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Bladder Cancer: Why the Spread of a Hidden Type Matters

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Bladder Cancer: Why the Spread of a Hidden Type Matters

Bladder cancer can sometimes return or get worse, even when it’s caught early and hasn’t spread into the muscle. A certain hidden type of bladder cancer, called carcinoma in situ (CIS), can appear alongside the main tumor. But does where this CIS is found affect a patient’s risk?

This new study looked at nearly 3,000 people with early-stage bladder cancer. It focused on whether the CIS was found in just one spot (unifocal) or in several places (multifocal) in the bladder. All patients had non-muscle-invasive bladder cancer (NMIBC).

The researchers found that when CIS was spread across more than one area—called multifocal CIS—the risk of the cancer becoming more serious and invading the muscle was nearly twice as high. In contrast, CIS found in just one area did not raise the risk.

This means the pattern of CIS may give doctors better tools to predict which cancers are more likely to worsen. Current risk calculators often don’t make this distinction. But this study suggests they should.

The takeaway: how bladder cancer is spread—even when it’s hidden—matters. If doctors send separate tissue samples from different parts of the bladder, they may get clearer answers and make better treatment plans.

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dr swati shah - uro & gynec cancer surgeon
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