Doctors use staging to help diagnose cancer, plan treatment, and explain a person's outlook clearly. There are four stages, which people often write using Roman numerals. Stage 4 cancer will sometimes appear in writing as stage IV.
Knowing what to expect from stage 4 bladder cancer can help people to make informed decisions about their treatment and care.
What does having stage 4 bladder cancer mean?
The most advanced stage of cancer is stage 4.
The stage of cancer denotes where cancer cells are in the body and how much of the body is affected. Some forms of cancer have a stage 0, but most use stages 1 to 4. Doctors will confirm the stage at the time of diagnosis, and this number will not change.
Stage 4 is the most advanced stage of cancer. At this stage, cancer cells will usually have spread beyond the original location of the disease to other organs.
Doctors consider three key factors when determining the stage of bladder cancer:
- size and location of the original tumor
- if cancer has spread (metastasized) to lymph nodes close to the bladder
- if cancer has spread to organs or lymph nodes that are further from the bladder
This is known as the TNM system, which stands for tumor, nodes, and metastasis.
The staging for bladder cancer is complex and can be confusing. Following diagnosis, a doctor will be able to explain what the stage of a person's cancer will mean for them.
What to expect
When bladder cancer reaches stage 4, the original tumor has often grown and pushed through the wall of the bladder. Cancer cells may have spread to organs close to the bladder or those further away, such as the liver or lungs.
The signs and symptoms of bladder cancer that has spread to other parts of the body include:
- tiredness or weakness
- pain when urinating
- difficulty urinating or inability to urinate
- pain in the lower back on one side of the body
- weight loss
- swollen feet
- bone pain
The standard treatment for stage 4 bladder cancer is chemotherapy, which often causes side effects. It works by slowing down or stopping fast-dividing cancer cells, but it can also affect healthy cells that are dividing quickly. These include cells in the mouth, throat, stomach, and hair.
This can cause a range of symptoms, including nausea, digestive problems, and hair loss, which researchers have found ways to reduce. However, every person is different, and not everyone will experience side effects from chemotherapy.
What are the treatment options?
Eradicating stage 4 cancer is very difficult. The aim of treatment is to make people feel better and give them more time to live. Treatment can reduce the symptoms of cancer and sometimes get rid of them.
The most common treatment for stage 4 bladder cancer is chemotherapy, which can slow down the growth of cancer cells or shrink a tumor. This sometimes makes it possible for surgeons to remove part or all of the bladder.
If a person cannot have chemotherapy, other treatment options include radiation therapy and immunotherapy drugs.
Palliative care is often an essential part of treatment for people living with stage 4 cancer. It provides people with pain relief, emotional support, and advice during the course of their treatment. Palliative care can help people to decide how they manage their symptoms so that they can be as comfortable and pain-free as possible.
Survival rates and life expectancy
Cancer survival rates are only estimates, and there are many individual factors to consider.
Experts base survival rates on information from a group of people with a particular type and stage of cancer, for example, people who have stage 4 bladder cancer.
They will usually look at the number of people in this group who have lived for 5 years after their cancer diagnosis.
Relative survival rates compare people with bladder cancer with people in the general population of the same age and sex. This method may result in a more accurate estimate of survival.
For a person with stage 4 bladder cancer, the 5-year relative survival rate is around 5 percent. This means that the person is 5 percent as likely as someone without cancer to live for a minimum of 5 years after diagnosis.
This percentage is the most recent figure available, but the calculations use data from 2008–2014. Scientists are continually making developments in treatment, and these can often improve survival rates.
It is important to remember that survival rates are estimates, and everyone is different. Many factors, such as age or general health, can play a significant role in determining how long a person may live for with this disease.
How to manage symptoms and treatment side effects
The symptoms of stage 4 bladder cancer and the treatment can both have an impact on the body. Maintaining a healthful lifestyle can make treatment more effective and symptoms easier to manage.
Cancer often causes tiredness, and chemotherapy can cause weight loss. Eating little and often throughout the day can help to maintain energy levels. A healthful diet includes whole grains, fruit and vegetables, some protein, and little or no sugar and saturated fats.
Gentle exercise is safe for most people who have cancer, but it is best to check with a doctor for advice first. Walking and swimming do not put much strain on the body and can help to boost mood and reduce tiredness.
Pain relief is an important part of cancer treatment for many people. As pain can differ from person to person, it is important to be as clear as possible when discussing pain with a doctor. This will allow the doctor to prescribe suitable, quick, and effective pain relief.
Living with stage 4 bladder cancer and making decisions about treatment can be difficult. It is often beneficial to get as much information as possible about the disease.
Advocacy groups are generally an excellent source of information in addition to healthcare professionals. Friends, family members, or other people who have stage 4 bladder cancer can often provide emotional support.
Stage 4 bladder cancer is different for every person, and survival rates are only an estimate. Treatment is often very effective at relieving symptoms and giving people a good quality of life.