Donate

Advanced and Metastatic Bladder Cancer (Stage 4) 

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. Understanding advanced or metastatic bladder cancer, its symptoms, treatment options, and prognosis, is crucial for patients, caregivers, and medical professionals. Let’s dive deep into what stage 4 bladder cancer entails and how it can be managed.

Table of Contents 

What is the difference between advanced, metastatic, and Stage 4 bladder cancer?

When discussing bladder cancer, terms like “advanced,” “metastatic,” and “stage 4” are often used interchangeably.

Advanced bladder cancer is a general term that can refer to both metastatic and locally advanced bladder cancer. Metastatic bladder cancer is the most advanced stage of bladder cancer, also known as stage 4 bladder cancer. Locally advanced bladder cancer means the cancer has grown outside the bladder but has not spread to other parts of the body.

When bladder cancer metastasizes, it commonly goes to the lymph nodes in the pelvis or abdomen, the liver, and lungs. It may even metastasize to the bones or other parts of the body. It is either stage T3 or T4.

Understanding Stage 4 bladder cancer

Metastatic (Stage 4) cancer happens when cancer cells travel through the lymphatic system or blood and form tumors in other parts of the body. The metastatic tumor is the same type of cancer as the primary tumor.

Stage 4 bladder cancer is the most advanced stage and is divided into two subcategories: 

  • Stage 4A: Cancer has spread to the pelvic or abdominal wall or nearby lymph nodes. 
  • Stage 4B: Cancer has metastasized to distant organs such as the liver, bones, or lungs.

What are the symptoms of advanced/metastatic bladder cancer? 

In addition to the common symptoms of bladder cancer, some signs, and symptoms that the bladder cancer may have advanced include:  

  • Being unable to urinate  
  • Lower back pain on one side of the body  
  • Loss of appetite and unexplained weight loss  
  • Increased tiredness or weakness  
  • Pain in bones

Many of these symptoms can be caused by something other than bladder cancer, but it is important to get checked if experiencing any new or worsening symptoms.

How is advanced or metastatic bladder cancer diagnosed? 

In some cases, bladder cancer may be diagnosed at an early stage and continue to progress. In other cases, bladder cancer may be advanced at the point of diagnosis. If advanced bladder cancer is suspected, your doctor will carry out an assessment, which may include some of the following tests: 

  • Cystoscopy: A thin tube with a camera is inserted into the bladder to look for tumors
  • Biopsy: A tissue sample is taken from the bladder for analysis
  • Imaging Tests: CT scans, MRIs, and PET scans help determine the extent of the spread

Treatments for Stage 4 advanced bladder cancer 

Advanced or metastatic bladder cancer now has a number of treatment options approved by the Food and Drug Administration (FDA). Ask your medical oncologist which treatments may be right for you. These can include:

Chemotherapy – Systemic chemotherapy is used to treat cancer that has advanced beyond the bladder to other parts of the body. This is because this treatment can travel through the bloodstream, reaching and affecting cells all over the body. 

Immunotherapy  – Immunotherapy helps the immune system to fight cancer cells by boosting or stopping certain immune responses. There are two types of immunotherapy used to treat bladder cancer that has spread. These are immune checkpoint inhibitors and antibody-drug conjugates. 

Maintenance therapy  – In some cases, immune checkpoint inhibitors can be used as maintenance therapy. A treatment regimen of chemotherapy, followed by an immune checkpoint inhibitor, may be used to maintain the benefits of chemotherapy and slow the progression of the cancer. 

Stage 4 bladder cancer survival rate

Advanced/metastatic bladder cancer poses a significant challenge because it has spread to other parts of the body. The later the diagnosis and the farther the cancer has traveled, the more difficult it becomes to control.

For bladder cancer that has spread to regional lymph nodes, the 5-year survival rate is approximately 39.2%. However, if the cancer has metastasized to distant sites, the 5-year survival rate drops to around 8.3%.

These survival rates indicate the percentage of people who will live for 5 years after their diagnosis compared to those without bladder cancer. It’s important to note that these rates have improved slightly over time.

Despite the challenges, there are still treatment options available for metastatic bladder cancer that aim to control the disease for as long as possible. These include:

  • Chemotherapy
  • Immunotherapy
  • Radiation Therapy
  • Surgery

New treatments are continually being developed, offering hope for better outcomes.

Patients undergoing treatment can also benefit from palliative care to manage symptoms and enhance their quality of life.

Additionally, participating in clinical trials can be an option. These trials explore the effectiveness of new therapies and combinations, such as adding novel anticancer or immunotherapy drugs to existing treatments. Some trials may offer financial compensation.

Ultimately, prognosis and treatment options depend significantly on the specifics of each person’s disease and overall health.

Podcast: What is Metastatic Bladder Cancer?

FAQs

Does chemo work for stage 4 bladder cancer?

Chemotherapy is part of the treatment a person with stage 4 bladder cancer receives. Its effectiveness, however, depends on the person and their specific cancer.

How aggressive is bladder cancer?

Bladder cancer can be aggressive. That said, it is less likely to be aggressive than many other cancers. Research shows that when it first manifests, about 70% of people will have a non-invasive form.

Where is the first place bladder cancer spreads?

If bladder cancer spreads, it usually affects the organs closer to the bladder first. This includes the urethra, prostate, and vagina.

What is the life expectancy for someone with stage 4 bladder cancer?

While challenging, remission is possible with aggressive and targeted treatment. However, it is relatively rare and often short-lived.

What are the newest treatments for stage 4 bladder cancer?

New treatments include advanced immunotherapies, targeted therapies, and novel chemotherapy regimens. Research is continuously evolving to find more effective treatments.

How can I support a loved one with stage 4 bladder cancer?

Offer emotional support, accompany them to appointments, assist with daily tasks, and encourage them to join support groups. Providing a listening ear and being there for them can make a significant difference. You can also reach out to our toll free support line for patients, loved ones and the bereaved.

Are there clinical trials available for stage 4 bladder cancer patients?

Yes, many clinical trials are exploring new treatments for stage 4 bladder cancer. Patients can discuss with their oncologist about eligibility and potential benefits of participating in a trial.

Read Our Stories