Stages of bladder cancer

Staging describes or classifies a cancer based on how much cancer there is in the body and where it is when first diagnosed. This is often called the extent of cancer. Information from tests is used to find out the size of the tumour, which parts of the organ have cancer, whether the cancer has spread from where it first started and where the cancer has spread. Your healthcare team uses the stage to plan treatment and estimate the outcome (your prognosis).

The most common staging system for bladder cancer is the TNM system. For bladder cancer there are 5 stages – stage 0 followed by stages 1 to 4. Often the stages 1 to 4 are written as the Roman numerals I, II, III and IV. Generally, the higher the stage number, the more the cancer has spread. Talk to your doctor if you have questions about staging.

When describing the stage, doctors may use the words local, regional or distant. Local means that the cancer is only in the bladder and has not spread to other parts of the body. Regional means close to the bladder or around it. Distant means in a part of the body farther from the bladder.

Find out more about staging cancer.

Stage 0

The tumour is only in the lining of the bladder. Stage 0 includes the following:

Stage 0A is also called non-invasive papillary carcinoma. The tumour looks like a mushroom.

Stage 0is is also called carcinoma in situ. The tumour is flat.

Stage 1

The tumour has grown into the connective tissue layer of the bladder.

Stage 2

The tumour has grown into the muscle layer of the bladder.

Stage 3A

The tumour has grown into nearby tissues outside of the bladder but not into the pelvic wall or abdominal wall.



The cancer has spread to 1 lymph node in the pelvis.

Stage 3B

The cancer has spread to 2 or more lymph nodes in the pelvis or to 1 or more of the common iliac lymph nodes found just above the pelvis.

Stage 4A

The tumour has grown into the pelvic wall or abdominal wall.



The cancer has spread to lymph nodes farther from the bladder.

Stage 4B

The cancer has spread to other parts of the body (called distant metastasis), such as to the lungs, liver or bone. This is also called metastatic bladder cancer.

Recurrent bladder cancer

Recurrent bladder cancer means that the cancer has come back after it has been treated. If it comes back in the same place that the cancer first started, it’s called local recurrence. If it comes back in tissues or lymph nodes close to where it first started, it’s called regional recurrence. It can also recur in another part of the body. This is called distant metastasis or distant recurrence.

Expert review and references

  • Brierley JD, Gospodarowicz MK, Wittekind C (eds.). TNM Classification of Malignant Tumours. 8th ed. Wiley Blackwell; 2017.

Medical disclaimer

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