STAGING AND GRADING YOUR BLADDER CANCER
Laboratory analysis of the material taken out during a Transurethral Resection of Bladder Tumour (TURBT) is used to determine the stage and grade of the cancer. The grade tells you how much the cancer cells look like normal cells and how aggressive (or fast-growing) they are. The stage tells you the size of the cancer and whether it has spread. This information helps your doctor to decide which treatment you need.
Tis – Carcinoma in situ (flat tumour), sometimes called Cis.
Ta – Non-invasive papillary carcinoma.
T1 – The tumour is in the first layer of the bladder lining, but not the surrounding muscle.
T2 – The tumour has grown into the muscle. In stage T2a, the tumour is in the inner half of the muscle layer and in stage T2b, the outer half.
T3 – The tumour has spread to the fatty layer around the bladder muscle. T3a describes a microscopic tumour and T3b a large tumour that can be seen or felt.
T4 – The tumour has spread to organs outside the bladder (T4a) or to the wall of the abdomen or pelvis (T4b).
Bear in mind that it can be somewhat difficult for your medical team to know the true extent of your tumour without surgery. That’s because there may be a difference between “clinical staging” and “pathological staging.”
The TURBT is part of the “clinical staging” process, which is done before treatment. Clinical staging also includes a physical exam, imaging tests (such as a CAT scan), laboratory tests (such as blood tests), and biopsies (such as those done following the TURBT).
A cancer can be further staged by examining the material removed during a radical cystectomy. This process is called “pathologic staging.” Complete staging combines the results of the clinical staging with the surgical results. Since you will not have this surgery, your medical team will rely on clinical staging.
In addition to showing what stage your cancer is, the pathology report following your TURBT will generally show whether your tumour is “high grade” or “low grade.” A higher-grade cancer may grow and spread more quickly and may require immediate or more aggressive treatment. Your diagnosis of muscle-invasive bladder cancer may be based on the finding of high-grade tumours.
IMPORTANT
Keep a copy of the pathology report, which will tell you the stage and grade of your tumour.
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