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Signs And Symptoms Of Bladder Cancer

Last updated and reviewed on May 21, 2026

A symptom is something you feel or notice in your own body, like pain, tiredness, or a cough that will not go away. A sign is something a doctor can observe or measure, such as an abnormal result on an X-ray or a change in your breathing sounds during an exam. 

Bladder cancer can cause both signs and symptoms, but one of the most challenging things about this disease is that it often causes no noticeable signs or symptoms in its early stages. Many people feel completely normal for months or even years while the cancer is quietly growing.

Another important fact is that bladder cancer does not always cause pain, especially in the early stages. This is why many people do not realize they might have a problem until they notice blood in their urine. Because of this, it is important not to ignore urinary symptoms, even if they seem mild or go away on their own for a while.

What are the signs and symptoms of bladder cancer?

Symptoms of bladder cancer can be divided into two groups: the more common symptoms that appear in earlier stages, and the less common or more severe symptoms that appear as the cancer grows or spreads. The earlier cancer is caught, the more treatment options are available and the better the chances of a good outcome.

The most common symptoms of bladder cancer

• The most common and well-known symptom of bladder cancer is blood in the urine. This can make the urine look pink, orange, red, or even dark brown, sometimes described as looking like cola or tea. In some cases, the blood is too small to be seen by the naked eye and is only found during a lab test called a urinalysis. Blood in the urine is the most important warning sign to watch for, and it should always be evaluated by a doctor.

• Another very common symptom is changes in urination habits. This can include needing to urinate more often than usual, feeling a sudden, strong urge to urinate that is hard to control, or feeling pain or burning during urination. These symptoms are also common with urinary tract infections, which is why bladder cancer is sometimes mistaken for a UTI at first.

• Some people with bladder cancer may feel like their bladder is never fully empty, even after urinating, or may have trouble starting the urine stream. These symptoms happen when the tumor is partially blocking the flow of urine from the bladder. If you notice any combination of blood in the urine, frequent urination, pain during urination, or difficulty urinating, especially if the symptoms keep coming back, it is important to see your doctor for evaluation.

Less Common Symptoms Of Bladder Cancer

Beyond the most well-known symptoms, bladder cancer can cause a range of less obvious signs that are easy to overlook or attribute to other causes. These less common symptoms are important to know because, in some cases, they may appear before the more typical symptoms, or they may be the only sign that something is wrong.

• Pain or pressure in the lower abdomen or pelvis, even when they are not urinating.

• Discomfort in the lower back, on one side or both. This kind of back pain can happen when the tumor grows large enough to press on nearby structures, like the ureters or other pelvic organs.

• Unusual fatigue

• A loss of appetite

• Feeling generally unwell

• Swelling in the feet or legs can occur if the cancer has spread to nearby lymph nodes and is blocking normal fluid drainage.

• Bone pain may occur in rare cases if the cancer spreads to the bones.

These symptoms are more often associated with advanced bladder cancer, not early-stage disease.

Symptoms of Advanced (Metastatic) Bladder Cancer

When bladder cancer has spread beyond the bladder to other parts of the body, it is called metastatic or advanced bladder cancer. At this stage, the symptoms can be more widespread and more serious. Common areas where bladder cancer spreads include the lymph nodes, bones, liver, and lungs. The symptoms experienced often depend on which organs are affected.

• If the cancer has spread to the bones, a person may have deep, aching bone pain that may be worse at night. Bone metastases can also weaken the bones, making them more likely to fracture (break).

• If the cancer has spread to the liver, a person might experience pain in the upper right side of the abdomen, jaundice (yellowing of the skin or eyes), or swelling in the belly. 

• Lung metastases can cause shortness of breath, a persistent cough, or chest pain.

• Significant unintentional weight loss

• Severe fatigue

• Loss of appetite

• Feeling weak all over

• Swelling in the legs (called edema) can occur when the cancer presses on or blocks lymph nodes.

• Some people may also develop anemia (low red blood cell count) from ongoing blood loss through the urine, which can make fatigue even worse.