Bladder cancer begins in the bladder or in the lining of the bladder. In time, the primary tumor can spread, or metastasize, into surrounding tissue. Cancer cells can also spread through the lymph system or bloodstream.
Cancer staging has to do with the size of the primary tumor and how far the cancer has spread.
If you have stage 2 bladder cancer, it means cancer cells have invaded connective tissue in the muscle wall, but it hasn’t spread outside the bladder or reached the lymph nodes.
Stage 2 bladder cancer is treatable and often curable.
Blood in the urine is often one of the first signs of bladder cancer. You might also have some discomfort or pain when you urinate. Symptoms of stage 2 bladder cancer may also include:
- frequent urination
- feeling like you have to urinate even when you don’t
- inability to urinate
- pelvic pain
- back pain
- loss of appetite
Your treatment options will depend on a number of factors, such as your age and general health. You’ll probably need a combination of treatments. Your doctor will monitor your progress and adjust therapy as needed. You may also need treatments to help control symptoms of cancer and side effects of treatment.
Most of the time, treatment will involve surgery. Learn more about the types of surgery used to treat bladder cancer.
A radical cystectomy is a procedure in which the bladder and surrounding tissue are removed.
In men, the prostate and seminal vesicles are also removed. In women, the uterus, fallopian tubes, anterior vaginal wall, and urethra are removed. These are the areas where cancer is most likely to spread.
In some cases, surgery may also include pelvic lymph node dissection.
Radical cystectomy means you’ll need a new way for urine to leave your body. There are several types of reconstructive surgery to accomplish this, including:
- incontinent diversion
- continent diversion
Incontinent diversion is a procedure in which a short piece of intestine is connected to the ureters. This allows urine to flow from your kidneys through an opening on the front of your abdomen. A small bag is used to collect urine. You won’t have any control over urination, and you must empty the bag when full.
Continent diversion also involves using a piece of intestine. In this procedure, the intestine is used to create a pouch, which is then attached to the ureters. The pouch is connected to an opening in front of your abdomen, but you’ll have a valve instead of a bag. Using the valve and a catheter, you’ll need to empty the pouch several times a day.
A neobladder is an artificial bladder made from a piece of your own intestine, and then sewn to the urethra. With a neobladder, you should be able to urinate normally.
Between 50 and 80 percent of people with stage 2 bladder cancer are cured following a radical cystectomy.
Risks of bladder surgery include:
- damage to nearby organs
- sexual dysfunction
If you only have one small tumor, you might have the option of a partial cystectomy. Only part of the bladder wall plus nearby lymph nodes are removed. Following this type of surgery, you’ll still be able to urinate normally, although your bladder probably won’t be able to hold as much as it did before surgery.
In some cases, transurethral resection (TUR or TURBT) may be all that is needed. This procedure is usually done to assess the extent of the cancer before treatment. A thin, lighted tube called a cystoscope is inserted into your bladder through the urethra so your doctor can examine the bladder. If the tumor is small and hasn’t reached too far into the bladder wall, your doctor may be able to remove the entire tumor at the same time.
Chemotherapy can be used before surgery (neoadjuvant) to shrink the tumor and prevent it from spreading. It can also be used after surgery (adjuvant) to help prevent distant recurrence. Side effects may include nausea, hair loss, and fatigue. Find out more about the effects of chemotherapy on your body.
Radiation therapy destroys cancer cells in a particular area of the body. It’s usually given five days a week for several weeks. Some of the potential side effects are temporary fatigue and skin irritation.
Treatment for stage 2 bladder cancer may involve removal of part or all of your bladder. This can affect the way you urinate for the rest of your life.
Your recovery will depend on the type of treatment you have. Your doctor will provide detailed information about:
- potential short-term, late, and long-term side effects
- signs and symptoms of recurrence
- lifestyle recommendations
- scheduling checkups and screening tests for bladder and other types of cancer
Based on people diagnosed with bladder cancer from 2007 to 2013, the five-year relative survival rate for stage 2 bladder cancer is about 77 percent. Treatment has improved a lot in recent years. Your outlook depends on many factors, including:
- your age and other health considerations
- type of bladder cancer and tumor grade
- type of treatment and how well you respond
- follow-up care
Your doctor can assess these factors to give you some idea what to expect.
As you go through cancer treatment, you may find that you need some extra support. It’s important to keep family and friends in the loop. Ask for help and allow yourself time to rest and recover. For more help coping with cancer, consider reaching out to support groups. Your oncologist can provide information on resources near you, or check out these organizations: