Bladder Cancer Symptoms
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Bladder Cancer Symptoms

Bladder Cancer Symptoms
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Published on October 10, 2024
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Bladder cancer starts when the cells lining the inside of the urinary bladder grow abnormally and form tumors. The most common symptom of bladder cancer is blood in the urine, but it can also cause symptoms that affect how you urinate.

Symptoms of Bladder Cancer

Since bladder cancer grows in your urinary bladder — a small pouch behind your pubic bone that collects urine — most bladder cancer symptoms are seen or felt in your bladder, urine, and sometimes your kidneys (the organs that filter your blood and create urine).

The most common symptom of bladder cancer is hematuria (blood in the urine).

 You may not see any blood, especially in the early stages of bladder cancer, but your doctor can detect it with a urine test.
Hematuria doesn’t always mean cancer — it can also indicate a bladder infection or kidney stones, for example.

 But about one-third of people who discover visible blood in their urine will be diagnosed with bladder cancer.

Other symptoms of early bladder cancer include:

  • Needing to pee more than usual
  • Painful urination
  • Burning sensation while you pee
  • Feeling like you have to pee urgently, even with an empty bladder
  • Difficulty urinating
  • Having to pee several times through the night
These symptoms can also signify a noncancerous cause like infection, but it’s always best to let your provider know about any new urinary symptoms.

If your bladder cancer becomes advanced and tumors have grown large or spread to other areas of the body, symptoms can change. Advanced bladder cancer symptoms may include:

  • The inability to urinate
  • Lower back pain (usually on one side)
  • Poor appetite
  • Weight loss
  • Fatigue
  • Weakness
  • Feet swelling
  • Bone pain
  • Abdominal pain

None of these symptoms alone guarantees you have advanced bladder cancer, but if you notice any of the above, let your healthcare provider know.

Types of Bladder Cancer

Bladder cancer symptoms may differ based on which type you have, although hematuria remains the top symptom for all bladder cancer types.

Urothelial Carcinoma

Urothelial carcinoma, also called transitional cell carcinoma (TCC), is the most common type of bladder cancer and originates in cells that line the inside of the bladder (called urothelial cells).

 Besides the general symptoms of bladder cancer, TCC can cause a lump in your kidney area (low back) and a low-grade fever.

Squamous Cell Carcinoma of the Bladder

Squamous cell carcinoma accounts for only 3 to 5 percent of all bladder cancers. These cells have a flat appearance when seen under a microscope.

 Symptoms of squamous cell carcinoma of the bladder are the same as overall bladder cancer symptoms.

Adenocarcinoma of the Bladder

Even more rare (1 to 2 percent of bladder cancers), adenocarcinomas grow in gland-forming cells that create mucus and other substances.

 Adenocarcinoma symptoms often include a lump you can feel in your lower abdomen.

Small Cell Carcinoma of the Bladder

Rare but aggressive, small cell carcinoma of the bladder accounts for less than one percent of bladder cancers.

 This bladder cancer type grows in nerve-like cells called neuroendocrine cells, and more frequently causes abdominal pain, painful urination, and urinary tract infections.

Muscle Invasive and Non-Muscle Invasive Bladder Cancers

Bladder cancers usually start in the bladder’s inner lining, but as tumors grow, cancer can spread into the muscle layers of the bladder wall.

 The main symptom for non–muscle invasive bladder cancer is hematuria, but once the cancer becomes muscle-invasive, it can cause some of the advanced symptoms listed above, like not being able to pee, weight loss, and fatigue.

Flat and Papillary Bladder Tumors

Non–muscle invasive bladder cancers have two subtypes: flat and papillary. Papillary bladder cancers have fingerlike projections that grow away from the bladder wall, toward the center of the bladder, while flat bladder cancers don’t. Either type can grow into the muscle wall, with symptoms that follow the same pattern as muscle- and non–muscle invasive types.

Potential Complications of Bladder Cancer

About 75 percent of bladder cancers are non–muscle invasive and have good treatment outcomes. But if bladder cancer isn’t treated, it can spread to other areas of the body. Complications of bladder cancer and its treatments can be extensive, and may include:

When to See a Doctor

Many symptoms of early bladder cancer could also point to other diagnoses, such as a urinary tract infection or a kidney stone. But if you notice any of the symptoms above, let your healthcare provider know. Whatever the cause, they can help you find the diagnosis and start a treatment plan.

The Takeaway

Blood in the urine is the most common symptom of bladder cancer. Other symptoms include painful or difficult urination, feeling the need to pee even when your bladder isn’t full, and needing to pee much more often than usual. These symptoms can also point to other conditions, like urinary tract infections. If you’re experiencing any of these symptoms, let your healthcare provider know what’s going on and they can help you find the appropriate treatment.

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Daniel Landau, MD

Medical Reviewer

Daniel Landau, MD, is a distinguished board-certified hematologist-oncologist with a career that has spanned two eminent institutions: the Orlando Health Cancer Institute and the Medical University of South Carolina. With a specialized interest in genitourinary oncology and hematology, he has been at the forefront of managing both benign and malignant conditions.

Dr. Landau is a pioneering figure in integrating advanced technology into oncology, having served as a director of telemedicine services. Under his leadership, multiple innovative systems have been designed and piloted, all with a singular focus: enhancing the patient experience.

Beyond his clinical and technological endeavors, Landau is deeply committed to medical education. He has dedicated significant time and expertise to nurturing the skills of medical students, residents, and fellows, ensuring that the flame of knowledge and compassion burns bright in the next generation of oncologists.

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Abby McCoy, RN

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Abby McCoy is an experienced registered nurse who has worked with adults and pediatric patients encompassing trauma, orthopedics, home care, transplant, and case management. She is a married mother of four and loves the circus — that is her home! She has family all over the world, and loves to travel as much as possible.

McCoy has written for publications like Remedy Health Media, Sleepopolis, and Expectful. She is passionate about health education and loves using her experience and knowledge in her writing.

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Resources
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  2. Your Kidneys & How They Work. National Institute of Diabetes and Digestive and Kidney Diseases. June 2018.
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  4. Bladder Cancer Signs and Symptoms. American Cancer Society. March 12, 2024.
  5. Hematuria (Blood in the Urine). National Institute of Diabetes and Digestive and Kidney Diseases. October 2022.
  6. Bladder Cancer Symptoms. National Cancer Institute. February 16, 2023.
  7. Urothelial Carcinoma (Transitional Carcinoma). Cleveland Clinic. January 4, 2023.
  8. What Is Squamous Cell Bladder Cancer? Moffitt Cancer Center.
  9. What Is Bladder Cancer? National Cancer Institute. February 16, 2023.
  10. Small Cell Carcinoma of the Bladder. Genetic and Rare Diseases Information Center. September 2024.
  11. Bladder Cancer. Mayo Clinic. March 29, 2024.