You probably don’t think much about bladder cancer – unless you’ve noticed some unusual changes when you go to the bathroom. Like many cancers, bladder cancer is easiest to treat when it’s caught early. That’s why it’s so important to know the signs and understand how it’s diagnosed.

Whether you’re just curious, managing new symptoms, or supporting a loved one, we’ve pulled together everything you need to know about bladder cancer symptoms and the process of getting a diagnosis.

What Is Bladder Cancer?

There are several types of bladder cancer, but the most common one is urothelial carcinoma (sometimes called transitional cell carcinoma). This type begins in the bladder's lining and can also occur in other parts of the urinary tract. It can be non-muscle invasive, also called superficial bladder cancer, or muscle-invasive, which is harder to treat and more likely to spread. Once the cancer cells have grown into the bladder wall, symptoms are more likely to appear.

What Are the Early Signs of Bladder Cancer?

The most common—and often the earliest—sign of bladder cancer is blood in the urine. This is called hematuria. Sometimes you can see the blood clearly, and it might turn your urine pink, red, or brown. But other times, the blood isn’t visible and is only found during a routine urine test.

Seeing blood in your urine can be alarming, but it doesn’t always mean cancer. It could also be a sign of something less serious, like a urinary tract infection (UTI), kidney stones, or even strenuous exercise. That said, it’s never something to ignore. If you notice blood in your urine, even once, you should talk to your doctor.

Other possible symptoms of bladder cancer include:

• Pain or burning when you urinate
• Needing to urinate more often than usual
• Feeling an urgent need to go, even when your bladder isn’t full
• Difficulty starting to urinate or having a weak stream
• Waking up multiple times at night to use the bathroom
• Lower back pain, usually on one side
• Pelvic pain or pressure

In later stages, bladder cancer can cause additional symptoms like:

• Fatigue or weakness
• Loss of appetite and unexplained weight loss
• Swelling in the feet or legs
• Bone pain, if the cancer has spread

It’s important to remember that these symptoms can also occur with other conditions. But if you’ve been experiencing any of them, especially more than one, it’s worth getting checked out.

How Is Bladder Cancer Diagnosed?

There’s no routine screening test for bladder cancer like there is for some other cancers (like colon or breast cancer). Most of the time, testing for bladder cancer starts because someone has symptoms that need to be investigated.

If you go to your healthcare provider with concerns about bladder cancer, they’ll likely start with a few initial tests to figure out what’s going on.

1. Urinalysis

This is a basic test that checks your urine for things like blood, proteins, or signs of infection. It’s often the first step when someone reports urinary symptoms.

2. Urine Cytology

In this test, a sample of your urine is examined under a microscope to look for abnormal or cancerous cells. While not 100% accurate, it can be a useful piece of the puzzle.

3. Cystoscopy

This is one of the most important tools for diagnosing bladder cancer. A cystoscope is a thin, flexible tube with a camera on the end. Your doctor inserts it into your bladder through the urethra to look directly at the lining of your bladder.

If anything looks suspicious, like a tumor or unusual growth, your doctor may take a biopsy during the cystoscopy. This means they remove a small piece of tissue to look at more closely under a microscope.

4. Imaging Tests

Imaging can help your care team get a better idea of what’s happening inside your urinary system.

• CT or MRI Scan: A CT or MRI scan can show tumors in the bladder and can also help determine whether cancer has spread to other parts of the body. The scans create detailed cross-sectional images of your body. A CT scan focused on the kidneys, ureters, and bladder is referred to as a CT urogram. 

The images provide more details on the size, shape, and location of any tumors within the urinary tract, including the bladder. It will also show any enlarged lymph nodes that may contain cancer.

• IVP (Intravenous Pyelogram): This test uses X-rays and a special dye to highlight your kidneys, ureters, and bladder.
  
  

Depending on what these tests show, your doctor will be able to determine whether cancer is present, what type it is, and how far it may have spread. All of that information is essential for creating the right treatment plan.

What to Expect After a Bladder Cancer Diagnosis

Being diagnosed with bladder cancer can feel overwhelming, but understanding the next steps can help you feel more in control. After diagnosis, your doctor will determine the cancer’s stage (how far it has spread) and grade (how aggressive it is). This is essential for creating a personalized treatment plan. You may meet with a team that includes a urologist, oncologist, and other specialists who will guide your care. Treatment options vary depending on the type and stage of the cancer, but may include surgery to remove the tumor or bladder, intravesical therapy (medication delivered directly into the bladder), chemotherapy, immunotherapy, or radiation. Your care team will help you understand the risks and benefits of each option.

Bladder Cancer Treatment in Colorado

At Rocky Mountain Cancer Centers, we’ve helped thousands of patients navigate their bladder cancer diagnosis with expert care and compassionate support.

From diagnosis through treatment and survivorship, our team is here to answer your questions, explain your options, and help you feel more in control.