Prognosis for Bladder Cancer
Bladder cancer generally affects the elderly population disproportionately, with most diagnoses occurring in those age 70 or over. The majority of bladder cancer diagnoses are transitional cell carcinomas. This means the cancer originates in the bladder lining as a result of cell inflammation in the bladder.
Often, there are no symptoms of bladder cancer until it is advanced. The prognosis for bladder cancer depends on the stage of the cancer at diagnosis and the patient’s overall health and ability to withstand treatment. Like most cancers, the prognosis is described in terms of five-year survival rates, which report statistics on the percentage of people who live at least five years after being diagnosed with the cancer.
Diagnosis and Fatalities
According to the National Cancer Institute, there will be an estimated 70,980 new diagnoses of bladder cancer in 2019. During 2019, approximately 14,330 people will die from bladder cancer. Between 2012 and 2016, 73 was the median age at diagnosis, with approximately 17.8 percent of cases of bladder cancer found in patients aged 55 to 64, 27.5 percent of cases found in patients aged 65 to 74 and 44.6 percent of cases in patients over 75.
The median age of death in cases where the bladder cancer proves to be fatal is 78. Fatalities occur in approximately 7.5 out of every 100,000 men and 2.2 out of every 100,000 women in the U.S., according to National Cancer Institute statistics from 2012 to 2016.
Stage 0 Prognosis
Stage 0 bladder cancer has two clinical pathologies. The first, Stage 0a, is characterized by a T factor of Ta, an N number of 0 and an M number of 0. These numbers are part of the TNM staging system used to gauge cancer.
The T number refers to the size of the tumor, which in this case is a papillary carcinoma that exists only in the bladder’s lining and has not grown into any tissue or muscle. The N and M factors refer to the extent of spread to lymph nodes or other areas of the body. Here, N and M are 0, so there is no cancer in the lymph nodes or outside the bladder anywhere.
Stage 0is is a slight variation in which the T factor is Tis instead of Ta. This means the cancer is a noninvasive carcinoma, as opposed to a papillary carcinoma. Like the papillary carcinoma, the cancer is in the lining only.
The five-year survival rate for both Stage 0a and Stage 0is is 98 percent. This means the prognosis is good if your bladder cancer is diagnosed at this stage because 98 percent of patients live at least five years after diagnosis.
Stage I Prognosis
The clinical pathology for Stage I has a T factor of 1. This means the cancer is no longer just in the bladder lining, it is also in the tissue of the bladder.
Although the cancer is more advanced, it has not yet spread into muscle or into the bladder wall. Both the N and M factors are 0 indicating no spread of cancer cells. The five-year survival rate here is 88 percent
Stage II Prognosis
In Stage II Cancer, the T factor is T2. This indicates that the cancer has penetrated some of the muscle in the bladder, but has not gotten through the muscle to the outer layer of tissue. Again, the N and M factors of 0 indicate no spread beyond the bladder.
The five-year survival rate drops to 63 percent, which means that although more than half of patients diagnosed are alive five years later, the prognosis is not nearly as good as those diagnosed with Stage 0 or Stage I.
Stage III Prognosis
Stage III bladder cancer has a clinical pathology characterized by a T factor of 3. This means the cancer has completely grown through the bladder tissue and muscle, into the layer of tissue that protects and surrounds the bladder.
The cancer still must be confined to the bladder itself, since if it has spread into other local organs (including the uterus, vagina or prostate), then it would be considered Stage IV. Again, the N and M factors of 0 indicate no spread into distant organs or lymph nodes. The five year survival rate drops to 46 percent here, which means fewer than half of the people are alive in five years so the prognosis is not nearly as positive for Stage III bladder cancer as it was for less advanced cancers.
Stage IV Prognosis
Stage IV refers to all bladder cancers that have penetrated beyond the bladder into other organs or lymph node. The five-year survival rate of 15 percent indicates a poor prognosis for those diagnosed with Stage IV cancer.