deeper than the bladder’s inner lining but has not reached the muscle layer. Instead, it is found in the connective tissue just beneath the lining. T1 tumors are considered non-muscle invasive.

Stage 2 Bladder Cancer

Stage 2 bladder cancer can also be referred to as muscle invasive bladder cancer. When tumors grow into or through the muscle wall of the bladder, it is known as “muscle invasive bladder cancer,” or MIBC. Bladder cancer is most often found in the tissue (called urothelial or transitional cells) that line the inside of the bladder and approximately 25-30% of bladder tumors grow into or through the muscle wall of the bladder which makes it muscle invasive bladder cancer. When bladder tumors spread into the bladder muscle, they are more likely to spread further and be more life threatening.

T2: Tumor invades the muscle layer

A T2 bladder tumor means the cancer has grown into the muscle layer of the bladder wall. This is different from earlier stages, where the tumor is only on the surface or in the tissue just beneath the lining. Because the bladder muscle is involved, T2 tumors are considered muscle-invasive bladder cancer.

Stage 3 Bladder Cancer

T3: Tumor penetrates the bladder wall and invades the surrounding fat layer

Stage 3 bladder cancer means the cancer has spread through the muscle of the bladder and into the tissues or organs around it. In men, it may reach the prostate, and in women, it may spread to the uterus or vagina. Even though it has grown outside the bladder, it has not yet spread to distant parts of the body. Stage 3 is a more advanced cancer, and treatment usually involves a combination of surgery, chemotherapy, and sometimes radiation.

Stage 4 Bladder Cancer

Bladder cancer is a challenging diagnosis that affects thousands of people every year. When it progresses to stage 4, the situation becomes even more serious as the tumor invades other organs (i.e., prostate, uterus, vagina, pelvic wall). 

Stage 4 is also often referred to as advanced or metastatic bladder cancer. Understanding advanced or metastatic bladder cancer, its symptoms, treatment options, and prognosis, is crucial for patients, caregivers, and medical professionals. 

 What is a bladder cancer grade?

Bladder cancer grade refers to what the cancer cells look like, 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. 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.

Information and services provided 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.