What Are the First Signs of Bladder Cancer?

Reviewed on 8/31/2021

Warning signs of bladder cancer include blood in the urine (hematuria), bladder irritation, urinary frequency, changes in bladder habits, pain or burning during urination, difficulty urinating, urinating multiple times during the night (nocturia), and others.
Warning signs of bladder cancer include blood in the urine (hematuria), bladder irritation, urinary frequency, changes in bladder habits, pain or burning during urination, difficulty urinating, urinating multiple times during the night (nocturia), and others.

Bladder cancer is a type of cancer that occurs when cells in the bladder become abnormal and grow out of control. 

Warning signs of bladder cancer include: 

  • Blood in the urine (hematuria)
    • Often the first sign of bladder cancer
    • Urine may appear pink, orange, or, less often, dark red
  • Bladder irritation
  • Urinary frequency
  • Changes in bladder habits 
  • Pain or burning during urination
  • Feeling as if you need to urinate immediately, even when the bladder isn't full
  • Difficulty urinating or having a weak urine stream
  • Urinating multiple times during the night (nocturia)

Many of the symptoms above are more likely to be caused by something other than bladder cancer, but it’s important to see a doctor for a proper diagnosis.

When bladder cancer is advanced and has grown large or spread (metastasized) to other parts of the body, symptoms may include:

What Causes Bladder Cancer?

It is unknown what causes most cases of bladder cancer, but genetic changes are thought to play a role. 

Risk factors for developing bladder cancer include:

  • Smoking 
    • The main risk factor for bladder cancer
    • Accounts for about half of all bladder cancers in both men and women
  • Certain medicines or herbal supplements
  • Workplace exposures to certain chemicals
    • Painters, machinists, printers, hairdressers (exposure to hair dyes), and truck drivers (exposure to diesel fumes)
    • Makers of rubber, leather, textiles, paint products, and printing companies
    • Aromatic amines, such as benzidine and beta-naphthylamine, sometimes used in the dye industry
  • Not drinking enough fluids
  • Gender
    • More common in men than in women
  • Age
    • About 90% of people who develop bladder cancer are over 55 years
  • Race and ethnicity
    • Whites are two times more likely to develop bladder cancer than African Americans and Hispanics
  • Chronic bladder irritation and infections
    • Urinary infections (UTIs), kidney and bladder stones, bladder catheters left in place a long time, and other causes of chronic bladder irritation 
    • Schistosomiasis (bilharziasis), parasitic worm infection that can get into the bladder
      • More common in Africa and the Middle East; rare in the U.S.
  • Personal history of bladder or other urothelial cancer
  • Bladder birth defects
  • Genetics and family history
  • Chemotherapy or radiation therapy
  • Arsenic in drinking water
    • Not a significant problem in the U.S. but may be in other parts of the world

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How Is Bladder Cancer Diagnosed?

Bladder cancer is diagnosed with a physical examination which may involve a digital rectal exam (DRE) and in women, a pelvic exam. 

Tests used to diagnose or rule out bladder cancer include: 

What Is the Treatment for Bladder Cancer?

Treatment for bladder cancer may involve one or more of the following:

  • Bladder cancer surgery
    • Transurethral resection of bladder tumor (TURBT) or a transurethral resection (TUR) is the most common treatment for early-stage or superficial (non-muscle invasive) bladder cancers
    • Surgical removal of all or part of the bladder (radical or partial cystectomy) is used for invasive bladder cancer
    • Reconstructive surgery after radical cystectomy
      • If the entire bladder is removed, patients need another way to store urine and pass it out of the body
  • Intravesical therapy in which a liquid drug is administered into the bladder 
  • Chemotherapy 
  • Radiation therapy 
  • Immunotherapy 
  • Monoclonal antibodies
  • Targeted therapy drugs 

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Reviewed on 8/31/2021
References
https://www.cancer.org/cancer/bladder-cancer.html