The bladder is a hollow, balloon-like organ located in the lower abdomen. Its primary function is to store and expel urine. Bladder cancer occurs when the bladder’s cells begin to grow uncontrollably, eventually forming a tumor. While symptoms can differ from person to person, they commonly involve urinary issues.

Most cases begin in the inner lining of the bladder, known as the urothelium. As the disease progresses, it can invade deeper layers of the bladder wall and spread to nearby lymph nodes or other parts of the body.

Common and Early Symptoms

blood in urine
Hematuria, or blood in the urine, is the most frequent sign of bladder cancer. The urine may appear pink, rusty red, or dark red. This bleeding may not be constant; it can appear, disappear, and return. When blood is visible to the naked eye, it's called gross hematuria. In some cases, the blood may be microscopic—only detectable through lab testing. Hematuria usually isn’t painful in the early stages.

However, having blood in your urine doesn’t necessarily mean you have bladder cancer. Many other conditions, such as urinary tract infections, trauma, kidney stones, and an enlarged prostate, can also cause hematuria.

abnormal urination
Bladder cancer may lead to noticeable changes in urination, including:

  • Frequent urination

  • Pain or burning sensation during urination

  • Weak urine stream or trouble urinating

  • Urgency to urinate before reaching the toilet

  • Feeling of incomplete bladder emptying

These urinary changes may also be caused by other health issues that require medical attention. It’s essential to consult a healthcare provider for a proper diagnosis.

pain
As the cancer grows, pain may occur in different areas, such as one side of the mid-back (flank), the pelvis above the pubic bone, or the perineum (area between the genitals and anus). Pain during urination, known as dysuria, is also common. Pain may result from partial or complete blockage of the urinary tract.

Advanced Stage Symptoms

If bladder cancer spreads beyond the bladder, it can trigger additional symptoms:

  • Inability to urinate due to a blocked urinary tract

  • Lower back or abdominal pain from pressure buildup

  • Fatigue caused by cancer-related stress, hormonal changes, or sleep disturbances

  • Loss of appetite and unintended weight loss

  • Swelling in the feet from poor lymphatic fluid drainage

  • Bone pain or tenderness when cancer spreads to or presses on bones

Symptoms in Children

Bladder cancer is rare in children. However, those previously treated with certain chemotherapy drugs (like alkylating agents) may face an increased risk. These include medications such as busulfan, ifosfamide, and cyclophosphamide.

Symptoms in children are similar to adults and may include:

  • Blood in urine

  • Frequent urination

  • Pain during urination

  • Pain in the lower back or abdomen

  • Urgency to urinate even when the bladder isn’t full

If your child displays any of these symptoms, contact a healthcare provider. They will review the history and recommend tests for an accurate diagnosis.

When To See a Healthcare Provider

If you're experiencing any symptoms that might indicate bladder cancer, you should consult your healthcare provider. Even if bladder cancer isn’t the cause, the symptoms may point to other treatable conditions such as infections or stones.

Your provider will likely ask how long symptoms have been present and how often they occur. A physical examination and medical history will also help guide further diagnostic steps. Imaging tests and lab evaluations may be necessary if bladder cancer is suspected.

Because bladder cancer symptoms are often similar to those of urinary infections or kidney diseases, misdiagnoses can happen. If you’re unsure about your diagnosis, don’t hesitate to ask for further tests or a second opinion.

A Quick Review

Bladder cancer typically presents with hematuria—visible or microscopic blood in the urine. Additional symptoms may include changes in urinary patterns, pain, or discomfort in the pelvic or abdominal area, and general fatigue or weight loss in more advanced stages.

Since many bladder cancer symptoms overlap with those of other conditions, it's vital to seek medical evaluation. Early detection significantly improves treatment outcomes and prevents the cancer from progressing to stages that are harder to treat.