Grading of Bladder Cancer

Once cancer has been diagnosed, the next step is to choose the best way to treat it. To help do this, your healthcare provider checks what the cancer cells look like under a microscope (the cancer grade).

Grade: What the cancer cells look like

The grade of bladder cancer is found by looking at cancer cells under a microscope. The grade is based on how much the cancer cells look like normal cells and how many cells are multiplying. The higher the grade, the more different the cells are and the more cells are multiplying. High-grade cancers are more likely to grow and spread quickly. Knowing the grade can help your healthcare provider predict how fast the cancer will grow and spread.

Microscopic view of low-grade cancer cells.
Low-grade cancer cells.

Low grade

Low-grade (or well-differentiated) cells look relatively normal when compared to normal bladder cells. A few of the cells vary in size. Some of the cells are multiplying.

Microscopic view of high-grade cancer cells.
High-grade cancer cells.

High grade

High-grade (or poorly differentiated) cells are very uneven in shape. They vary widely in size. A significant proportion of the cells are multiplying. They may also look heaped up and/or loose compared to the normal architecture of bladder cells.

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