Stage 4 bladder cancer is typically hard to treat because it has spread to other areas of the body. Treatment often aims to improve your well-being, slow cancer growth, and extend your life.
Stage 4 bladder cancer is also known as metastatic bladder cancer. It’s typically hard to treat metastatic cancers since they have spread to other parts of the body.
Read on to learn some facts about stage 4 bladder cancer, including what treatment options are available and what your life expectancy may be if you have stage 4 bladder cancer.
Bladder cancer is
Stage 4 bladder cancer means it has spread to other areas of your body, also known as “metastatic.”
Stage 4 bladder cancer means the cancer has spread to one or more of the following:
- nearby structures, such as the abdominal wall or the pelvic wall
- lymph nodes
- distant parts of the body, such as the lungs, bone, or liver
Bladder cancer that’s spread to other parts of your body is still called bladder cancer no matter where it now is, but it’s known as metastatic bladder cancer.
Metastatic cancers are typically difficult to treat but are not untreatable.
According to the
However, these figures are based on earlier cases from previous years, so a person who gets a diagnosis today may have a better outlook due to improvements in treatment.
Each person may also respond differently to treatment, and factors such as age and health before the diagnosis can also affect your individual outcome.
Additionally, there are also different types of
Tumor grade refers to how normal the cells look. If the cells look more “normal” — like your regular bladder cells — this means the cancer grows and spreads slower and is less aggressive.
Cells that look “abnormal” grow and spread faster and mean the cancer is more aggressive. Higher grade cancers typically need stronger treatment methods as a first-line option.
The symptoms of bladder cancer that has grown large or spread to other parts of the body typically differ from earlier stage bladder cancer.
Symptoms of more advanced bladder cancer can
- inability to urinate
- back pain on one side of the lower back
- abdominal pain
- bone pain
- feet swelling
- extreme tiredness
- appetite loss
- weight loss
It’s important to work closely with your doctor to find ways to help manage and relieve your symptoms.
Although stage 4 bladder cancer is considered hard to treat, options are available. Treatments usually aim to slow the cancer’s growth, help you live longer, and improve your well-being.
Your doctor may recommend surgery in some situations. However, it’s unlikely surgery can completely remove stage 4 bladder cancer.
Chemotherapy is usually the first treatment your doctor will suggest if your cancer has spread to other areas of your body.
Two common chemo regimens for bladder cancer include:
- gemcitabine (Gemzar) and cisplatin
- methotrexate, vinblastine, doxorubicin (Adriamycin), and cisplatin
If chemo shrinks your cancer significantly, your doctor might recommend a cystectomy or surgery to remove all or part of your bladder.
Radiation therapy is another option for treatment. You’ll usually have it alone or in combination with chemo.
Sometimes, immunotherapy drugs like atezolizumab or pembrolizumab (Keytruda) can help.
Additionally, a new standard of care for metastatic bladder cancer treatment involves the antibody drug conjugate enfortumab vedoitn and pembrolizumab. Compared with chemo, this treatment significantly improved survival in a 2024 study.
Palliative care may be a part of the care plan for people with stage 4 cancer. It aims to provide support and improve your quality of life. Your care will be tailored to you and may involve both psychological and physical treatment to increase your well-being.
You may also choose to take part in clinical trials to gain access to new treatments that could help extend your life. It’s important to weigh your options with your doctor and make an informed choice that is right for you.
You can search for clinical trials in the United States at ClinicalTrials.gov.
Some people with stage 4 bladder cancer may experience complications.
If you had surgery to remove part of your bladder, you might need to urinate more often because your bladder is smaller.
Surgery to remove all of your bladder may require doctors to create a new way for you to pass urine, such as urostomy. With urostomy, a plastic bag is attached to an opening in your abdominal wall to collect urine.
Other potential complications of surgery include:
- fertility issues
- sexual dysfunction
- premature or early menopause
Following a diagnosis of stage 4 bladder cancer, you might have to make important decisions about which treatments are necessary and which you may choose to opt out of.
It’s important to discuss your options with your doctor. Take the time you need to make the right decision for you.
As your cancer progresses, you may experience:
- pain
- weakness
- loss of appetite
- tiredness
With these symptoms, it’s important to listen to your body and try not to do too much. Rest when you’re tired so you can keep your strength up. Your doctor can prescribe certain medications to help effectively manage your pain.
It’s also a good idea to identify close family members and friends who can help you with everyday activities, such as driving to doctors’ appointments or shopping for groceries.
It’s important to remember that survival rates are only estimates and do not apply to everyone. Each particular case is different.
As newer detection and treatment options become available, the outlook for people with stage 4 bladder cancer is likely to keep improving. Take your time to discuss all options with your doctor.
If you or someone you know has stage 4 bladder cancer, it’s important to work closely with doctors to find the most suitable treatment and care plan.