Staging of Bladder Cancer

Different systems for staging of Bladder Cancer  :

1. The AJCC TNM staging system for bladder cancer :

A system desinged to stage cancer helps the doctor’s to determine the spread of the cancer and take care and cure steps for the patient accordingly. An example of such a system is the AJCC TNM system. AJCC stands for American Joint Committee on Cancer and TNM stands for Tumor, Nodes, Metastasized.

The TNM staging system conveys three main pieces of information about the patient’s disease. The letter “T” is followed by numbers or letters that show how much has the cancer grown. In case of bladder cancer it directly signifies how much the tumor has grown, and answers basic questions like, has the tumor penetrated the bladder wall, or whether it has spread to the nearby tissues. The higher the T-numbers, the greater is the spread of the tumor.

This “T” method can be differentiated as under :

Stage Name                                 Description
==========                            ===========
1. TX                                Main tumor cannot be assessed due to lack of information.

2. T0                                No evidence of a primary tumor.

3. Ta                                Non invasive papillary carcinoma

4. Tis                            Non invasive flat carcinoma (flat carcinome in-situ, or CIS)

5. T1                             The tumor has grown from the layer of cells lining the bladder into the                                                 connective  tissue below. It has not grown into the muscle layer of the bladder.

6. T2                            Tumor has grown into the muscle layer.

T2a                            The tumor has grown into the inner half of the muscle layer.

T2b                            The tumor has grown into the outer half of the muscle layer.

7. T3                                The tumor has grown through the muscle layer of the bladder and into the                                                             fatty tissue  that surrounds it.

T3a                            The tumor’s spread to fatty tissue on the outside of the bladder can only                                                             be seen  by using a microscope.

T3b                            The tumor’s spread to fatty tissue on the outside of the bladder is large                                                             enough  to be seen on imaging tests or to be seen or felt by the surgeon.

8. T4                                The tumor has spread beyond the fatty tissue and into nearby organs or                                                  structures. It  may be growing into any of the following: the stroma
                                      (main tissue) of the prostate, the  seminal vesicles, uterus, vagina, pelvic wall,                                       or abdominal wall.

T4a                            The tumor has spread to the stroma of the prostate (in men), or to the                                                      uterus  and/or vagina (in women).

T4b                            The tumor has spread to the pelvic wall or the abdominal wall.

In bladder cancer, there may be more than one tumors at the same time. In order to signify the existance of more than one tumor, a letter M is added to the appropriate T category.

The different versions of the T-category, define the main tumor.