Bladder Cancer Symptoms, Risk Factors and Treatment Options: 6 Things to Know

Bladder cancer occurs when abnormal cells in the bladder start to grow out of control. Symptoms can often be subtle, so recognizing signs is important for early diagnosis and treatment.

What causes bladder cancer?

Bladder cancer is the sixth most-common type of cancer in the United States, with more than 81,000 new cases reported each year. It is not known exactly what causes most bladder cancers, but there are known risk factors that can make a person more likely to develop it. Bladder cancer risk factors include:

• Smoking: Smoking is the leading cause of bladder cancer.
• Workplace chemicals: Exposure to certain industrial chemicals, like those used in the dye, rubber, leather, textile, and paint industries, can increase bladder cancer risk. Jobs like machinists, painters, hairdressers (due to hair dyes), and truck drivers (exposed to diesel fumes) also carry higher risks. Smoking combined with chemical exposure makes the risk even greater.
• Medicines and supplements: Some diabetes medications, like pioglitazone, and herbal supplements containing aristolochic acid have been linked to bladder cancer. Always talk to your doctor about the risks of any medication or supplement.
• Arsenic in drinking water: In some parts of the world, arsenic in drinking water is a concern. However, most public water systems in the U.S. meet safety standards, so this is less of an issue for Americans.
• Not drinking enough water: Staying hydrated may help lower your risk. Drinking plenty of fluids helps flush out harmful chemicals from your bladder.
• Age: Bladder cancer is more common in people over 55.
• Sex: Men are more likely to develop bladder cancer than women.
• Race: White people are twice as likely to get bladder cancer as African American or Hispanic people. Asian Americans have the lowest rates of bladder cancer.
• Chronic bladder irritation: Long-term bladder irritation from infections, stones or catheters can increase bladder cancer risk.
• Personal or family history: If you’ve had bladder cancer or other cancers in the urinary tract, your risk of developing it again is higher. A family history of bladder cancer or inherited genetic conditions, like Lynch syndrome, can also increase your risk.
• Birth Defects: Rare birth defects affecting the development of the bladder can raise the risk of bladder cancer.
• Cancer Treatments: Certain cancer treatments, like the chemotherapy drug cyclophosphamide or radiation to the pelvis, can irritate the bladder and increase cancer risk. Staying hydrated during treatment can help reduce irritation.

What is the most common symptom of bladder cancer?

The most common symptom of bladder cancer is blood in the urine, also known as hematuria.

This may show up as visible blood, or pink, red or dark brown urine. It also may only be detected only through laboratory tests.

If you experience any change in urine color, you should visit your primary care doctor. 

What are other symptoms of early bladder cancer?

Signs and symptoms of bladder cancer can vary. Aside from blood in the urine, other early symptoms of bladder cancer include:

• Frequent urination. You may feel the need to urinate more often, sometimes with a strong urge even when the bladder is not full.
• Painful urination. This symptom, also known as dysuria, causes discomfort or a burning sensation during urination. While dysuria can stem from infections or other conditions, you should consult a doctor if you experience this to rule out serious issues.

What symptoms indicate advanced bladder cancer?

Advanced bladder cancer symptoms can include:

• Unexplained weight loss and fatigue
• Bone pain and swelling
• Jaundice, which may occur if the liver is affected
• Headaches or seizures 

What are bladder cancer treatment options?

Bladder cancer treatment options vary depending on the stage of the cancer.

Early stage bladder cancers have not yet grown deep into the muscle layer of the bladder. These cancers can often be managed by urology doctors by removing the tumor during a cystoscopy procedure – where a camera is inserted into the bladder and the tumor is scraped out. Some patients may require medicines to be applied directly inside the bladder to reduce the risk of recurrence. If the cancer returns, some patients may choose to have their bladder removed.

Locally advanced bladder cancers have grown into the muscle wall of the bladder. These patients often require bladder removal surgery, sometimes with chemotherapy before surgery. Some patients with locally advanced bladder cancers may be treated with combinations of chemotherapy and radiation therapy instead of surgery.

Bladder cancers that have spread beyond the bladder (metastatic disease) cannot be cured with surgery or radiation. Immunotherapy treatments and chemotherapy treatments can be used to control the cancer and delay further spread. 

What happens when your bladder is removed?

Your bladder stores urine until it can be removed from the body. When the bladder is entirely removed, a surgery called a cystectomy, the body needs a new way to store and eliminate urine.

A surgeon will create a new way for urine to leave the body. They usually use small piece of your small intestine to create a new path, or “conduit” for your urine to drain through a stoma, or opening, on your abdomen. The urine then collects in a bag on your abdomen attached over the stoma; this is called a urostomy.

Some patients may be eligible for a continent diversion, where the urine collects in a new internal pouch created from the intestine. The patient may then drain the internal pouch through a stoma using a catheter.

The bottom line is if you are experiencing any symptoms of bladder cancer, talk to your doctor right away. Bladder cancer symptoms can vary from person to person. Some people may have obvious signs, while others may experience more subtle symptoms.

Early intervention can greatly improve chances of survival, so it’s important to pay attention to concerning signs. 

Learn more about bladder cancer care at Ochsner Health.