Stage 1 Bladder Cancer

What is Stage 1 Bladder Cancer?

Bladder cancer is a type of cancer that starts in the cells of the bladder, a muscular organ located in the lower abdomen. The stage of bladder cancer is determined by how far it has spread into the bladder wall and surrounding tissues. Stage 1 bladder cancer is early-stage cancer that has not spread beyond the bladder lining [¹].

What are the subtypes of stage 1 bladder cancer?

There are three main subtypes of stage 1 bladder cancer:

Papillary urothelial carcinoma: This subtype accounts for about 80% of all bladder cancers. It develops in the urothelial cells that line the inside of the bladder [²]. This type of cancer grows in finger-like projections, called papillae, that extend into the bladder cavity.
Squamous epithelial carcinoma: This is uncommon and only affects around 3-7% of Americans [³]. This is usually associated with chronic inflammation in the bladder, commonly due to infection.
Adenocarcinoma: This subtype is less common, accounting for about 20% of all bladder cancers. It grows as a flat or sessile lesion on the bladder lining and tends to be more aggressive than papillary urothelial carcinoma.

Stage 1 Bladder Cancer Staging and Diagnosis

Bladder Cancer Stages

Cancer is stage by using the American Joint Committee on Cancer (AJCC) TNM system [4] for cancer to allow doctors and the cancer care team to assess how far cancer has spread. In general, the TNM system is used to describe and classify cancers, including {cancer type}, where:

T (tumor) describes the size and location of the tumor
N (nodes) indicates whether or not it has spread to nearby lymph nodes
M (metastasis) describes if and how far cancer has spread from its origin

How Common is Stage 1 Bladder Cancer?

Bladder cancer is one of the most common cancers in the world. Stage 1 bladder cancer is the fourth most common cancer in those assigned male at birth and the eighth most common cancer in those assigned female at birth [⁵].

In the United States, it is estimated that there will be around 81,180 new cases of bladder cancer in 2022, with about 4.2% new cancer cases. Stage 1 bladder cancer is relatively common in people aged 65 to 74 (31.7%) [⁶].

How is stage 1 bladder cancer diagnosed?

Some of the main ways of diagnosing stage 1 bladder cancer include the following:

Physical Examination: Your doctor will begin by conducting a physical examination, including a pelvic exam for women. They will look for abnormal growth or lumps in the bladder or surrounding areas [⁷].
Urine Tests: A urine test gives insight into the presence of cancer cells. This is called a urine cytology test. The test looks for cancer cells shed from the bladder's lining and into the urine [⁸]. However, this test is not always reliable and can miss some cases of bladder cancer.
Imaging Tests: If your doctor suspects you may have bladder cancer, they will order imaging tests to better look at the bladder and surrounding areas. Imaging tests may include a CT scan, MRI, or ultrasound to check abnormal growth [⁹]. The growth location determines the cancer stage, as illustrated in table 1.
Cystoscopy: A cystoscopy is a procedure that involves using a thin, flexible tube with a camera attached to examine the inside of the bladder. This is the most reliable way to diagnose bladder cancer [¹⁰]. During the procedure, your doctor will insert the cystoscope through your urethra and into your bladder. They will be able to see any abnormal growths or tumors and may take a biopsy to test for cancer.
Biopsy: A biopsy is a procedure in which a small piece of tissue is removed from the bladder and examined under a microscope to determine if cancer cells are present. In stage one, bladder cancer, the biopsy is usually done during a cystoscopy [¹¹]. The doctor will use a special tool to remove a small piece of tissue from the bladder wall, which will be sent to a laboratory for analysis.

Stage 1 Bladder Cancer Symptoms

Early-stage bladder cancer may not cause notable symptoms. However, as the cancer grows, it can cause a variety of symptoms, including:

Blood in the urine (hematuria)
Painful or difficult urination (dysuria)
Frequent urination
Urgent urination
Pelvic pain

It's important to note that other conditions, such as a urinary tract infection or kidney stones, can also cause these symptoms. However, if you experience any of these symptoms, seeing a doctor is important to determine the cause.

Stage 1 bladder cancer treatment

Stage 1 bladder cancer is early-stage cancer that has not spread beyond the bladder lining. Stage 1 cancer treatment depends on the type and size of the tumor, as well as the patient's overall health and personal preferences.

Stage 1 bladder cancer primary/first-line treatment

The standard stage 1 bladder cancer treatment is transurethral resection of bladder tumor (TURBT) [¹²]. This is a surgical procedure in which a small, flexible instrument is passed through the urethra and into the bladder to remove the tumor. During TURBT, the surgeon may also remove a small amount of surrounding tissue for examination under a microscope (biopsy).

Following TURBT, the patient may receive intravesical therapy, administering medication directly into the bladder. This destroys any remaining cancer cells and reduces the risk of recurrence. The most commonly used intravesical therapy is Bacillus Calmette-Guérin (BCG) therapy, an immunotherapy that stimulates the immune system to attack cancer cells [¹³].

Other Types of Treatments for Stage 1 Bladder Cancer

Additional treatments may be necessary if cancer has spread deeper into the bladder wall or to other nearby organs. These may include:

Radical cystectomy: This is a surgical procedure in which the entire bladder is removed. This is typically done for more advanced cancers or patients with recurring tumors despite the administration of other treatments.
Chemotherapy: This is a type of medication that is given to kill cancer cells. It can be given before or after surgery or in combination with radiation therapy.
Radiation therapy: This type of treatment uses high-energy radiation to kill cancer cells. It can be used alone or in combination with other treatments.

Can Stage 1 Bladder Cancer Be Cured?

The chances of curing stage 1 bladder cancer are generally good, especially if the cancer is detected early and treated promptly. The death rate per 100,000 persons suffering from stage 1 blood cancer has been steady at four from 1992 to 2020. However, there is still a risk of recurrence, so regular follow-up with a doctor is important.

Prognosis: Stage 1 Bladder Cancer Survival Rate

Bladder Cancer Stage 1 Survival Rate

According to the National Cancer Institute, cancer stage 1 survival rate for bladder cancer is around 77.1% [⁶], which means that out of 100 patients, 77 would survive for five years or more. However, the rate does not include the possibility of patients dying from causes other than bladder cancer. Moreover, the exact stage 1 cancer survival rate is difficult to assess as patients vary in health and illness. 51% of survivors suffered from primary cancer, while 34% had localized cancers.

Stage 1 bladder cancer recurrence rate

Patients that suffer from stage one cancer have a range of effective treatment options that can help improve their chances of survival and cure. However, stage 1 bladder cancer has a high chance of recurrence, and regular medical checkups are necessary. Although TURB and other treatment methods provide a significant cure rate, stage 1 bladder cancer recurs in about 80% of all cases [¹⁴].

Stage 1 bladder cancer growth rate

Stage 1 bladder cancer is divided into two types:

Low grade: Cancer cells that grow slowly and look normal
High grade: Cancer cells that grow quickly and look abnormal

Most bladder cancers are low-grade. However, the early stages of cancer are relatively quickly growing and can spread quickly. Thus, it is important to diagnose the disease quickly.

Lifestyle changes for preventing and managing bladder cancer

While there is no guaranteed way to prevent bladder cancer, certain lifestyle changes can reduce your risk of developing the disease. Additionally, if you have been diagnosed with bladder cancer, making certain lifestyle changes can help manage the disease and improve your quality of life [¹⁵].

Quit Smoking

Smoking is a major risk factor for bladder cancer. Smokers are two to three times more likely to develop bladder cancer than non-smokers. If you smoke, quitting can reduce your risk of developing bladder cancer and improve your overall health. Talk to your healthcare provider about resources to help you quit smoking, such as nicotine replacement therapy, medications, or counseling.

Maintain a Healthy Weight

Being overweight or obese can increase your risk of developing bladder cancer. Maintaining a healthy weight through a balanced diet and regular exercise can help reduce your risk of developing the disease. Eat a diet rich in fruits, vegetables, whole grains, lean protein, and healthy fats. A healthy regime would include moderate-intensity exercises, such as walking, cycling, or swimming.

Stay Hydrated

Drinking plenty of fluids can help flush toxins out of your body, which can help reduce your risk of developing bladder cancer. You should drink at least eight glasses of water per day. You can also increase your fluid intake by drinking herbal tea, low-sugar fruit juice, or water-rich fruits and vegetables.

Reduce Exposure to Chemicals

Certain chemicals, such as those in industrial workplaces, can increase your risk of developing bladder cancer. If you work in an industry that exposes you to chemicals, take precautions to protect yourself, such as wearing protective clothing and equipment. You can also reduce exposure to chemicals in your home by using natural cleaning products and avoiding exposure to secondhand smoke.

Manage Chronic Bladder Inflammation

Chronic bladder inflammation, such as recurring urinary tract infections or interstitial cystitis, can increase your risk of developing bladder cancer. If you experience chronic bladder inflammation, talk to your healthcare provider about treatment options to manage the condition and reduce your risk of developing bladder cancer.

Conclusion

Takeaway

Stage 1 bladder cancer is the early stage of cancer that has not spread beyond the bladder lining. While stage 1 bladder cancer is relatively uncommon, it is important to be aware of the symptoms and to see a doctor if you experience any of them, as early diagnosis and treatment can improve the chances of a successful outcome. The first-line treatment for stage 1 bladder cancer is TURBT, followed by intravesical therapy to reduce the risk of recurrence. Additional treatments may be necessary if cancer has spread deeper into the bladder wall or to other nearby organs. While the chances of cure for stage 1 bladder cancer are generally good, regular follow-up with a doctor is important to monitor for any signs of recurrence.