Bladder Cancer Symptoms: 10 Early Signs You Shouldn't Ignore
Discover the 10 early warning signs of bladder cancer, including blood in urine, urinary changes, and advanced symptoms. Learn about diagnosis, treatment, and when to see a doctor.
Written by Dr. Rohinipriyanka Pondugula
Reviewed by Dr. J T Hema Pratima MBBS
Last updated on 12th Sep, 2025
Introduction
Your body often sends signals when something is wrong, and listening to these cues is crucial for your health. When it comes to bladder cancer, early detection can significantly improve treatment outcomes and quality of life. This article will guide you through the key signs and symptoms of bladder cancer, from the most common early warning to the indicators of more advanced stages. We’ll demystify what these symptoms mean, explain how the disease is diagnosed, and, most importantly, advise you on the critical steps to take if you recognise any of these signs. Understanding these signals empowers you to take proactive action for your well-being.
What is Bladder Cancer?
Bladder cancer begins when cells in the bladder—the hollow, muscular organ in your lower abdomen that stores urine—start to grow uncontrollably. These abnormal cells can form a tumour and, over time, invade nearby tissues and spread to other parts of the body. It is one of the most common cancers, particularly affecting older adults, but it can occur at any age.
How the Bladder Works
Think of your bladder as a flexible storage sack. Kidneys filter waste from your blood to create urine, which then travels down tubes called ureters into the bladder. The bladder wall relaxes to store urine and contracts to expel it through the urethra when you urinate. This lining, called the urothelium, is where most bladder cancer starts.
Common Types of Bladder Cancer
The type of bladder cancer is determined by the cells involved. The most prevalent type, accounting for about 90% of cases, is urothelial carcinoma (formerly transitional cell carcinoma). This begins in the urothelial cells that line the inside of the bladder. Other, rarer types include squamous cell carcinoma and adenocarcinoma.
The Most Common Early Sign of Bladder Cancer
The number one red flag for bladder cancer, occurring in over 80% of cases, is blood in the urine. Medically, this is known as haematuria. It's the symptom that most often prompts people to see a doctor.
Visible Blood in Urine (Gross Haematuria)
This means you can see the blood with your naked eye. Your urine may appear:
Pink, red, or cola-coloured: This is the most common presentation.
Occasionally bright red: This can indicate fresh bleeding.
It's important to note that the amount of blood isn't necessarily related to the severity of the condition. Even a small, visible amount warrants immediate medical attention. Crucially, blood in urine with no pain is a common scenario with bladder cancer, which can lead to dangerous delays as people may assume it's not serious without discomfort.
Microscopic Blood in Urine
Sometimes, the blood is not visible but is detected during a routine urine test (urinalysis) done for another reason. This is called microscopic haematuria. While it can be caused by many non-cancerous issues like infections or kidney stones, it still requires a proper medical evaluation to rule out bladder cancer or other serious conditions.
Other Key Urinary Symptoms of Bladder Cancer
While haematuria is the headline symptom, changes in bladder function can also be significant indicators. These signs are often mistaken for a UTI or urinary tract infection, but if they persist after treatment, further investigation is needed.
Consult an Oncologist Specialist for the best advice
Changes in Bathroom Habits
A tumour can irritate the bladder wall, causing symptoms that mimic an infection. Be mindful of:
Increased frequency: Feeling a strong, urgent need to urinate more often than usual, even at night (nocturia).
Urgency: A sudden, intense urge to urinate that is difficult to delay.
Dysuria: Pain or a burning sensation during urination.
Hesitancy: Difficulty starting the urine stream.
A weak or intermittent stream.
Pain and Discomfort
As the tumour grows, it can cause physical discomfort. You might experience:
Pelvic pain: Aching or pressure in the lower abdomen.
Back pain: Typically pain on one side of the lower back (flank pain), which could suggest involvement of the kidneys.
Pain in the bones: This is a symptom of more advanced disease that has spread.
Symptoms of Advanced Bladder Cancer
When bladder cancer metastasises (spreads beyond the bladder to other organs), it can cause a new set of systemic symptoms. These signs of advanced bladder cancer include:
Unintended weight loss: Losing weight without trying is a common sign of many advanced cancers.
Loss of appetite: Feeling full quickly or having no desire to eat.
Fatigue: Persistent, overwhelming tiredness that isn't relieved by rest. This can be caused by the body fighting the disease or by anaemia from chronic blood loss.
Swelling in the legs: This can occur if the cancer blocks lymph nodes or blood flow.
Bone pain: If the cancer spreads to the bones, it can cause significant pain or fractures.
How is Bladder Cancer Diagnosed?
If you present with symptoms, your doctor will follow a diagnostic pathway to confirm or rule out bladder cancer.
Initial Tests and Procedures
The process usually begins with:
Medical history and physical exam: Discussing your symptoms, risk factors, and overall health.
Urinalysis: A test to check for blood, infection, or other abnormalities in the urine.
Urine cytology: A microscopic examination of urine to look for cancer cells.
Imaging tests: A CT urogram or ultrasound can provide images of your urinary tract to identify any tumours, stones, or blockages.
Confirming the Diagnosis
The definitive test for diagnosing bladder cancer is a cystoscopy. In this procedure, a urologist inserts a thin, lighted tube with a camera (cystoscope) through the urethra to see the inside of the bladder. If any suspicious areas are found, they will perform a transurethral resection of bladder tumour (TURBT). This procedure is both diagnostic (a biopsy is taken) and therapeutic (it can remove the tumour). The biopsy confirms the type and stage of the cancer, guiding all future treatment decisions.
What to Do If You Experience These Symptoms
Do not panic, but do act promptly. If you notice blood in your urine, even if it's painless and goes away, or if you experience persistent urinary changes, schedule an appointment with your primary care physician or a urologist immediately. While these symptoms are often linked to less serious conditions like UTIs or kidney stones, assuming this without a professional diagnosis can be risky. If symptoms persist beyond two weeks, or if you have visible blood in your urine, consult a doctor online with Apollo24|7 for further evaluation and to discuss the need for a referral to a specialist.
Conclusion
Recognising the signs and symptoms of bladder cancer is a powerful first step in safeguarding your health. While the presence of these symptoms does not mean you have cancer, it unequivocally means you need to see a doctor. Ignoring blood in your urine or persistent urinary changes is a risk not worth taking. The diagnostic process is straightforward, and modern medicine offers a range of effective treatments, especially when the disease is caught early. Your health is your most valuable asset—be proactive, listen to your body, and seek expert medical advice without delay. If you have any concerns based on what you’ve read, book a physical visit to a urologist with Apollo24|7 for a comprehensive evaluation.
Consult an Oncologist Specialist for the best advice
Consult an Oncologist Specialist for the best advice
Dr. Gopal Kumar
Head, Neck and Thyroid Cancer Surgeon
15 Years • MBBS, MS , FARHNS ( Seoul, South Korea ), FGOLF ( MSKCC, New York )
Delhi
Apollo Hospitals Indraprastha, Delhi
(25+ Patients)
Dr Gowshikk Rajkumar
Oncologist
10 Years • MBBS, DMRT, DNB in Radiation oncology
Bengaluru
Apollo Clinic, JP nagar, Bengaluru
Dr. Rupam Manna
Radiation Specialist Oncologist
4 Years • MBBS MD(RADIO THERAPY)
Barasat
Diab-Eat-Ease, Barasat
Dr.sanchayan Mandal
Oncologist
17 Years • MBBS, DrNB( MEDICAL ONCOLOGY), DNB (RADIOTHERAPY),ECMO. PDCR. ASCO
Kolkata
Dr. Sanchayan Mandal Oncology Clinic, Kolkata
Dr. B Shravanthi Reddy
Radiation Specialist Oncologist
8 Years • MBBS, DNB(Radiation Oncology)
Manikonda Jagir
Apollo Clinic, Manikonda, Manikonda Jagir
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Frequently Asked Questions
Can you have bladder cancer without blood in your urine?
Yes, it is possible, though less common. Some early-stage cancers may not cause visible bleeding. This is why other symptoms like persistent urinary urgency, frequency, or pain are also important to discuss with a doctor.
Is blood in the urine always a sign of cancer?
No, not always. Haematuria can be caused by many non-cancerous conditions, including urinary tract infections (UTIs), kidney stones, an enlarged prostate, or vigorous exercise. However, because it is the primary sign of bladder cancer, it must always be investigated by a medical professional.
What are the main risk factors for developing bladder cancer?
The biggest risk factor is smoking, which contributes to about half of all cases. Other risk factors include exposure to certain industrial chemicals (e.g., in dye, rubber, or paint industries), chronic bladder inflammation, previous cancer treatments, a family history, and being male and older.
How is early-stage bladder cancer treated?
The most common initial treatment is TURBT (Transurethral Resection of Bladder Tumour), a procedure to remove the tumour. This is often followed by intravesical therapy, where medication is placed directly into the bladder to kill any remaining cancer cells and prevent recurrence.
Are the symptoms of bladder cancer different in women vs. men?
The core symptoms—blood in urine, urinary frequency, and pain—are the same. However, women may be more likely to initially misattribute their symptoms to a common UTI or post-menopausal bleeding, potentially leading to a delay in diagnosis. Men might suspect prostate issues. It's vital for both genders to seek evaluation for persistent symptoms.