Cancer has spread beyond the pelvis, or can be seen in the lining of the bladder and/or rectum, or has spread to other parts of the body. Stage IV is divided into stages IVA and IVB, based on where the cancer has spread. In stage IVA, cancer has spread to nearby organs, such as the bladder or rectum. In stage IVB, cancer has spread to other parts of the body, such as the liver, lungs, bones, or distant lymph nodes.