Bladder Cancer Symptoms
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Medically reviewed by Doru Paul, MD
The bladder is a balloon-shaped hollow organ located at the lower abdomen near the pelvis. It helps in the storage and release of urine from the body. Bladder cancer is a type of cancer that develops when the cells of the bladder start to grow uncontrollably, leading to the formation of a tumor. The symptoms of bladder cancer usually vary from one person to another, but often include issues with urination.
Most cases of bladder cancer begin in the innermost lining of the bladder, which is called the urothelium. The cancer progresses by growing through the deeper layers of the bladder wall. Over time it may grow outside the bladder and spread to nearby lymph nodes or other body parts.
Common and Early Symptoms
Blood in urine—also called hematuria—is a common symptom of bladder cancer. Other symptoms include frequent urination, pain during urination, and pelvic pain. The symptoms usually come and go and are often not severe.
Blood in Urine
The most common symptom of bladder cancer is the presence of blood in the urine, or hematuria. It can change the color of the urine to pink, rusty red, or dark red. Blood in the urine is not visible persistently; you might see it for some time and then not see it for a while. It is called “gross hematuria” when you can see the blood in your urine.
In some cases, very small amounts of blood are present in the urine which is detectable only through urinalysis (urine testing) or under a microscope. This is referred to as “microscopic hematuria.” Hematuria usually doesn’t cause pain in the initial stages of bladder cancer.
Many conditions can cause hematuria, so having blood in your urine doesn’t mean you have bladder cancer. The most common cause of hematuria are urinary tract infections (UTIs). Other causes include physical trauma, sexual activity, endometriosis, urinary tract stones, and enlarged prostate gland, and infections of the bladder, kidneys, urethra, or prostate, among others.
Abnormal Urination
Bladder cancer often causes a few changes in urination. These include:
Frequent urination
Burning or pain during urination
Having trouble expelling urine; having a weak urine stream
Urinating on the way to the bathroom
Feeling like you need to urinate even when your bladder is not full
Similarly to hematuria, problems with urination can be due to conditions other than bladder cancer. However, many of these potential causes also require medical treatment. If you are experiencing issues with urination, consult your healthcare provider for a proper diagnosis.
Pain
Pain on one side of the mid-back (the flank), in the pelvic area above the pubic bone, and in the perineum (the flesh between the genitals and anus) can be indicative of bladder cancer. Pain can occur due to partial or complete blockage of the tube that carries urine from the kidney to the bladder. Pain can also occur during urination, which is known as dysuria.
Advanced Stage Symptoms
Bladder cancer that grows and spreads to other parts of the body can cause several other symptoms. These include:
Inability to urinate: Blockage of the tube that carries urine from the kidney to the bladder can make urination difficult.
Pain in the abdomen or lower back: Pain can arise due to pressure from the stored urine that cannot be released.
Fatigue: Most people experience significant fatigue at advanced stages of bladder cancer. Fatigue can result from excessive stress from cancer, changes in hormone levels, lack of physical activity, and disturbed sleep.
Weight loss and loss of appetite: Bladder cancer can cause changes in eating habits due to cancer-related pain and stress. Loss of appetite that lasts for several days can result in weight loss and make you feel weak.
Foot swelling: Advanced cases of bladder cancer that have spread outside the bladder into nearby nodes can cause swelling in the feet due to improper drainage of lymphatic fluid.
Pain or tenderness in your bones: Bladder cancer tumors that press against bones can cause pain or tenderness in them. In a few cases, the cancer can spread to nearby bones which can also result in bone pain.
Symptoms in Children
The occurrence of bladder cancer is quite rare in children. Children previously treated for some other type of cancer with anti-cancer drugs called alkylating agents are at a higher risk of developing bladder cancer. These drugs include Busulfex (busulfan), Ifex (ifosfamide), or Cytoxan (cyclophosphamide).
The symptoms of bladder cancer in children are similar to those in adults. They usually experience hematuria along with other symptoms, such as:
Increase in frequency of urination
Pain in the abdomen or lower back
Pain during urination
The feeling of urinating even when the bladder is not full
Your child should see their healthcare provider if they are experiencing any of these symptoms. Their healthcare provider will ask when the symptoms began and how often they are experiencing them before recommending tests to find an appropriate diagnosis.
When To See a Healthcare Provider
It is important to schedule a visit with your healthcare provider if you are experiencing any symptoms of bladder cancer. Even if you do not have bladder cancer, other common causes of these symptoms, such as a UTI, require prompt treatment.
Your healthcare provider will initially ask how long you have been experiencing symptoms and how often you are experiencing them. They will also carry out a physical exam to determine possible signs of bladder cancer and ask about your family history. They may recommend several laboratory and imaging tests to confirm the diagnosis, especially if they suspect bladder cancer.
Bladder cancer can also be mistaken for other conditions such as UTIs, bladder or kidney stones, or other kidney diseases. If you think you are given an incorrect diagnosis, it may be beneficial to ask for further diagnostic testing or a second opinion.
A Quick Review
Hematuria, or blood in urine, is the most common symptom of bladder cancer. Other symptoms include an increase in the frequency of urination, pain or burning during urination, abdominal or lower back pain, and a feeling of urination even when the bladder is not full.
The symptoms of bladder cancer can be mistaken for other conditions such as kidney diseases and urinary tract infections. Early diagnosis and treatment of bladder cancer can improve symptoms and ensure that the disease does not progress to advanced stages where it becomes difficult to treat.
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