Most often, bladder cancer is found on the inside lining of the bladder wall. Muscle-invasive bladder cancer is a form of bladder cancer that is located deep within the bladder wall, in the detrusor muscle. This subtype accounts for about 25% of all cases of bladder cancer.
Muscle-invasive bladder cancer is more likely to spread than other types of bladder cancer, but treatment options are still available.
Muscle-invasive bladder cancer symptoms
Many of the early signs and symptoms of muscle-invasive bladder cancer are similar to those of other subtypes, and include:
- Blood in the urine.
- Frequent and urgent need to urinate.
- Pain with urination.
- Pain in the lower abdomen and back.
As bladder cancer advances and moves into the muscle, you may experience swelling in the feet, along with fatigue and a lack of appetite. Others may have pain in the bones or lower back.
Read more about bladder cancer signs and symptoms
Staging of muscle-invasive bladder cancer
Your doctor might use many different terms to describe the stage of your bladder cancer. If the cancer is graded as Stage II or higher, it means that the cancer cells have begun to grow into the muscle.
Alternatively, you may hear your providers using the TNM staging system, which describes tumor size (T), extent of spread into the lymph nodes (N) and metastasis (M). T2 indicates that cancer is present in the muscle, T3 indicates that the cancer has grown past the muscle into the fatty tissue and T4 indicates that the disease has spread beyond the bladder.
Read more about bladder cancer stages and grades
Muscle-invasive bladder cancer prognosis
The prognosis for all forms of bladder cancer varies by age, type of cancer, stage and other factors. Because muscle-invasive bladder cancer has a higher risk of spreading and recurring, though, the prognosis is poorer than in non-muscle invasive bladder cancer.
On average, the five-year survival rate for patients with muscle-invasive bladder cancer is approximately 50%.
Treatment options for muscle-invasive bladder cancer
The main treatment for patients with muscle-invasive bladder cancer is radical cystectomy, which removes the entire bladder and the surrounding lymph nodes. Before surgery, you may receive neoadjuvant chemotherapy, which helps shrink the main tumor and may treat microscopic spread beyond the bladder.
However, bladder removal isn’t always the only option. Some patients may be eligible for trimodality therapy, a three-step regimen that involves:
- Tumor removal surgery via transurethral resection.
- Chemotherapy to make the tumor cells more susceptible to radiation.
- Radiation to kill the cancer cells.
If you decide on trimodality therapy, make sure to attend all follow-up appointments so your care team can monitor you for possible recurrence.
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