What Each Stage Means and How It Guides Your Care

If you or someone you love has been diagnosed with bladder cancer, it’s normal to have questions. One of the most important things to understand is the stage of bladder cancer—a way doctors describe how far the cancer has spread and what treatment might be needed.

This guide explains each stage clearly, in everyday language, so you can feel more confident as you talk with your care team and make decisions that are right for you.

What Are the Stages of Bladder Cancer?

The stage of bladder cancer tells your doctor how deep the cancer has grown and whether it has spread to other parts of the body. It’s usually based on:

• T (Tumor): How large the tumor is and whether it has grown into the bladder wall

• N (Nodes): Whether the cancer has spread to nearby lymph nodes

• M (Metastasis): Whether it has spread to distant parts of the body

Bladder cancer is typically grouped into five main stages: Stage 0, Stage I, Stage II, Stage III, and Stage IV. Let’s walk through what each stage means.

Stage 0: Cancer Is Only in the Inner Lining

In Stage 0, the cancer is found on the surface of the bladder’s inner lining. It hasn’t grown into the deeper layers or muscle. This is also called carcinoma in situ (CIS) or non-invasive bladder cancer.

Treatment may include:

• TURBT (transurethral resection of bladder tumor): A procedure that removes the tumor through the urethra

• Intravesical therapy: Medicine placed directly into the bladder to kill cancer cells

This stage is often caught early and can usually be treated successfully.

Stage I: Cancer Has Grown Into the Connective Tissue

In Stage I, the cancer has spread into the layer beneath the bladder lining but hasn’t reached the muscle yet. It’s still considered early-stage but may require more aggressive treatment.

Treatment may include:

• TURBT to remove the tumor

• Intravesical chemotherapy to lower the chance of the cancer returning

• Additional surgery if needed

Stage II: Cancer Has Reached the Bladder Muscle

Stage II means the cancer has grown into the muscle layer of the bladder. It’s a more serious stage and can be harder to treat.

Treatment often includes:

• Radical cystectomy: Surgery to remove the bladder

• Chemotherapy before or after surgery

• Radiation therapy to help control the cancer

Stage III: Cancer Has Spread Beyond the Bladder

In Stage III, the cancer has moved beyond the bladder to nearby tissues, like the prostate, uterus, or vagina. It may also be found in nearby lymph nodes.

Treatment often combines:

• Bladder removal surgery

• Chemotherapy

• Radiation therapy, depending on your situation

Stage IV: Cancer Has Spread to Distant Areas

Stage IV is the most advanced stage. The cancer has spread to distant parts of the body, such as the lungs, liver, or bones. At this point, the focus often shifts to controlling the disease and improving quality of life.

Treatment options include:

• Chemotherapy

• Immunotherapy

• Targeted therapy

• Palliative care to manage symptoms like pain or fatigue

Why Staging Matters

Knowing the stage of bladder cancer helps your care team recommend the best treatment plan. Early stages (Stage 0 and I) are often treated successfully. Later stages (Stage II, III, and IV) may need a mix of treatments to help control the cancer and manage symptoms.

You’re Not Alone

Understanding the stage of your cancer is one step toward feeling more in control. If you're looking for support, the Inspire Bladder Cancer Community is filled with people who understand what you're going through. Members share real experiences about treatments, recovery, and finding strength.

You can also find more tools and information from trusted resources like the Bladder Cancer Advocacy Network (BCAN).

Disclaimer

Some comments from Inspire members may have been lightly edited for clarity. This article is for general information only. It’s not medical advice. Be sure to talk with your doctor about your specific diagnosis, treatment options, and questions.

Sources:

• Bladder Cancer Types, Stages, and Grades. BCAN. 

• What is Transurethral Resection of Bladder Tumor (TURBT)? Roswell Park Comprehensive Cancer Center. 

• Intravesical Therapy for Bladder Cancer. American Cancer Society. April 2025.

• Carcinoma in situ, National Cancer Institute