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The spread of urothelial cancer is via the following routes:

  • direct invasion - through the bladder wall and perivesical fat, and into adjacent structures such as the prostate and uterus
  • lymphatics - there are few lymphatics immediately under the bladder mucosa but they are abundant in its muscle wall. Bladder cancer that penetrates the muscle quickly reaches pelvic lymph nodes.
  • haematogenous distant spread - to liver, lungs, bone, and brain

Last reviewed 01/2018