Bladder Cancer: 5 Warning Signs You Can’t Afford to Ignore

Updated on September 11, 2023

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Medically reviewed by Tumas Beinortas, MD, PhD Candidate

Bladder Cancer Awareness Month is dedicated to increasing knowledge and understanding about this significant health concern. This year, around 82,290 new cases of bladder cancer are expected to be diagnosed in the U.S. Of these, approximately 62,420 cases occur in men or those assigned male at birth and 19,870 in women or assigned female at birth.

The good news is that there has been a decline in the rates of new cases and deaths associated with bladder cancer in recent years.

What is bladder cancer?

Bladder cancer begins when bladder cells grow uncontrollably. The bladder is an empty sac located in the lower part of the belly, and it stores urine. When we urinate, the bladder muscles contract, pushing the urine out through a tube called the urethra.

Bladder cancer is rare compared to other types of cancer. It is the fourth most common cancer in men or people assigned male at birth. It’s less common in women or those assigned female at birth.

Urothelial carcinoma or transitional cell carcinoma (TCC) is the most prevalent type of bladder cancer. It begins in the urothelial cells that line the inside of the bladder. If left untreated, the cancer cells can spread to other parts of the body, making it more challenging to treat.

What causes bladder cancer?

Scientists are still uncovering the exact causes of bladder cancer. However, they have identified certain risk factors and are beginning to understand how they lead to the development of the disease.

Changes in the DNA, known as gene mutations, can disrupt the normal functioning of bladder cells, causing them to grow abnormally and uncontrolled. Over time, these changes can lead to the formation of cancer cells.

5 warning signs of bladder cancer

Bladder cancer can have different symptoms. Here are five warning signs to watch for:

Blood in the urine. This symptom is common in bladder cancer. Blood can range in color from slightly rusty to bright red. Sometimes, the amount of blood is small and can only be detected through a test.
Frequent urination. If you need to urinate more often than usual, it could be a sign of bladder cancer.
Pain or burning during urination. Feeling pain or a burning sensation when you urinate is another symptom to be aware of.
Urgency to urinate. You may feel a strong urge to urinate even when your bladder isn't full.
Nighttime urination. Waking up multiple times during the night to urinate could indicate a potential problem.

The symptoms above may also be caused by other conditions such as urinary tract infections, kidney stones, or prostate enlargement.

When bladder cancer has advanced, additional symptoms may include:

Difficulty passing urine
Pain in the lower back on one side
Discomfort or pain in the abdomen
Aching or tenderness in the bones
Unintentional weight loss and reduced appetite
Swelling in the feet
Fatigue or feeling excessively tired

If you experience any of these symptoms, it's important to consult your healthcare provider. Remember that other conditions like urinary tract infections or kidney and bladder stones can also cause these symptoms. Your healthcare provider may request a urine sample or other tests to help them understand the cause of your symptoms.

What are the risk factors for bladder cancer?

While the exact causes of bladder cancer are still being investigated, it's important to know the risk factors and take steps to minimize them.

Factor	Impact
Smoking	Smokers are three times more likely to develop bladder cancer.
Workplace exposures	Certain chemicals like dye, benzidine, and beta-naththylamine can increase your risk. Workers in industries that make rubber, leather, and pain products are also at increased risk.
Certain medicines or herbal supplements	The diabetes medicine pioglitazone (Actos) and supplements made with aristolochic acid are associated with higher risk.
Arsenic	In some areas, arsenic in drinking water is linked to increased risk.
Not drinking enough fluids	Insufficient fluid intake, especially water, may raise your risk.
Race and ethnicity	White people have a higher risk of bladder cancer.
Age	Risk increases with age, and most cases occur in people over 55.
Gender	Bladder cancer is more common in men or people assigned male at birth.
Chronic bladder irritation and infections	Conditions like urinary infections and bladder stones can increase your risk.
Personal history of bladder or other urothelial cancer	Previous bladder or urinary tract cancers raise your risk of developing new cancers.
Bladder congenital disabilities	Certain rare congenital disabilities related to the bladder can increase your risk.
Genetics and family history	Having relatives with bladder cancer or specific gene mutations can cause a higher risk of developing bladder cancer.
Chemotherapy or radiation therapy	Long-term use of certain medications or radiation to the pelvic area can raise the risk.

Having risk factors doesn't mean you will develop the disease. Not having any risk factors doesn't guarantee protection either, but there are steps you can take to lower your chances.

There are no screening tests available for bladder cancer. No test has been proven to decrease the chances of dying from bladder cancer in people with average risk. However, stopping smoking, decreasing exposure to certain chemicals, and drinking plenty of fluids can help reduce the risk.

Discuss your risk factors and concerns with your healthcare providers. These conversations will help you monitor your health and address potential risks.

How fast does bladder cancer spread?

Bladder cancer can spread at different rates, depending on several factors. The cancer stage at the time of diagnosis plays a significant role in determining how fast it spreads.

If you’re diagnosed with bladder cancer, your cancer care team will perform tests to understand how far it has spread in the body – this is called staging. Staging involves physical exams, biopsies, imaging tests, and sometimes surgery. It helps determine the seriousness of the cancer and the most appropriate treatment.

Cancer is classified based on how far it has spread. For bladder cancer, the TNM staging system is commonly used. This system assigns a stage to your cancer, such as stage I, II, III, or IV. Stage 0 is the earliest stage.

The stage number indicates the extent of cancer spread. Lower numbers mean the cancer is contained, while higher numbers, like stage IV, indicate more advanced cancer. Within a stage, an earlier letter also suggests a lower stage. For example, stage IIIB indicates a more advanced cancer than stage IIIA.

How is bladder cancer treated?

Bladder cancer can be treated using various methods, and your cancer care team will determine the best option for you based on factors such as your age, the cancer stage, and your overall health. Some common treatments for bladder cancer include:

Surgery. Surgery is often necessary for many bladder cancer cases. It aims to remove the cancerous cells and may involve removing a portion of the bladder (partial cystectomy) or the entire bladder (radical cystectomy). In some cases, other nearby tissues or lymph nodes may also be removed.
Chemotherapy. Chemotherapy involves using medications to kill cancer cells or prevent their growth. For bladder cancer, chemotherapy can be administered directly into the bladder (intravesical chemotherapy) or given through the bloodstream to target cancer cells throughout the body (systemic chemotherapy).
Radiation Therapy. Radiation therapy uses high-energy rays to destroy cancer cells. It can be delivered externally from a machine (external beam radiation). Radiation therapy may be used alone or in combination with other treatments.
Immunotherapy. Immunotherapy helps the immune system recognize and attack cancer cells. Certain drugs, such as immune checkpoint inhibitors, boost the body's immune response against bladder cancer. Immunotherapy can be effective in treating advanced or metastatic bladder cancer.
Bacillus Calmette-Guerin (BCG) therapy. BCG therapy is an immunotherapy specifically used for early-stage bladder cancer. A weakened form of tuberculosis bacteria is put into the bladder during BCG therapy. This helps to boost the immune system and allows it to recognize and destroy cancer cells in the bladder.
Targeted therapy. Targeted therapy uses drugs focusing on specific changes in cancer cells, like their genes or molecules. The goal is to stop the cancer from growing and spreading by blocking certain pathways or proteins involved in the tumor’s formation. These drugs work in a targeted way to fight against cancer and help stop its progression.

Each treatment option has its benefits and considerations, and your healthcare providers will guide you through the decision-making process to develop a personalized treatment plan.

Bladder cancer, although relatively rare, is a significant concern, especially for men or people assigned male at birth. Understanding the risk factors and recognizing warning signs make early detection and prompt treatment possible. You can actively manage your health and well-being if you’ve been diagnosed with bladder cancer. Don’t hesitate to discuss concerns, share your family history, and address any risk factors with your healthcare provider.

Bladder cancer is rare compared to other types of cancer but is more frequently seen in men or those assigned male at birth.
Urothelial carcinoma, which begins in the urothelial cells lining the bladder, is the most prevalent form of bladder cancer.
Symptoms of bladder cancer include blood in the urine, frequent urination, pain or burning during urination, urgency to urinate, and nighttime urination. Advanced symptoms may include difficulty passing urine, back or abdominal pain, weight loss, and fatigue.
Smoking, workplace exposure to certain chemicals, certain medicines or herbal supplements, and chronic bladder irritation are risk factors for bladder cancer.
Treatment for bladder cancer includes surgery, chemotherapy, radiation therapy, immunotherapy, Bacillus Calmette-Guerin (BCG) therapy, and targeted therapy.