Non-muscle invasive bladder cancer (NMIBC) starts in the inner lining of the bladder but hasn’t spread to the muscle layer. Treatment may involve surgery, chemotherapy, or immunotherapy.
Non-muscle invasive bladder cancer (NMIBC) is a type of bladder cancer. This means that it is made of bladder cells that have begun to grow abnormally. Non-muscle invasive refers to the location of the cancer. In this case, it is confined to the bladder’s surface on the inner lining or the more superficial layers of the inner lining.
Treatment aims to prevent the progression of bladder cancer into the muscle lining.
Doctors may use the terms “grades” to describe the level of mutation in bladder cancer cells and “stage” to describe how far the cancer has spread.
Keep reading to learn about NMIBC, including causes, symptoms, and treatment.
Your bladder is a flexible, sac-like organ located in front of your pelvis. After your kidneys make urine, the liquid travels to your bladder, where it’s stored until it leaves your body.
Your bladder is made of several layers. From the inside to the outside, the main layers are the:
- inner lining (urothelium, or transitional epithelium)
- connective tissue
- muscle layer
- fatty layer
It’s possible for your bladder to develop cancer. According to the
Bladder cancer usually starts in your bladder’s inner lining. When the cancer is only found in the inner lining or connective tissue layers at diagnosis, it’s called non-muscle invasive bladder cancer (NMIBC) because it hasn’t reached the muscle layer.
Any type of bladder cancer is the atypical growth of cells in your bladder. You have many types of cells in your bladder that can become cancerous, but the urothelial cells are by far the most frequent type to cause bladder cancer.
Exactly what causes bladder cells to become cancerous isn’t known. However, certain things have been found to increase the risk of bladder cancers, including NMIBC. These include:
- tobacco use, especially smoking
- a family history of bladder cancer
- genetic mutations
- exposure to certain industrial products, like paints, dyes, metals, and petroleum products
- a history of radiation therapy around your pelvis
- prior use of some chemotherapy drugs, like cyclophosphamide or ifosfamide
- taking the herb Aristolochia fang chi
- drinking water containing arsenic or chlorine
- a history of bladder infections
- prolonged use of urinary catheters
- older age
The most common symptom of bladder cancer is blood in your urine (hematuria). This does not necessarily mean your urine is dark red, though it can be in some cases. More often, you may notice your urine appears pink or orange.
Other symptoms of NMIBC include:
Many of these symptoms overlap with less severe conditions, like urinary tract infections (UTIs), but even these can become serious if left untreated.
If you’re experiencing these symptoms, it’s best to talk with a healthcare professional to determine the cause and begin treatment.
Learn more about bladder cancer symptoms.
Bladder cancers are classified into grades and stages. This system helps doctors track the cancer’s progress and determine the best treatment methods.
Bladder cancer grades
Grades were previously described as a number (1 to 3). Today, they’re usually split into low grade (1 to around 2.5) or high grade (around 2.5 to 3).
The less the cancer cells resemble healthy cells, the higher the grade. Higher grades are more likely to spread into your bladder’s muscle layer and then beyond to other parts of your body.
Bladder cancer stages
Bladder cancer stages are expressed using the TNM system, which uses a number to describe each of three variables:
- tumor (T)
- lymph nodes (N)
- metastasis (M)
The higher the T number, the deeper into your bladder’s layers the cancer has reached. NMIBC is any bladder cancer with a T number under 2.
An N number greater than 0 means the cancer has reached at least one lymph node. An M number greater than 0 means the cancer has spread to a distant lymph node or another organ (most often the lungs, liver, or bones).
Complications of NMIBC can include:
The risk of complications increases as the tumor grows. Because NMIBC tumors have not reached the bladder’s muscle layer, they’re generally smaller and less likely to cause complications when treated quickly than some other types of bladder cancer.
NMIBC accounts for more than half of all bladder cancer diagnoses, reports the Bladder Cancer Advocacy Network.
If a doctor suspects you may have any type of bladder cancer, including NMIBC, they will start by asking about your history and symptoms.
Your doctor might refer you to a specialist called a urologist. They may take urine and blood samples and send them to a lab for several tests that might detect cancer or other conditions with similar symptoms.
Urologists may look inside your bladder with a small camera called a cystoscope or by using imaging scans like MRI or a retrograde pyelogram. If any atypical areas are found, they may take a sample, called a biopsy.
There are several treatments for NMIBC. Not all treatments will be needed for every case of cancer. The cancer’s grade, stage, and response to treatment determine the next steps.
Transurethral resection of bladder tumor (TURBT)
In TURBT surgery, a doctor passes a cystoscope through your urethra into your bladder and removes abnormal cells. They do not need to cut into the abdomen.
Intravesical immunotherapy
Immunotherapy helps your immune system fight cancer. Bacillus Calmette-Guerin (BCG), often used to vaccinate against tuberculosis, is put directly inside the bladder to help the immune system get rid of bladder cancer cells.
Intravesical chemotherapy
Doctors may recommend Intravesical chemotherapy immediately after surgery. Chemotherapy drugs are introduced directly inside your bladder.
Cystectomy
During cystectomy, a surgeon removes your bladder. This can prevent bladder cancer from spreading to other organs. In some situations, it can be partially removed, but in others, a surgeon must remove it entirely.
After receiving an NMIBC diagnosis, you may be wondering what to do next.
It may help to learn what you can about NMIBC and how doctors treat it. You can ask your doctor or care team any questions, whether big or small. It may help to write them down when you think of them and bring a list of questions to your appointment.
You can expect to feel many strong emotions. You may need time to process your diagnosis. If you feel ready to talk with others about your diagnosis, consider reaching out to trusted loved ones or joining a support group. You can also ask your care team for a referral for therapy.
If you’re able, and if your doctors approve, try to exercise and get outdoors. Doing things you enjoy is important for maintaining your mental health during treatment and beyond.
According to the
The 5-year survival rate for bladder cancer as a whole is 78%.
What is a 5-year survival rate?
Health professionals often use 5-year survival rate as a measure of a disease’s outlook. It refers to the percentage of people with the disease who are still alive at least 5 years after their diagnosis.
It’s important to remember that survival rates are estimates. They also generally do not account for the last five years’ worth of research, so the outlook of a person diagnosed now may be better than that of someone diagnosed 5 years ago.
Many factors can affect your individual outlook, such as:
- age
- overall health
- presence of specific mutations
- how the cancer responds to treatment
Your doctor can give you a more detailed outlook based on your unique circumstances.
Non-muscle invasive bladder cancer (NMIBC) is a type of bladder cancer that hasn’t spread beyond the inner layers of the bladder.
Most people who receive a diagnosis of bladder cancer have NMIBC. The outlook for people with this stage of cancer is very good. Most cases of NMIBC are curable.
The earlier cancer is detected, the better the outcome in most cases. If you suspect you may have NMIBC, make an appointment with a doctor.