Stage 3 Bladder Cancer: Symptoms, Treatment, Outlook, and More (2024)

If you have stage 3 bladder cancer, it means that cancer has spread into tissue outside your bladder. Stage 3 bladder cancer is treated with surgery, chemotherapy, or radiation therapy, and has a 5-year survival rate of 39%.

Bladder cancer is cancer that starts in the bladder or lining of the bladder.

Cancer can spread (metastasize) into nearby tissue, or it can use the blood or lymph system to spread to distant sites. Cancer is staged according to how far cancer cells may have spread.

In stage 3 bladder cancer, cancerous tissue has grown in areas beyond the bladder. In females, it may have spread to their uterus or vagin*. In males, it may have spread to their prostate or seminal vesicles.

But in stage 3, the cancer hasn’t reached distant sites. Learn more about the other types of bladder cancer.

Though stage 3 bladder cancer is advanced, it can be successfully treated.

In earlier stages, you probably had some blood in your urine and changes to urinary and bowel habits. In this advanced stage, you may also experience:

  • inability to urinate
  • appetite loss
  • weight loss
  • lower back pain
  • weakness and fatigue
  • swelling of your feet
  • bone pain

The standard treatment for stage 3 bladder cancer is surgery, usually in combination with other therapies.

Be sure to discuss your treatment goals with your doctor. Assess all the potential benefits and risks of each therapy. Some treatments aim for a cure. Others work to slow progression or relieve symptoms. The recommended treatment may depend on your overall health.

If cancer continues to progress or comes back during treatment, you may have to reconsider your options.

Radical cystectomy

This surgical procedure requires general anesthesia and a hospital stay. It involves removing the bladder and surrounding tissues through an abdominal incision or laparoscopically.

In women, the ovaries, fallopian tubes, uterus, anterior vagin*l wall, and urethra are removed. In men, the prostate and seminal vesicles are removed. Nearby lymph nodes may also be removed.

You’ll need reconstructive surgery to create a new way to store and pass urine, which can be accomplished in several ways:

  • Incontinent diversion is a procedure in which a piece of the intestine is used to create a passageway for urine. The urine will flow from your kidneys to a small bag on your abdomen.
  • Continent diversion makes use of a piece of intestine to create a pouch. The pouch is connected to an opening in the skin of your abdomen. You won’t need a bag on the outside of your body, and the pouch can be drained several times a day.
  • Your surgeon can make a new bladder, or neobladder, out of intestine. This will enable you to urinate normally.

Risks of surgery include infection, blood clots, and damage to nearby organs. Some post-surgical pain can be expected, and you may experience some sexual dysfunction.

Chemotherapy

Chemotherapy drugs are given intravenously over several months. This can be done before surgery (a technique called neoadjuvant therapy) to shrink the tumor and get the powerful cancer-killing drugs into your system right away.

Chemotherapy can also be used after surgery (as adjuvant therapy) to destroy any cancer cells that were missed during surgery.

If the cancer is inoperable or you can’t tolerate surgery, chemotherapy alone or in combination with radiation can be used as your primary treatment. Among the side effects are nausea, hair loss, and fatigue.

Radiation

External beam radiation therapy is normally given 5 days a week for several weeks. Radiation kills cancer cells in a targeted area of your body. It’s usually used in combination with chemotherapy but can be used alone if you can’t tolerate chemotherapy. Side effects include skin irritation and fatigue.

Radiation can also be used for symptom relief.

Immune checkpoint inhibitors

Checkpoint inhibitors are a class of drugs that harness the immune system to attack cancer cells. These medicines are given intravenously every 2 or 3 weeks. Side effects may include fatigue, nausea, and urinary tract infections.

Supportive care

Medications and other treatments can help control side effects and improve quality of life.

Clinical trial

Clinical trials are used to test experimental treatments. Ask your doctor for information on trials that might be a good fit for you.

Complications of bladder tumor may include:

  • fatigue
  • UTI
  • weight loss
  • metastasis
  • urinary obstruction, which can lead to chronic kidney failure

Complications of the surgery can include:

  • UTI
  • urinary tract obstruction
  • pouch stones
  • erectile dysfunction
  • vagin*l narrowing
  • urinary leakage

When there’s no sign of cancer, you’re in a state of remission. Even if you’ve finished treatment, you’ll need plenty of follow-up care. Your doctor will provide a plan for recovery, which may include:

  • information about late or long-term side effects
  • diet, exercise, and self-care recommendations
  • schedule for regular checkups
  • schedule for bladder cancer tests and screening tests for other types of cancer
  • information about signs of recurrence

When considering outlook, it’s important to keep in mind that this is a very individual thing. Your doctor has a lot to consider when discussing your outlook, including:

  • age and overall health
  • type of bladder cancer and tumor grade
  • whether this is a recurrence after prior treatment for bladder cancer
  • how well you’re responding to various treatments

Using data compiled from 2012–2018, the 5-year relative survival rate for stage 3 bladder cancer is about 39%. Cancer treatments are rapidly improving, so remember that this is only an estimate and doesn’t include more recent data.

If you or a loved one is living with stage 3 bladder cancer, you don’t have to go through it alone. Talk with your family and friends, and ask for the help you need. You might also find it helpful to look into support groups where you can connect with others who have cancer.

Your oncologist or treatment center can provide information about support groups and other resources in your area. In the meantime, here are some ways to get started:

Stage 3 Bladder Cancer: Symptoms, Treatment, Outlook, and More (2024)

FAQs

What is the best treatment for stage 3 bladder cancer? ›

Treatment of stages II and III bladder cancer

The two main treatments for stage II bladder cancer and stage III bladder cancer are radical cystectomy or a combination of radiation therapy and chemotherapy. Radical cystectomy is surgery to remove the bladder and surrounding tissues and organs.

What is the outlook for stage 3 bladder cancer? ›

According to the American Cancer Society, the 5-year relative survival rate for regional bladder cancer, which can include stage 3 bladder cancer, is 39% . This means about 39% of people diagnosed with stage 3 bladder cancer will still be alive 5 years after their diagnosis.

Can you recover from stage 3 bladder cancer? ›

Stage 3. Around 40 out of 100 people (around 40%) survive their cancer for 5 years or more after they are diagnosed. Stage 3 means that the cancer has grown through the muscle into the fat layer. It may have spread outside the bladder to the prostate, womb or vagin*.

What are the odds of beating bladder cancer? ›

The 5-year relative survival rate of people with bladder cancer that has not spread beyond the inner layer of the bladder wall is 96%. Almost half of people are diagnosed with this stage. If the tumor is invasive but has not yet spread outside the bladder, the 5-year relative survival rate is 70%.

What is the new treatment for bladder cancer? ›

UPDATE: On December 15, 2023, the Food and Drug Administration (FDA) approved enfortumab vedotin (Padcev) in combination with pembrolizumab (Keytruda) for people with bladder cancer that has spread to other parts of the body or cannot be removed surgically.

How bad is stage 3 bladder cancer? ›

If you have stage 3 bladder cancer, it means that cancer has spread into tissue outside your bladder. Stage 3 bladder cancer is treated with surgery, chemotherapy, or radiation therapy, and has a 5-year survival rate of 39%.

How bad is Stage 3 cancer? ›

stage 3 – the cancer is larger and may have spread to the surrounding tissues and/or the lymph nodes (or "glands", part of the immune system) stage 4 – the cancer has spread from where it started to at least 1 other body organ, also known as "secondary" or "metastatic" cancer.

What causes death with bladder cancer? ›

But researchers also noted that people with bladder cancer had a higher risk of dying from secondary cancers, heart diseases, and COPD than the people who never had bladder cancer. It should be noted that heart disease and COPD are both smoking-related diseases, as is bladder cancer.

What is the life expectancy of Stage 3 bladder cancer? ›

If the cancer has spread through the bladder muscle into the layer of tissue around the bladder and maybe to nearby organs (such as the prostate gland in men or the vagin* in women), but has not spread to lymph nodes or other organs (Stage III), the 5-year survival rate is about 46%.

What organ does bladder cancer spread to first? ›

Bladder cancer is most likely to spread to the structures close to the bladder, such as the ureters, urethra, prostate, vagin*, or into the pelvis. This is called local spread or locally advanced cancer.

How long can you survive after Stage 3 cancer? ›

Overall, the chance of a person surviving another 5 years after this diagnosis is around 86%, but this depends on many factors. The type and grade of the cancer, the treatment a person receives, how the cancer responds to treatment, and various individual factors can all affect the outlook.

What hurts when you have bladder cancer? ›

Pain in flank, the section of the back between the ribs and the hip bone. Painful urination. Frequent urination. Urinary hesitancy, or difficulty beginning to urinate.

Do you feel sick with bladder cancer? ›

Bladder cancers that have grown large or have spread to other parts of the body can sometimes cause other symptoms, such as: Being unable to urinate. Lower back pain on one side. Loss of appetite and weight loss.

What is the red flag for bladder cancer? ›

Blood in the urine is the most common symptom of bladder cancer. Around 80 out of 100 people with bladder cancer (around 80%) have some blood in their urine. Doctors call blood in the urine haematuria (pronounced heem-at-you-ree-ah). You may see the blood in your urine.

What is the first line treatment for metastatic bladder cancer? ›

Chemotherapy. Currently, the standard first-line treatment options include chemotherapy regimens that contain cisplatin or carboplatin. These regimens include MVAC (rarely), dose-dense MVAC, and gemcitabine-cisplatin.

How do you slow down bladder cancer? ›

Immunotherapy. Immunotherapy uses your own immune system to treat cancer. Immunotherapy for bladder cancer uses a treatment called Bacillus Calmette-Guérin (BCG) to stop or slow down the cancer. Because this immunotherapy goes directly into the bladder through a tube (catheter) it is called intravesical immunotherapy.

What stage is bladder cancer that has spread to lymph nodes? ›

Treatment is often a total (radical) cystectomy, also known as bladder removal. You may have chemotherapy before and after this surgery. Stage 4 is advanced bladder cancer. It is metastatic bladder cancer, or cancer that has spread to distant lymph nodes or organs.

How often should you have a cystoscopy after bladder cancer? ›

Cystoscopy and urine cytology — Repeat cystoscopy and urine cytology testing are recommended for surveillance, beginning three months after treatment ends. If there are no signs of recurrence, cystoscopy and urine testing are usually recommended every three to six months for four years, then once per year.

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