Bladder Cancer Signs and Symptoms

Bladder cancer can often be found early because it causes blood in the urine or other urinary symptoms that cause a person to see a health care provider.

Blood in the urine

In most cases, blood in the urine (called hematuria) is the first sign of bladder cancer. There may be enough blood to change the color of the urine to orange, pink, or, less often, dark red. Sometimes, the color of the urine is normal but small amounts of blood are found when a urine test (urinalysis) is done because of other symptoms or as part of a general medical check-up.

Blood may be present one day and absent the next, with the urine remaining clear for weeks or even months. But if a person has bladder cancer, at some point the blood reappears.

Usually, the early stages of bladder cancer (when it's small and only in the bladder) cause bleeding but little or no pain or other symptoms.

Blood in the urine doesn't always mean you have bladder cancer. More often it's caused by other things like an infection, benign (not cancer) tumors, stones in the kidney or bladder, or other benign kidney diseases. Still, it’s important to have it checked by a doctor so the cause can be found.

Changes in bladder habits or symptoms of irritation

Bladder cancer can sometimes cause changes in urination, such as:

  • Having to urinate more often than usual
  • Pain or burning during urination
  • Feeling as if you need to go right away, even when your bladder isn't full
  • Having trouble urinating or having a weak urine stream
  • Having to get up to urinate many times during the night

These symptoms are more likely to be caused by a urinary tract infection (UTI), bladder stones, an overactive bladder, or an enlarged prostate (in men). Still, it’s important to have them checked by a doctor so that the cause can be found and treated, if needed.

Symptoms of advanced bladder cancer

Bladder cancers that have grown large or have spread to other parts of the body can sometimes cause other symptoms, such as:

  • Being unable to urinate
  • Lower back pain on one side
  • Loss of appetite and weight loss
  • Feeling tired or weak
  • Swelling in the feet
  • Bone pain

Again, many of these symptoms are more likely to be caused by something other than bladder cancer, but it’s important to have them checked.

If there's a reason to suspect you might have bladder cancer, the doctor will use one or more exams or tests to find out if it's cancer or something else.

The American Cancer Society medical and editorial content team

Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

American Society of Clinical Oncology. Bladder Cancer: Symptoms and Signs. 10/2017. Accessed at www.cancer.net/cancer-types/bladder-cancer/symptoms-and-signs on December 19, 2018.

DeGeorge KC, Holt HR, Hodges SC. Bladder Cancer: Diagnosis and Treatment. Am Fam Physician. 2017;96(8):507-514.

National Cancer Institute. Bladder Cancer Symptoms, Tests, Prognosis, and Stages (PDQ®)–Patient Version. October 19, 2018. Accessed at www.cancer.gov/types/bladder/patient/about-bladder-cancer-pdq#section/all on December 19, 2018.

Last Medical Review: January 30, 2019 Last Revised: January 30, 2019

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