Bladder cancer is a common type of cancer that affects around 81,400 U.S. adults each year. It is more likely to develop in men than women, though it is often picked up in women at a more advanced stage. It also is more prevalent in the elderly, though it can affect anyone at any age.
When urinary bladder cells begin growing out of control, bladder cancer develops. As more cancer cells begin developing, a tumor can form. With time, the cancer can start spreading to other areas of your body, causing various symptoms.
It's important to educate yourself on bladder cancer signs as early detection is vital when it comes to treatment. If you notice anything unusual, don’t wait for symptoms to worsen. Speak to your doctor as soon as possible.
The good news is that bladder cancer can often be found at an early stage when it is more likely to be treatable. Let's take a look at the symptoms of bladder cancer — early, advanced and recurrent — and the various tests available to detect it.
Early Symptoms of Bladder Cancer
The following are some of the early-stage bladder cancer symptoms you might experience:
1. Blood in the Urine
Blood in urine, often referred to as hematuria, is the most common symptom or sign of bladder cancer. With this symptom:
- You might have enough blood to change your urine color to pink, orange or, less often, dark red.
- Your urine color is sometimes normal, but a urine test (urinalysis), which the doctor performs during a general medical checkup or if you have other symptoms, can still detect small traces of blood.
- You may have blood one day and not the next, with your urine staying clear for weeks or maybe even months at a time.
Generally, the earlier stages of bladder cancer — when the cancer is small and confined to your bladder only — cause bleeding with either no pain or little pain.
It's important to note that blood in your urine doesn't necessarily indicate bladder cancer. The cause of blood may be due to another factor. In fact, up to 18% of healthy individuals may have some unseen blood in their urine at some stage (microscopic hematuria). And, for most individuals, the cause isn't cancer.
In many situations, the cause is due to other things like benign (not cancerous) tumors, medications or foods, infection, bladder or kidney stones or another benign kidney disease. Still, you should have your doctor check it out.
2. Symptoms of Irritation or Changes in Bladder Habits
Bladder cancer can also cause urination changes like:
- Burning or pain during urination.
- Having to urinate more than usual.
- Having a weak urine stream or having trouble urinating.
- Feeling an immediate urge to go, despite your bladder not being full.
- Having to urinate several times during the night.
It's important to note, however, that symptoms like these are often caused by other conditions like bladder stones, a urinary tract infection (UTI) or an enlarged prostate in men. To find out what's really causing these symptoms, speak to your doctor for a diagnosis and treatment.
Advanced Symptoms of Bladder Cancer
Bladder cancer is considered advanced when the tumor has grown and penetrated the bladder lining and surrounding layers of tissue and muscle. At this stage, the cancer may have spread to other parts of the body (metastasized). Symptoms of advanced bladder cancer include the following:
- Urination problems: Inability to urinate
- Pain in the lower back: Another indication the tumor has spread is pain, particularly in the area above your pubic bone or the flank area. Pain in your perineum (the area between the penis/vagina and the anus) might also occur if your bladder cancer has reached tissues nearby. Pain may only be on one side.
- Weight loss or loss of appetite: You lose weight without trying, or you've lost your appetite and aren't as hungry as usual.
- Feeling weak or fatigued: You may feel lethargic and extremely tired a lot of the time.
- Bone pain: If your cancer has spread to the bone, it can cause bone pain or a bone fracture.
- Swollen feet: Bladder cancer that has spread (metastasized) to your lymph nodes, for instance, could cause your feet to swell.
If the bladder cancer has spread to another part of your body, you could develop symptoms specific to that particular area. For example:
- Lungs: If your bladder cancer has spread to your lungs, it could cause you to have trouble breathing, cough or even cough up blood.
- Kidneys: If your cancer has spread to your kidneys, you could have problems with kidney function that can result in swelling of your feet and legs.
- Abdomen: If your cancer has spread to your stomach lymph nodes or liver, it could cause abdominal pain.
Once again, these symptoms could be due to something other than bladder cancer, so be sure to have your doctor check them out.
Symptoms of Recurrent Bladder Cancer
Although seven of every 10 cases of bladder cancer are diagnosed at an early stage when the cancer is treatable, post-treatment recurrence is a particular risk, and the disease has a recurrence rate of about 70%19. Because of this, individuals who have had bladder cancer will require surveillance for years following treatment.
Recurrence happens when you have smaller areas of cancer cells that stay in your body undetected. These cells, over time, might increase in number and eventually cause symptoms or show up on test results. Your doctor, who knows your medical history, will discuss your risk of recurrence during follow-up care.
Symptoms of recurrent bladder cancer often resemble those of early or advanced cancer. Let your doctor know if you develop any new symptoms like frequent urination, blood in your urine, immediate need to urinate or pain while urinating. These symptoms could be signs of bladder cancer recurrence or signs of another health condition.
Knowing the symptoms and signs of bladder cancer, no matter if it's early, advanced or recurrent, is important and your first step to diagnosis and treatment.
How Is Bladder Cancer Diagnosed?
Frequently, a doctor will diagnose bladder cancer after an individual tells them about blood in their urine. When there's enough blood in the urine to see it with the naked eye, it's called "gross hematuria." If you have small traces of blood in your urine you can't see, it's "microscopic hematuria." As mentioned previously, only a urine test can detect microscopic hematuria.
Procedures and tests your doctor may use to diagnose your bladder cancer include the following.
During cystoscopy, your doctor will insert a cystoscope (a narrow, small tube) through your urethra. This tool has a lens that allows them to see inside your bladder and urethra to examine their structures for signs of cancer.
2. Urine Cytology
The doctor analyzes a sample of your urine under a microscope, checking for cancer cells.
3. Genomic Urine Test
This is a lab test that measures several biomarker genes in your urine to accurately assess the probability that you have cancer.
During a cystoscopy procedure, your doctor might pass a specific tool into your bladder through the scope to biopsy (collect a cell sample) for testing.
5. Imaging Tests
Imaging tests like retrograde pyelogram or computerized tomography (CT) allow your doctor to view and examine your urinary tract structures.
During a CT urogram, the doctor injects a contrast dye into your hand in a vein, and it eventually flows into your ureters, kidneys and bladder. They'll then take X-ray images during the procedure to obtain a detailed view of your urinary tract, helping them identify any areas with potential cancer.
During a retrograde pyelogram, the doctor uses an X-ray exam to obtain a detailed view of your upper urinary tract. They'll thread a catheter (a thin tube) into your bladder through your urethra to inject your ureters with contrast dye. This dye then begins flowing up to your kidneys as the doctor captures X-ray images.
Determining the Stage and Extent of Your Cancer
Once your physician confirms you have cancer of the bladder, they might recommend additional testing to determine if the cancer has spread to other areas of your body, like your lymph nodes.
Testing might include:
- Magnetic resonance imaging (MRI)
- CT scan
- Chest X-ray
- Bone scan
The doctor will use the information from this testing to determine the stage of your cancer. The bladder cancer stages are indicated by a 0 to IV range of Roman numerals. The lowest cancer stages indicate it's confined to your bladder's inner layers and hasn't begun affecting your muscular bladder wall. Stage IV, the highest stage, indicates the cancer has begun spreading to distant organs and lymph nodes of your body.
The cancer stages system is continually evolving and becoming more complex with the improvement of cancer diagnosis and treatment. The stage of cancer you have will also determine which treatment will serve you best.
Genomic Urine Tests for Bladder Cancer
If you have hematuria or you have other reasons for suspecting bladder cancer, a non-invasive, accurate genomic urine test can provide you with peace of mind while helping your Doctor make informed decisions about your care.
Urine-based laboratory tests like Cxbladder offer reliable results that, when combined with other tests, can potentially reduce the need for additional invasive procedures.
What Is Cxbladder?
Cxbladder is a family of non-invasive genomic lab tests that accurately help detect or rule out bladder cancer. Cxbladder urine tests provide your doctor with actionable results that will make a meaningful difference in your treatment.
There are several types of Cxbladder urine tests, each designed for a different point in the patient journey.
1. Cxbladder Triage
If your urine has blood in it, your doctor may want to rule bladder cancer out quickly. Cxbladder Triage is designed to help rule out the presence of bladder cancer at an early stage. It is particularly appropriate for low-risk patients with hematuria and takes factors like smoking and age into account. Cxbladder Triage can provide accurate results and peace of mind without the need for cystoscopy or other invasive procedures for many patients.
2. Cxbladder Detect
If your doctor thinks you may have bladder cancer, they might use Cxbladder Detect combined with other tests to confirm your diagnosis. This test may be used as a substitute for X-ray tests or other urine-based tests, or it may be used in addition to cystoscopy or imaging. The Cxbladder Detect test analyses and quantifies cancer signs at a molecular level, outperforming other urine-based tests. This makes it a great choice for bladder cancer testing when patients present with hematuria. The reliable and accurate test results it provides will guide your doctor's recommendations for care and provide a meaningful difference to your treatment.
3. Cxbladder Monitor
Given the high risk of recurrence, bladder cancer survivors have unique and ongoing testing requirements. You'll need to have your condition monitored at regular intervals for life after completing treatment to make sure the cancer doesn't return. The Cxbladder Monitor genomic urine test is optimized for surveillance and can be a valuable tool in helping the doctor rule out a bladder cancer recurrence in patients who have already been diagnosed and treated for bladder cancer. Cxbladder offers accurate results with just one urine sample. It's a pain-free test that helps reduce your need for having to undergo regular cystoscopy.
You can benefit from Cxbladder by receiving test results that are:
- Efficient: Cxbladder is pain-free and non-invasive. It offers a complete sampling collection system of your urine sample and shipment to our lab.
- Reliable: Cxbladder is more objective and reliable than other types of urine-based tests, such as cytology. It uses Negative Predictive Value and high sensitivity to provide accurate results.
- Credible: More than 10 years of research has found five mRNA (specific messenger RNA) biomarkers that can indicate bladder cancer's presence. Multiple multicenter clinical studies have validated Cxbladder, and several highly respected peer-reviewed journals have published the studies.
- Actionable: Cxbladder offers actionable results to simplify early bladder cancer detection by either helping to complement other diagnostic tests and procedures or by ruling out bladder cancer.
If you have a history of bladder cancer, Cxbladder can improve your quality of life significantly by reducing your need for uncomfortable and invasive monitoring procedures while maintaining quality of care and safety. Cxbladder test results are usually available a week after the laboratory receives the sample.
Get Tested for Bladder Cancer With Cxbladder
Early detection saves lives. If you're concerned about bladder cancer, schedule an appointment to speak with doctor right away. A bladder cancer test can provide peace of mind and ensure you receive the right treatment for your individual needs.
When you speak with your doctor, ask them if Cxbladder can help identify your symptoms and rule out bladder cancer. You can also contact us to learn more about our testing options.