One of the most common signs of bladder cancer is blood in the urine (hematuria). In the majority of cases, this includes microscopic amounts of blood that can only be picked up by the laboratory on a urine sample. Some people will have so much bleeding that it turns the urine pink or red (gross hematuria). Obviously, gross hematuria is not normal, and because it is so alarming, it will often prompt quicker evaluation. Microscopic hematuria though is also not normal and should always be evaluated by a urologist. Even if the blood in the urine clears up on its own, it still always needs to be evaluated. The absence of pain does not mean that there is no need for concern. Hematuria is not the only warning sign, however.
Depending on its location within the bladder, the tumor may interfere with the normal functioning of the bladder, which could manifest as irritative voiding symptoms. These symptoms include urinary urgency and urinary frequency. Urgency is the feeling of a sudden, compelling desire to urinate that is difficult to defer. Frequency means going to the bathroom eight or more times per day. Urgency and frequency are also symptoms of a urinary tract infection. Kidney stones can also cause these symptoms as they pass through the last part of the ureters. Irritative voiding symptoms such as urgency and frequency are also the most common symptoms of an overactive bladder. Overactive bladder is common in both older men and women. Obviously then, these symptoms do not necessarily mean that you have cancer and are not in and of themselves reason to suspect cancer.
If the tumor is located near the ureteral orifice (the opening of the ureter into the bladder), it may block the flow of urine from the kidneys and cause an obstruction. Obstruction may often lead to back pain, nausea, and vomiting, especially if it occurs quickly. More gradual obstruction is often asymptomatic. Very rarely, both ureteral orifices may become obstructed, leading to low urine output and kidney failure. If the cancer has spread to an area outside of the bladder, then it could cause swelling of the legs or bone pain. Finally, if the tumor is very large, it could be felt as a mass in the lower abdomen. Patient says: I was very young when I was diagnosed with bladder cancer.
In fact, because I was so young no one even thought that I could have bladder cancer. For several months, I had episodes of urinating bloody urine, which were thought to be urinary tract infections. When I told one of my friends about it she recommended that I have it checked out. So I had my primary care doctor refer me to a urologist. The urologist requested my records and told me that I had never had an infection. The urologist told me that it was not uncommon that young women who present with bloody urine are thought to have a urinary tract infection. But he added that the lack of bacteria in my urine should have alerted my primary care doctor and the emergency room doctors that I had seen that something else was going on.