It’s most common for people to experience one of these three classifications of bladder cancer.

​

1. Superficial low-grade disease 

​
 

• The tumor isn’t deep into the bladder and is developing slowly. 

​

• Treatment is relatively noninvasive; the small lesions get scraped out of the bladder.

  • Urologist uses instruments that enter through the urethra.

  • No incisions are needed.

  • Patients typically see a great recovery.

​

• Some studies find the specific survival rate with superficial low-grade cancer to be 100%; however cancerous lesions do have about a 30% chance of recurring. 

​

• The chance of lesion recurrence typically decreases if mitomycin chemotherapy is used in the bladder during tumor removal and routine cystoscopy (looking in the bladder) is done periodically.

​

This guide from the National Comprehensive Cancer Network (NCCN) that suggests how often patients with superficial bladder cancer should have follow-up surveillance. Click to open the NCCN guide.

​

  2. Invasive bladder cancer

​

• More serious than superficial low-grade bladder cancer. 

​

• Patients with invasive bladder cancer have a tumor that invades the lining or wall of their bladder, which means the tumor has gone into the muscle of the bladder. 

​

• The technical term for this stage of cancer is T2; however the stage may change with additional scans or surgery. Other stages include:

  • T3 bladder cancer, which means the tumor is invading the fat around the bladder

  • T4 which means the tumor has invaded a nearby organ

​

• Being diagnosed with T2 stage bladder cancer should be taken very seriously.

  • The best survival rate is seen in patients who have their tumor aggressively scraped out followed by chemotherapy, and eventually have their bladder removed.

    • By maximizing the scraping of the tumor internally and receiving chemotherapy before the
      bladder is removed, the survival of invasive bladder cancer is increase by 6-10%.

    • Chemotherapy is generally given over a 6- to 12-week period and consists of two-to-four
      intravenous (IV) drugs in three-to-four cycles. This aggressive treatment approach yields
      an average survival rate of above 80%.

    • In some cases, survival rate can be up to 90% in patients who have their bladder removed
      and have very little tumor remaining.

  • Patients who do not have their bladder removed have an average survival of 1-2 years and experience
    a slow and painful death. 

  • The same is true for patients who cannot tolerate bladder removal surgery and instead receive
    chemotherapy and radiation therapy.

    • Patients who receive only chemotherapy without bladder removal have a 70% chance of
      experiencing a tumor reoccurrence often in the liver, bones, lungs, or brain. For this reason
      we do not recommend that approach.

​

 3. Non-muscle invasive (NMI) bladder cancer

​

• Falls in between the first two classifications discussed above. 

​

• Patients with NMI bladder cancer don’t have the non-aggressive low-grade superficial lesions or invasive disease that requires bladder removal.

​

• Instead, they have high-grade tumors that invade just under the surface of the bladder and are categorized as stage T1.

​

• All patients with NMI bladder cancer should have a CT scan at the time of diagnosis and additionally should have the tumor resected twice to ensure the correct diagnosis.

​

• Patients with high-grade stage T1 cancer should be treated with Bacille Calmette Guerin (BCG).

  • When instilled into the bladder, BCG elicits an immune response that makes it less likely for a bladder
    cancer recurrence. 

  • Typical recurrence rate for NMI tumors is about a 50-70%. Because BCG can reduce recurrence, it’s
    an important treatment step toward recovery.

​