Bladder cancer can usually be treated successfully when detected at an early stage, so it's important to recognise and act on the signs and symptoms.
In this post we take a closer look at some of the common early signs and symptoms of bladder cancer and provide some advice for discussing these symptoms with your doctor.
How common is bladder cancer?
Bladder cancer is the tenth most common cancer worldwide1. On a global basis, approximately 1 in 100 men and 1 in 400 women will develop bladder cancer during their lifetime2. Rates of the disease vary by region, the highest occurring in North America and Europe. In the United States, where bladder cancer is the sixth most common cancer type diagnosed, it is estimated that approximately 81,000 new cases and 18,000 related deaths occur annually.3
What are the usual early warning signs of bladder cancer?
Blood in the urine
For most people, the first sign of bladder cancer is finding blood in the urine. The technical term for this condition is hematuria. There are two different types of hematuria.
- Gross hematuria: Gross hematuria means you can see the blood in your urine, which may appear pink, red, or brownish in color.
- Microhematuria: Microscopic hematuria (also referred to as ‘microhematuria’) is impossible to see with the naked eye, because the amount of blood present is too small. Tests such as urinalysis or microscopy must be carried out on urine samples to detect the presence of microscopic amounts of blood.
During the early stages of bladder cancer it's common to experience hematuria without other symptoms such as pain or changes in urinary habits. The hematuria may even disappear for periods of weeks or even months in some cases.
It’s important to note that blood in your urine does not necessarily mean you have bladder cancer. Many different conditions and factors can cause hematuria, such as:
- Bladder or kidney stones
- Urinary tract infections (UTIs)
- Intense physical exercise
- Prostate enlargement
- Physical kidney injury
Some foods (e.g., certain berries, beets, fava beans, some food dyes) and certain medications can also cause discoloration of the urine similar to that of hematuria.
Given that hematuria is the most common symptom of bladder cancer, and often the first warning sign, it's important to seek a definite diagnosis if you notice you have red, pink, or brownish colored urine.
If you're concerned about bladder cancer, ask your doctor about Cxbladder, a non-invasive genomic urine test that can quickly and accurately detect or rule out the disease. Cxbladder can provide peace of mind for those experiencing symptoms.
Learn more about Cxbladder
A change in urination habits and/or symptoms of urinary irritation
Early symptoms of bladder cancer may also include a change in urine habits and/or urinary irritation, such as:
- Increased frequency of urination (e.g., needing to urinate several times during the night)
- Experiencing a more urgent need to urinate
- Having trouble passing urine
- Feeling pain or burning while urinating
While these symptoms are often likely to be due to less serious causes (e.g., a UTI or overactive bladder) it is still important to speak to your doctor so you can identify the cause and rule out bladder cancer.
Are there other signs or symptoms of bladder cancer?
Less commonly, an individual may not experience any signs or symptoms of bladder cancer until it has spread to other parts of the body. For example, if cancer has spread to the liver, abdominal pain may be the first symptom noticed. Other symptoms of advanced bladder cancer can include:
- Pain on one side of the lower back
- Pelvic pain
- Loss of appetite
- Unexplained weight loss
- General weakness or fatigue
- Bone pain
- Swelling in the feet
- An inability to urinate
Again, the fact you have one (or more) of these symptoms does not necessarily mean you have bladder cancer – but it is important to consult a doctor as soon as possible if you’re concerned.
Can bladder cancer go undetected for years?
If symptoms such as blood in the urine and changes in urinary habits are ignored by an individual and/or repeatedly misdiagnosed, it's possible that bladder cancer may not be detected for months or, in some cases, even years. In most cases, however, bladder cancer is diagnosed in its early stages: approximately half are found when the cancer is entirely within the surface layer of the bladder, while a third are found when the cancer has spread to deeper layers of the bladder wall but is still limited to the bladder. In the remainder of cases, the cancer has spread to nearby tissues or lymph nodes or, rarely (in <5% of cases), to more distant parts of the body at the time of diagnosis.4
If you're experiencing any of the warning signs of bladder cancer it's essential to consult your doctor. If your symptoms continue to persist after your first appointment, or if new symptoms arise, be sure to arrange a follow-up visit.
Is bladder cancer curable if it is caught early?
When detected at an early stage, bladder cancer can usually be treated successfully whereas later-stage cancers may be more difficult to manage. This is reflected in the 5-year survival rate for bladder cancer. This rate refers to the estimated percentage of bladder cancer patients who would be expected to survive the effects of their cancer for 5 years or more. When bladder cancer is diagnosed while still confined to the surface layer of the bladder, the 5-year survival rate is 96%; in contrast, if the cancer has penetrated into deeper layers of the bladder wall the survival rate decreases to 69%5. It's also important to keep in mind that people who have had bladder cancer are at risk of recurrence, so ongoing surveillance to detect recurrent bladder cancer at an early stage is essential.
How is bladder cancer diagnosed?
Several different diagnostic tests can be used to detect bladder cancer and are often used in combination. The tests selected by doctors depend on the patient’s symptoms as well as their age, general health, and risk factors (for example, smoking history, occupation, past diagnosis of bladder cancer). They may include:
- Non-invasive urine tests, which may include a dipstick urinalysis (a quick test that can detect blood and other substances), cytology (a microscopic examination), or a next generation genomic test such as Cxbladder.
- Cystoscopy, which involves inserting a thin, flexible tube with a light and lens (a ‘cystoscope’) into your urethra to look inside the bladder. This procedure is usually performed when bladder cancer is suspected.
- Diagnostic imaging techniques, such as ultrasound, CT scan, MRI scan, and x-ray.
Talking to your doctor about bladder symptoms
When you meet with your doctor, it's important to share all the symptoms you're experiencing and to be as specific as possible. It's a good idea to prepare for your appointment by writing a list of your symptoms and the questions you would like to ask.
When you create a list of your symptoms, try to include the following:
- All the symptoms you have experienced
- How often and at what time of day the symptoms occur
- How long the symptoms last
- If the symptoms seem to be getting better or worse
- If (and how) the symptoms interfere with your usual daily activities
- If anything relieves or worsens these issues
In addition to having a detailed list of symptoms to bring to your appointment, be ready to share information such as all of the medications you take (including over-the-counter medicines, supplements, and herbal remedies), your habits and lifestyle (including how you sleep, what you eat, and whether you smoke or drink), and any major life changes or stressors you may be experiencing.
Most importantly, be sure to answer your doctor's questions openly and honestly, as this will help them to achieve a timely and accurate diagnosis.
If you're concerned about bladder cancer, ask your doctor about Cxbladder
Cxbladder is a non-invasive genomic urine test that quickly and accurately detects or rules out bladder cancer. The test combines clinical risk factor markers with genetic information, measuring five biomarker genes to detect the presence or absence of bladder cancer.
When should you consider using Cxbladder?
- When you’ve seen blood in your urine
- If preliminary tests have detected blood in your urine
- If you have a history of bladder cancer and are being monitored for recurrence
- World Cancer Research Fund. Global cancer statistics for the most common cancers. https://www.wcrf.org/dietandcancer/cancer-trends/worldwide-cancer-data.
- Richters A et al. The global burden of urinary bladder cancer: an update. World J Urol 2020;38:1895–1904.
- American Society of Clinical Oncology. Bladder cancer statistics. https://www.cancer.net/cancer-types/bladder-cancer/statistics.
- American Cancer Society. Key Statistics for Bladder Cancer. https://www.cancer.org/cancer/bladder-cancer/about/key-statistics.html.
- American Cancer Society. Survival Rates for Bladder Cancer. https://www.cancer.org/cancer/bladder-cancer/detection-diagnosis-staging/survival-rates.html.
- American Cancer Society. Bladder Cancer Signs and Symptoms.
- American Cancer Society. Tests for Bladder Cancer.
- American Society of Clinical Oncology. Bladder Cancer: Symptoms and Signs. .
- Bladder Cancer Advocacy Network (BCAN). Women & Bladder Cancer.
- International Agency for Research on Cancer, Global Cancer Observatory. Bladder.
- Mayo Clinic. Urine color.
- MSD Manual. Urine, Blood In.
- National Institute on Aging. Talking with Your Doctor: What Do I Need to Tell the Doctor?
- O’Leary MP. Patient education: Blood in the urine (hematuria in adults (Beyond the Basics).