What Is Metastatic Bladder Cancer?
Medically reviewed by Scott Gilbert, MD, Genitourinary Oncology Program.
Metastatic bladder cancer is cancer that has spread from its original location in the bladder. This is sometimes referred to as "deep" or "invasive" bladder cancer.
Bladder cancer that has spread into nearby structures, such as the connective tissues and muscles that make up the bladder wall, is considered to be metastatic bladder cancer, but this term is more commonly used to refer to cancer that has spread to lymph nodes and/or other organs. Cancer tends to spread by entering the lymphatic system, at which point it can spread throughout the body. Low-grade bladder cancers are less likely to metastasize than high-grade bladder cancers.
If cancerous cells accumulate outside the bladder – e.g., in the prostate gland or the uterus – the resulting tumors are called "secondary" tumors. Even though they are located elsewhere, these tumors still carry the same characteristics of primary bladder cancer and are generally treated in the same way. That said, metastatic bladder cancer often requires systemic treatment, which can destroy abnormal cells throughout the entire body. Surgery is not usually recommended for bladder cancer that has spread to other organs, although there are some situations in which it may be used to relieve symptoms related to a secondary tumor.
Treatments for metastatic bladder cancer
Metastatic bladder cancer is usually treated with systemic therapies that circulate throughout the body. Treatment plans are individualized and may include:
- Chemotherapy: Often used as an initial treatment to shrink tumors and slow disease progression.
- Immunotherapy: Drugs such as immune checkpoint inhibitors help the immune system recognize and attack cancer cells and are now a standard option for many patients with advanced or metastatic bladder cancer.
- Targeted therapies and antibody–drug conjugates: Newer treatments can target specific changes in cancer cells or deliver chemotherapy directly to them, helping to limit damage to healthy cells.
- Radiation therapy: Used to relieve pain, control bleeding or treat specific metastatic sites.
- Clinical trials: Many patients with metastatic bladder cancer may be candidates for clinical trials that provide access to the latest therapies and combinations.
These newer therapies have improved outcomes and, for some patients, can extend survival and maintain a higher quality of life.
After six weeks of immunotherapy treatments, Doug Aman opted for robotic cystectomy, a procedure that would completely remove his bladder. “I decided if I wanted to live long, I wasn’t going to roll the dice,” he says.
What is bladder preservation therapy for metastatic bladder cancer?
For some patients with muscle-invasive or metastatic bladder cancer, bladder preservation therapy may be an alternative to removing the bladder. This approach combines tumor removal, radiation, and low-dose chemotherapy to treat the cancer while keeping the bladder. For certain patients who meet the qualifications, it can offer results similar to surgery while avoiding the long-term effects of bladder removal.
At Moffitt, we begin with a thorough evaluation by a team of specialists in bladder cancer. They consider each patient’s condition, overall health, and goals to decide if this option is appropriate and provide personalized treatment and follow-up care.
How long can you live with metastatic bladder cancer?
How long someone can live with stage 4 metastatic bladder cancer is highly individual. Ongoing advances in immunotherapy, targeted therapies and combination regimens continue to improve outcomes for many patients. Your care team can help you understand expectations and tailor treatment to your goals.
Bladder Cancer Outcomes
The primary aim of cancer treatment is to attain the best possible outcome with minimal side effects, ensuring the highest quality of life for the patient. On average, Moffitt's bladder cancer treatment survival rates are 2.5 times higher than the national average.
Common questions about metastatic bladder cancer
Moffitt Cancer Center is here to help with any questions that you might have about metastatic bladder cancer. Please take a look through the following articles:
- Where does metastatic bladder cancer spread to?
- What are the most common symptoms of metastatic bladder cancer?
If you’d like to learn more about metastatic bladder cancer treatment at Moffitt, call 1-888-663-3488 or submit a new patient registration form online to request an appointment. Referrals are welcome, but never required. At Moffitt Cancer Center, we treat patients with all types and stages of bladder cancer. Our oncologists have seen almost every situation, including extensive and distant metastases, and have the experience needed to provide comprehensive, individualized treatment.