The spread of any cancer outside of its organ of origin is called a metastasis. Bladder cancer tends to metastasize first to the lymph nodes in the pelvis. This is why the lymph nodes are removed during surgery.
Some surgeons feel that removal of these lymph nodes only provides information to doctors and patients about the extent of disease. Recently, however, other surgeons have reported that some patients can be completely cured of their cancer by removing all of the affected lymph nodes. This idea remains under investigation, but many surgeons are now performing more extensive lymph node removals with the hope of improving survival.
Other sites of metastases for bladder cancer include lung, brain, liver, and bone. Lung metastases often cause short-ness of breath, chronic cough, or blood in the sputum. Brain metastases often cause prolonged headaches. Liver metastases can cause more vague symptoms such as weight loss, appetite loss, fever, or easy fatigue.
Bone metastases can often be painful but can also weaken the bones and can cause the bone to fracture easily. Bladder cancer metastases can be treated with various combinations of chemotherapy with or without radiation. A few patients will also require surgery to improve the symptoms associated with some sites of metastases, that is, to stabilize a weakened bone.