Urinary urgency, painful urination, and blood in the urine are all possible bladder cancer symptoms. However, they can also indicate less serious conditions.

Typically, the first sign of bladder cancer is blood in the urine, or hematuria.

People may experience hematuria in the early stages, when the tumor is small and only in the bladder. There may be little to no pain or other symptoms.

This article explores the main symptoms of bladder cancer, what they can mean, and more.

To discover more evidence-based information and resources for cancer, visit our dedicated hub.

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Hematuria can be an early sign of bladder cancer.

However, it is more likely to have a benign (noncancerous) cause, such as a urinary tract infection (UTI) or kidney stones. A person should contact a doctor if they experience hematuria.

A change in typical urine color can indicate hematuria. There may be enough blood to turn the urine:

  • slightly rusty
  • pink
  • orange
  • dark red
  • bright red

Sometimes, there is not enough blood to change the urine’s color. A doctor may instead detect hematuria during urinalysis.

A person may experience hematuria that goes away after a couple of days. However, if a person has bladder cancer, the blood will appear again at some point, sometimes weeks or months later.

Learn more

Learn more about hematuria.

A person with bladder cancer may experience frequent urination and urinary urgency.

This means they have to urinate more often, and they often have a sudden, urgent urge to urinate, even if their bladder is not full.

A person may notice that they have to get out of bed several times in the night to urinate.

Similar to hematuria, these symptoms can have less serious causes, such as UTIs, kidney or bladder stones, or an overactive bladder. It is important to contact a doctor if any of these symptoms occur.

Learn about how often a person should urinate here.

Painful urination can also be a sign of bladder cancer. A person may feel a burning or stinging sensation when they pass urine.

They may also feel the need to strain or have difficulty trying to urinate.

This can have other causes, such as a sexually transmitted infection (STI) or UTI. It is important to contact a doctor about this symptom, especially if a person is experiencing other symptoms of bladder cancer.

Bladder cancer symptoms can change as the disease progresses. It may move from the lining of the bladder to the muscle wall, lymph nodes, or adjacent organs.

Advanced bladder cancer can present with the same symptoms as early bladder cancer. However, symptoms may also include:

Small amounts of blood are a common early sign of bladder cancer. A large amount of blood in the urine often indicates advanced bladder cancer.

Doctors often find bladder cancer early because people contact a healthcare professional when they notice blood in their urine or other urinary symptoms.

Finding cancer early greatly improves a person’s outlook.

It is important to contact a doctor as soon as possible after experiencing any of the above symptoms.

Although all of these symptoms are likely to have less serious causes, receiving a checkup can rule out or detect bladder cancer.

Here are some frequently asked questions about bladder cancer and their answers.

What is often the first symptom of bladder cancer?

Hematuria is often the first symptom of bladder cancer.

When the tumor is small and only present in the bladder, a person may see blood in their urine.

There may be little or no pain. Other symptoms may not occur in the early stages either.

Small amounts of blood are a common early sign of bladder cancer. More symptoms often occur with advanced bladder cancer.

Can a person have bladder cancer for years and not know it?

It is possible to have bladder cancer for years and not know.

The symptoms of early bladder cancer can mimic those of other common conditions, such as bladder infections. Because of this, it is important to contact a doctor about any urinary symptoms.

There are no specific tests for the early detection of bladder cancer.

And tests that can help with detection can produce abnormal results even in people without the condition.

What is the outlook for people with bladder cancer?

If a doctor detects bladder cancer early, curing the condition is more likely.

This is because the outlook is better for people with bladder cancer in the early stages. Doctors can cure many cases of bladder cancer with treatment in the early stages.

For example, bladder cancer confined to the lining of the bladder (also called “in-situ”) has a 5-year relative survival rate of 96%.

This means that people with this stage of bladder cancer are 96% as likely to survive for 5 years after diagnosis as people in the overall population.

The 5-year relative survival rates for other bladder cancer stages are as follows:

  • cancer localized to the bladder: 70%
  • bladder cancer that has spread to adjacent tissues: 38%
  • bladder cancer that has spread to distant sites in the body: 6%

Blood in the urine can be an early sign of bladder cancer. Changes in a person’s urination habits can also indicate the disease.

As the disease progresses, bladder cancer symptoms can become more intense, and new symptoms may develop. Sometimes, bladder cancer makes urinating impossible, which can be a medical emergency.

The outlook for bladder cancer in the early stages is better than with advanced stages. Because of this, a person should contact their doctor about any urinary symptoms they experience.