What are the main symptoms of bladder cancer?
- Blood in the urine
- Recurrent urine infections
- Pain and frequency on passing urine with no infection found on urine tests by the doctor
Blood in the Urine
The most common way that bladder cancer presents is when someone passes blood in their urine when they go to the toilet (the medical name for this is Visible Haematuria or Macroscopic Haematuria). The urine is usually red or cola/rusty coloured.
Occasionally the bleeding is so pronounced that the urine may look like blood. If the bleeding is heavy it may also clot in the bladder and patients may pass dark red clots in the urine (they look a bit like dark red slugs!).
Sometimes the clots formed in the bladder may be difficult to pass and the person is unable to urinate leading to urine retention. This requires immediate presentation to hospital via the A and E department to relieve the retention with a catheter (a fine tube passed into the bladder to drain off urine and blood).
Blood in the urine may only occur once. It may not re-occur until months after the initial bleed. Just because the bleeding has stopped doesn’t mean that the problem has resolved. It is very important that you go to see your doctor at the first sign of blood.
It can be difficult for younger women who are still having periods to decide whether the blood is from the bladder or the vagina. If in doubt please consult your GP who can arrange appropriate investigations depending upon whether any other symptoms or signs are present.
Bladder cancer is more common after the menopause and any bleeding down below should be investigated.
Blood in the urine is sometimes detected only when your doctor sends a sample to the laboratory to check for a urine infection, or tests the urine sample with a special urine dipstick testing stick. This usually detected blood is not visible to the naked eye (the medical name for this is Non-visible Haematuria or Microscopic Haematuria).
Recurrent Urine Infections
Another common symptom related to bladder cancer, especially in women is visible blood in the urine (haematuria) associated with urinary tract infections (UTI). Your GP may diagnose a UTI and treat you with antibiotics and the bleeding may well settle.
The nature of bladder cancer is that bleeding is often intermittent and it may appear that the antibiotics have “cured the problem”. Visible blood in the urine should be investigated and not assumed to be due to an infection especially if the patient has risk factors such as being a smoker (the biggest single risk factor for developing bladder cancer).
Pain on passing urine or passing urine frequently
Occasionally bladder cancer can present with non specific urine symptoms such as pain on passing urine (medical term Dysuria) and passing urine frequently; when the urine is tested by the doctor there may well be traces of non-visible blood (see above). If all of these signs and symptoms are present together you need to make your doctor aware and ask them to arrange appropriate investigations. (These symptoms can also be caused by small stones that develop in the kidneys moving down the tube from the kidney (medical term Ureter) to the bladder). Further investigations will look for all the potential causes.
Pain is an uncommon symptom in the initial stages of bladder cancer and may indeed only be a symptom occurring late in the disease.
If detected early bladder cancer is treatable and curable and most people with bladder cancer can lead a normal life following treatment. There are rapid referral systems set up across the UK for your doctor to access specialist hospital services if there is a concern that your symptoms are possibly due to a bladder cancer. Only a minority of patients require aggressive treatment such as removal of the bladder or radiotherapy.