Bladder cancer spreads at different speeds depending on the type of bladder cancer you have. Urothelial bladder cancer is slow to spread, while other types are much faster.

Urothelial bladder cancer is the most common type of bladder cancer. It typically doesn’t spread very quickly. However, other types of bladder cancer, such as adenocarcinoma, squamous cell carcinoma, and small cell carcinoma, spread much faster.

In most cases, treatment, if started early enough, can prevent the spread of bladder cancer. But even if bladder cancer has spread to other locations at the time of diagnosis, it can still be treated successfully.

In this article, we take a closer look at the types of bladder cancer that spread quickly, where these cancers typically spread to, and treatment options that can be used for bladder cancer that has spread.

There are multiple types of bladder cancer. Urothelial bladder cancer is the most common. About 90% of bladder cancers are this type. Urothelial bladder cancer is also slower to spread than other types of bladder cancer.

According to the American Cancer Society, fast-spreading types of bladder cancer include:

  • Small cell carcinoma: Less than 1% of bladder cancers are small cell carcinoma. This type of bladder cancer can spread very quickly.
  • Adenocarcinoma: About 1% of bladder cancers are adenocarcinomas. These cancers are typically invasive and fast-spreading.
  • Squamous cell carcinoma: Squamous cell carcinomas make up about 1% to 2% of all bladder cancer cases. In many cases, these cancers spread and grow quickly.

Bladder cancer first spreads into the bladder wall. The bladder wall has four layers. As cancer spreads, it will grow into each layer. When cancer spreads beyond the bladder wall, it can spread to a number of locations, including the:

  • pelvic lymph nodes
  • abdominal lymph nodes
  • liver
  • lungs
  • bones
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Locations in the body where bladder cancer is likely to spread. Medical illustration by Bailey Mariner

Other, less serious conditions can also cause many of the signs and symptoms of bladder cancer. For instance, blood in your urine is typically the first symptom of bladder cancer, but it’s also a common symptom of a urinary tract infection (UTI).

It’s a good idea to talk with a doctor if you have any symptoms that could be bladder cancer. Although it’s likely there’s another cause, finding bladder cancer early will give you better treatment options.

Symptoms of bladder cancer include:

You might have additional symptoms if bladder cancer spreads. These can include:

Treatment options for bladder cancer depend on the type of cancer you have and how far the bladder cancer has spread.

Surgery can often remove early stage tumors. However, once cancer spreads, it’s common for doctors to do a radical cystectomy. This surgical procedure is also done for high grade, invasive, and large volume bladder tumors that have not yet spread but are highly likely to.

A radical cystectomy removes the entire bladder and some of the surrounding pelvic organs. Depending on your anatomy, this might include the:

It’s worth noting there is growing support in the medical community to try to preserve the bladder whenever possible. This means limiting treatment to removing as much as possible of the primary tumor and supplementing with chemotherapy and radiation.

A procedure called urinary diversion is typically part of a radical cystectomy. This allows people who have had a radical cystectomy to urinate.

Treatments in addition to surgery will depend on how far the cancer has spread and might include:

  • Chemotherapy: Chemotherapy can kill cancer cells. It can help destroy cancer that has spread.
  • Radiation therapy: Radiation therapy can kill cancer cells and shrink tumors. It’s sometimes used alongside chemotherapy.
  • Immunotherapy: Immunotherapy is a newer type of cancer treatment. It helps teach your immune system to attack cancer cells.
  • Targeted therapy: Targeted therapy identifies how cancer cells are genetically distinct from healthy cells so your body can find and destroy them.

Does bladder cancer always spread?

Not all bladder cancers spread throughout the body. If caught early, bladder cancer can be treated before it spreads.

Urothelial cancer commonly spreads into the layers of the bladder wall including the muscle. It begins on the urothelial lining of the bladder and can grow up into the bladder cavity, or deeper into the surrounding submucosal and muscle layers. It can also spread beyond the bladder, including to the lungs and bone.

How long does it typically take bladder cancer to spread?

Bladder cancer spreads at different speeds depending on the type of bladder cancer. As an overall rule, small cell carcinoma, squamous cell carcinoma, and adenocarcinoma spread faster than urothelial bladder cancer.

Is bladder cancer likely to spread if I’m undergoing treatment?

In most cases, treatment will slow and stop the spread of bladder cancer.

The overall survival rates for bladder cancer are good. According to the American Cancer Society, the 5-year survival rate for all stages of bladder cancer was 77% between 2011 and 2017.

However, when bladder cancer is aggressive and advanced, it can be treatment-resistant. This means it might continue to spread while you’re undergoing treatment.

Is bladder cancer curable once it has spread?

Bladder cancer is still curable once it has spread. The treatment options and outcomes are best when bladder cancer is treated before it spreads, but there are still options if the cancer has spread beyond the bladder.

Surgery, chemotherapy, targeted therapy, and immunotherapy can help treat bladder cancer that has spread.

Bladder cancer spreads at different speeds depending on the type of bladder cancer you have and how soon you start treatment.

The most common type of bladder cancer, urothelial carcinoma, is also the least invasive and slowest growing. Rare types of bladder cancer, such as small cell carcinoma, squamous cell carcinoma, and adenocarcinoma, typically grow much faster.

Treatment options depend on the type of cancer you have and how far your bladder cancer has spread.

If the cancer has spread or is an invasive type that’s likely to spread, doctors may choose to remove the bladder and the surrounding pelvic organs.

However, doctors try to preserve the bladder whenever possible. Treatment options may be the removal of the primary tumor and surrounding tissues along with chemotherapy and radiation to prevent further spread.

Additional options, such as immunotherapy and targeted therapy, can also help treat bladder cancer that has spread.