Symptoms & Signs

of Bladder Cancer

The most common sign of bladder cancer is hematuria or blood in the urine, which will turn the urine rust or red in color.1,2,3 Other signs and symptoms of bladder cancer may include pain during urination and frequent urination. Most patients with bladder cancer do not have symptoms other than hematuria. Unfortunately, most bladder cancers are not diagnosed until they have become very large. As a result, research is ongoing in order to develop urine tests that would enable earlier detection of bladder cancer when it is small and more easily treated. There are several promising tests under evaluation, but currently none are reliable enough for routine use.

People with bladder cancer may experience the following symptoms or signs. Sometimes however individuals with bladder cancer may not have any of these changes

  • Hematuria -blood in the urine
  • Pain or burning sensation during urination
  • Frequent urination
  • Urgency to urinate many times throughout the night
  • Feeling the need to urinate, but not being able to pass urine
  • Lower back pain on one side of the body

Having these symptoms does not necessarily mean a person has bladder cancer. Infections, benign tumors, bladder stones, or other problems also can cause these symptoms. Anyone with these symptoms should see a doctor so that the problem can be caught early.1,2


Bladder cancer occurs predominantly in elderly men and less frequently in women and younger men. Many bladder cancers are thought to be caused by exposure to cancer-causing agents that pass through the urine and come into contact with the bladder lining. The most important risk factor for bladder cancer is smoking, which increases risk by at least four-fold.1,2

Risk Factors

A risk factor is anything that increases a person’s chance of developing cancer.  Risk factors can influence the development of cancer but most do not directly cause cancer. Many individuals with risk factors will never develop cancer and others with no known risk factors will.

Although most bladder cancers develop sporadically, which means for no known reason the following factors may raise a person’s risk for developing bladder cancer:1,2,3

Age: The chance of getting bladder cancer increases with age. Bladder cancer affects primarily people in their sixties and seventies. People younger than 40 rarely get this disease, but it does happen occasionally.

Cigarette smoking: Cigarette smoking is directly responsible for most cases of bladder cancer, causing about half of all bladder cancer deaths in men and about one-third of those in women.

Working in certain industries: Some workers have a higher risk of getting bladder cancer because of carcinogens (cancer-causing agents) in the workplace. Workers in the rubber, dye, chemical, and leather industries are at increased risk as are hairdressers, machinists, metal workers, printers, painters, textile workers, and truck drivers.

Race: Whites get bladder cancer twice as often as African Americans and Latinos. The lowest rates are among Asians.

Gender: Men are three times more likely than women to develop bladder cancer. Women are more likely to die from the disease, however, because they are often not diagnosed in the early stage.

Pioglitazone (Actos) use: People who have taken the diabetes drug pioglitazone for more than 1 year may have a higher risk of developing bladder cancer.

Prior history of bladder cancer: People who have already had bladder cancer once are more likely to develop bladder cancer again.

Schistosomiasis: Individuals infected with this parasite are more likely to develop squamous cell bladder cancer.

Lynch syndrome: People with hereditary nonpolyposis colorectal cancer or HNPCC appear to be at increased risk of developing bladder cancer.

Arsenic exposure: Arsenic when found in drinking water has been associated with an increased risk of bladder cancer.1,2

Family history: People with family members who have bladder cancer are more likely to get the disease. Researchers are studying changes in certain genes that may increase the risk of bladder cancer.

Radiation Exposure: The use of radiation therapy for treating uterine cancer is associated with an increased risk of developing and dying from bladder cancer.4

Some risk factors, such as a genetic mutation within a gene called the p53 gene, are associated with a poor outcome following treatment with chemotherapy and/or radiation therapy. Therefore, physicians may look for the presence of such risk factors upon a diagnosis of bladder cancer in order to best plan a treatment regimen. Research is ongoing to identify risk factors that are associated with a poor outcome, as well as factors that indicate that some patients may require less treatment. By identifying such factors, physicians are better able to tailor treatment to meet the needs of individual patients.

Next: Diagnosis & Tests for Bladder Cancer


1 National Cancer Institute. Bladder and Other Urothelial Cancers (PDQ®): Screening. Health Professional Version. Available at:

2 Pashos CL, Botteman MF, Laskin BL, Redaelli A. Bladder Cancer: Epidemiology, Diagnosis, and Management. Cancer Practice 2002;10:311-322.

3 National Cancer Institute. Bladder Cancer (PDQ®): Treatment. Health Professional Version. Available at:

4 Baack Kukreja JE, Scosyrev E, Brasacchio RA, et al: Bladder cancer incidence and mortality in patients treated with radiation for uterine cancer. BJU International. Published early online. DOI: 10.1111/bju.12543