What are Advanced and Metastatic Bladder Cancer?

Bladder cancer occurs when cells grow abnormally and begin to form tumors in the bladder. Advanced bladder cancer occurs when the abnormal cells of a muscle-invasive tumor spread beyond the bladder lining.

Locally advanced bladder cancer may spread to the urethra or ureters or to nearby organs or tissues such as the prostate in men or the uterus, cervix, or vagina in women.

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.

What are the common symptoms? 

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:  

• Ultrasound scan  
• CT scan  
• MRI scan  
• Bone scan  

Patient stories about advanced or metastatic bladder cancer

Click the button below to read first-person accounts from patients.

Video: What is advanced bladder cancer?

How is it treated?

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.  

Video: How is advanced bladder cancer treated?

Podcast: What is Metastatic Bladder Cancer?