New bladder cancer cases in the United States were expected to number about 74,000 in 2015, reports the American Cancer Society. While your doctor may not be able to detect bladder cancer in its early stages by physical examination, bladder cancer can often be detected from the symptoms it causes. The most common first symptom is blood in the urine. Other early symptoms of bladder cancer are related to bladder irritation and include pain with urination and urinary urgency. Symptoms such as straining when urinating or being unable to empty your bladder fully may result from urinary obstruction.
Blood in the Urine
Painless, intermittent blood in the urine is a common first symptom of bladder cancer. Blood in the urine -- known as hematuria -- can be visible, turning your urine orange, pink or red, depending on the amount of blood. Other times, the urine looks normal, but a small amount of blood is present. This is called microscopic hematuria and is detected by a urine test called a urinalysis.
While the majority of people with bladder cancer have hematuria, most people with blood in the urine do not have bladder cancer. More common causes include kidney and bladder stones, prostate enlargement and urinary tract infections.
Bladder irritation, signaled by a change in your urination, may also be a sign of bladder cancer. Symptoms of bladder irritation include pain with urination, a sense of urgency when urinating, urinating more frequently or losing urine involuntarily -- known as urge incontinence. These symptoms could also result from more benign causes, like a urinary tract infection or an enlarged prostate in men.
Urinary obstruction can also be a sign of bladder cancer. It usually occurs when the tumor is near the neck of the bladder or the urethra -- the tube through which urine flows to leave the body. Symptoms of obstruction include straining or bearing down when urinating, feeling like you are unable to empty your bladder, or noticing a weak or intermittent stream of urine .
Signs of Advanced Disease
As it becomes more advanced, bladder cancer spreads to nearby organs. At this stage, doctors may be able to feel a mass in the kidney or in the pelvis on physical examination. Advanced bladder cancer may be accompanied by symptoms like fatigue, loss of appetite, weight loss and paleness due to anemia -- a deficiency of healthy red blood cells. Depending on where the cancer has spread, there may be pain in the abdomen, bones or lower back. Kidney failure and swelling of the legs can also occur in advanced bladder cancer.
When to Seek Medical Attention
If you have blood in your urine or you notice a change in or difficulty with urination, see your doctor for a further evaluation. Your doctor may ask you questions to assess your risk for developing bladder cancer, with smoking being the greatest risk factor. In fact, according to the American Cancer Society, you are approximately 4 times more likely to get bladder cancer if you smoke. Your risk of bladder cancer is also increased if you work in the dye, rubber, leather, painting or aluminum industries, or if you were born with a bladder abnormality.
- American Family Physician: Diagnosis and Treatment of Bladder Cancer
- American Cancer Society: Signs and Symptoms of Bladder Cancer
- American Cancer Society: Cancer Facts and Figures 2015
- American Urological Association: Asymptomatic Microhematuria
- National Cancer Institute: What You Need to Know About Bladder Cancer
- American Cancer Society: Bladder Cancer Overview