14 Scary Symptoms Of Bladder Cancer Every Woman and Man Needs To Know

Cancer is the name given to an abnormal division of cells that the body fails to control and starts having its own blood supply. In time, cancer cells start spreading to other tissues of the body, resulting in impaired function of the organs. This abnormal group of cells is usually found in the form of a mass called tumor, which can be benign or malignant. Benign means the dividing cells are within the same organ, and they do not have the ability to spread further. But cancer has a high chance of spreading in a late phase of the disease, in a process called metastasis.

Read More:

The urinary bladder is an organ that stores the urine. During urination, the urinary bladder passes urine via the urethra to the outside. The bladder is made up of transitional epithelium, which means that the lining it has can alter its shape depending on the stress it gets from its own filling pressure.

There are various types of bladder cancer, depending on the shape of the cancerous cells, and it can be determined by seeing a sample under the microscope. Most bladder cancers are malignant, and benign bladder tumors are rare. The most common types are:

Transitional cell carcinoma

It is by far the most common bladder cancer, accounting for 90% of cases.

Squamous cell carcinoma

It accounts for 4% of all bladder cancers, and they develop whenever there is irritation in the lining of the bladder.

Adenocarcinoma

It account for 2% of bladder cancers, and it arises from glandular cells in the urinary bladder.
Bladder cancer mostly affects older adults, mostly above 60 years old. Men are more affected than women. It is relatively difficult to diagnose, but the signs and symptoms to suspect this type of cancer are as follows:

Hematuria

It is the clinical name of finding blood in the urine. Hematuria can be of two types: gross hematuria and microscopic hematuria. When patients can see blood or clots in the urine, that is gross hematuria, but when blood cannot be seen in the urine by the naked eye, and blood cells are detected under a microscope, that is microscopic hematuria. In bladder cancer, there is a classic presentation of blood or blood clots present in the urine, which is visible with the naked eye but usually painless and occurs in above 90% of patients.

Dysuria

It is the clinical name of pain or a burning sensation during urination, and it can occur whenever the bladder gets irritated. It is a common symptom in urinary infections, which irritates the bladder, but other conditions may also cause the same effect. When there’s a tumor in the bladder, cancer promotes inflammation, and the tissue becomes irritated and tender. Nerves supplying the bladder get irritated, and this symptom appears in 20 to 30% of patients. Since urinary infections are far more common than cancer, it is highly likely you will need to rule out this cause first.

Frequent urination

Normally, people urinate 6-7 times in 24 hours, but this rate may change according to how much liquid the patient drinks every day. However, patients who exceed this level should explore the reason for this increased frequency. It can be for benign causes, including urinary infections or benign prostatic hyperplasia, but we should also consider bladder cancer. Patients with bladder cancer increase their urinary frequency because they cannot hold urine for a long time. The bladder muscle tissue cannot expand properly because of the abnormality in the bladder lining (urothelium).

Nocturia

It is the clinical name of waking up several times in the night with an urge to urinate. This symptom is usually found in association with other urinary symptoms, especially increased frequency of urination. It is reported in about 20% of patients with bladder cancer. Normally a person does not wake up more than once to pass urine in the night because during nighttime the body produces less urine, and it becomes more concentrated. However, it can be common and it is not always alarming in patients with higher fluid intake. Nocturia can be associated with sleep disorders, and only appears in patients with bladder cancer when the tumor has grown big enough to create alterations in the perception of the pressure of the urinary bladder.

Urgency

This symptom may appear in patients with bladder cancer when the mass is expanding and triggers an urgent need to urinate, but in some cases, the patient may not be able to pass urine. This symptom usually increases with age, and older patients may complain of a compelling urge to urinate. This urge is sometimes sudden and unexpected and may be accompanied with incontinence.

Urinary incontinence

It is the clinical name of not being able to control urination and leaking urine unintentionally. Urine leaks are usually preceded by urinary urgency, or sometimes after patients have finished urinating. This is an annoying symptom, and appears in many different urinary problems, including old age and hormonal changes in menopause.

Inability to urinate

In some cases, patients may not be able to urinate properly, have a reduced flow of urination, or their urinary tract becomes blocked by bladder cancer. Thus, urinating too much or not being able to urinate at all are both alarming signs that should not be neglected. In some cases, patients may be obstructed for too long, and start filling their urinary bladder with too much liquid. This sometimes requires an urgent medical procedure to empty the bladder and clear the emergency.

Lower back pain

Patients with bladder problems may also report lower back pain. When we look at the anatomical position of the bladder, it is anterior to the sacral spine. Thus, in bladder cancer, the expanding bladder compresses the nerves coming from the lower vertebrae, which may result in pain located in the lower back. Additionally, bladder cancer may sometimes cause obstruction of the urinary tract. When the obstruction becomes chronic, the urine starts flowing backward and accumulates in the kidneys, causing swelling and pain in this area of the back.

Lower extremity edema

Some patients with bladder cancer may experience edema in the feet. This symptom is not common in an early stage of the disease, and it is only seen in patients who are diagnosed with an advanced stage of bladder cancer. The swollen feet look puffy and heavy, and swelling results in decreased flexibility of the adjacent joints. Diseases of the heart, lungs, liver, kidneys, and ovaries may also cause swelling of the lower limbs, and they are more common than bladder cancer.

Palpable mass

In advanced cases of bladder cancer, patients may notice a mass that can be felt over the bladder. When it is not felt by the patient, it may be encountered during a physical examination performed by a doctor. This symptom is not common but can be seen in patients with an advanced stage of bladder carcinoma. A palpable mass is usually a sign of a very large tumor, and it is often associated with obstruction of the urinary tract, pain symptoms, lower extremity edema, and other signs of alterations.

Weight loss

In a late stage of the disease, bladder cancer causes weight loss. This is an unintentional weight loss that should be differentiated from normal weight changes resulting from dietary and lifestyle modifications. If your weight has dropped dramatically without any modification in your diet or lifestyle, it is important to talk to your doctor about this symptom, which may be caused by a hidden chronic condition.

Fatigue

Another common symptom shared by the majority of cancers is fatigue. Patients with bladder cancer have accelerated and uncontrolled growth of tissue, which increases their metabolic requirements, and burns extra energy. Thus, it is possible that patients feel overwhelmed and exhausted after performing relatively simple tasks, and even after a good night’s rest.

Bone pain

This type of pain is not caused by having a tumor in the urinary bladder. Instead, it is caused by the spread of bladder cancer into other tissues, and that includes bone tissue. This symptom is found in advanced cases of bladder cancer, and it is highly suspicious of metastasis.

Read More:

Most of the symptoms explained above are also seen in benign conditions, such as urinary tract infections, kidney diseases, uterus, and prostate-related problems. The cause of such symptoms can only be confirmed via investigations and various tests performed using samples of blood, urine and through radiological images such as ultrasound and MRI. The workup and some of the criteria to rule out bladder cancers include microscopic analysis of the urine, urine culture and testing for urinary tumor markers, ultrasound KUB, CT scan of the urinary bladder and cystoscopy (a test that is performed to take a biopsy of the bladder cancer to investigate its type). Blood tests such as renal function tests, liver function tests and complete blood count can be done to confirm bladder cancer, as well.