<s>[INST] My sister is about to have her second transurethral resection this week, and after her first procedure, her surgeon told her that she has a lot of cancer. She saw an oncologist for a second opinion and he said that she was stage 1 CA. The wall of her bladder and kidneys are very thin thus they cannot give her chemo. My question is how fast does this type of cancer spread and about how long would she have to live. She also has a 9c nodule on her right lung. [/INST] Thanks for your question on Chat Doctor. I can understand your problem. Bladder cancer with malignant nodule classify it as stage 4 cancer. So it is inoperable.  And patient usually offered only palliative treatment. Usual life expectancy of stage 4 bladder cancer is less than 15-16 months. Bladder cancer can spread by homogenous route and lymphatic route. So practically it metastasize to all organs of the body but common ones are liver, lung and brain. So in your sisters' case life expectancy is less than 12 months as tumor is already metastasize in lung. </s>