What Is the First Sign of Bladder Cancer?

  • Medical Author: Pamela I. Ellsworth, MD

Ask a Doctor

My mom just received a diagnosis of stage T2 bladder cancer, which came as a shock to all of us because she had no early signs or symptoms. Now I’m wondering if my sister and I should get screened. Would I know if I had bladder cancer?

Doctor's Response

The most common symptoms of bladder cancer include the following:
  • Blood in the urine (hematuria)
  • Pain or burning during urination without evidence of urinary tract infection
  • Change in bladder habits, such as having to urinate more often or feeling the strong urge to urinate without producing much urine, having troubles urinating, or having a weak urine stream

These symptoms are nonspecific. This means that these symptoms are also linked with many other conditions that have nothing to do with cancer. Having these symptoms does not necessarily mean you have bladder cancer.

If you have any of these symptoms, you should see your health-care professional right away. People who can see blood in their urine (gross hematuria), especially older males who smoke, are considered to have a high likelihood of bladder cancer until proven otherwise.

Blood in the urine is usually the first warning sign of bladder cancer; however, it is also associated with a number of benign medical problems such as urinary tract infection, kidney/bladder stones, and benign tumors, and does not mean a person has bladder cancer. Unfortunately, the blood is often invisible to the eye. This is called microscopic hematuria, and it is detectable with a simple urine test. In some cases, enough blood is in the urine to noticeably change the urine color, gross hematuria. The urine may have a slightly pink or orange hue, or it may be bright red with or without clots. If your urine changes color beyond just being more or less concentrated, particularly if you see blood in the urine, you need to see your health-care professional promptly. Visible blood in the urine is referred to as gross, or macroscopic, hematuria.

Bladder cancer often causes no symptoms until it reaches an advanced stage that is difficult to cure. Therefore, you may want to talk to your health-care professional about screening tests if you have risk factors for bladder cancer. Screening is testing for cancer in people who have never had the disease and have no symptoms but who have one or more risk factors.

  • Any new changes in urinary habits or appearance of the urine warrant a visit to your health-care professional, especially if you have risk factors for bladder cancer.
  • In most cases, bladder cancer is not the cause, but you will be evaluated for other conditions that can cause these symptoms, some of which can be serious.

For more information, read our full medical article on bladder cancer.

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"What You Need to Know About Bladder Cancer." National Cancer Institute. Aug 30, 2010.