What Are The 5 Warning Signs of Bladder Cancer?

Bladder cancer is a serious but often treatable condition when caught early. Recognizing the early symptoms can be life-saving.

In this blog, Dengyue’ll walk you through what are the 5 warning signs of bladder cancer, explore its early symptoms, common causes, main cancer types, and treatment options such as Enfortumab Vedotin and Gemcitabine Hydrochloride Injection.

Dengyuemed’ll also highlight the differences in how bladder cancer presents in men and women.

The 5 Warning Signs of Bladder Cancer

Bladder cancer often develops silently in its early stages, but some warning signs may appear before the disease progresses.

How I knew I had bladder cancer? Let’s explore about what are the 5 warning signs of bladder cancer.

1. Painless Blood in the Urine (Hematuria)

The most common and earliest symptom of bladder cancer is blood in the urine.

• It may be visible (gross hematuria), turning the urine pink, red, or cola-colored.
• In other cases, the blood is microscopic, only detected during a routine urine test.
• It often appears without pain, which is why it can be easily overlooked.

2. Urinary Changes

Some patients experience changes in urination patterns, especially if the cancer has started to irritate the bladder lining. This includes:

• Increased urgency – a strong, sudden need to urinate.
• Frequency – urinating more often than usual, even during the night.
• Burning or pain while urinating (dysuria).
• Difficulty urinating or a weak urine stream.

3. Pelvic or Lower Back Pain (in later stages)

Although not usually an early symptom, persistent pain in the lower abdomen or flank may appear as the tumor grows or invades nearby structures.

4. Fatigue and Weight Loss

In advanced stages, some patients may report unexplained weight loss, loss of appetite, or tiredness, but these are non-specific symptoms.

5. Swelling in the Legs or Feet

In some advanced cases, bladder cancer can obstruct lymphatic drainage or blood flow, leading to:

• Edema (swelling) in the lower limbs
• Discomfort or tightness in the legs
  This may also suggest lymph node involvement or vascular compression caused by the tumor.

⚠️ Why Early Detection Matters

Catching what are the 5 warning signs of bladder cancer early greatly improves the chances of successful treatment.

That’s why any sign of blood in the urine—even once—should be evaluated by a doctor, especially in adults over age 50 or those with risk factors like smoking or chemical exposure.

Bladder Cancer Causes

Bladder cancer begins when cells in the bladder lining mutate and grow uncontrollably. Common causes and risk factors include:

1. Smoking – The Leading Cause

Cigarette smoking is the most significant risk factor for bladder cancer.

Harmful chemicals in tobacco smoke (especially aromatic amines) are absorbed into the bloodstream, filtered by the kidneys, and stored in the bladder with urine.

Prolonged exposure to these carcinogens damages the bladder lining, increasing the risk of cancer. Smokers are up to 6 times more likely to develop bladder cancer than non-smokers.

2. Exposure to Industrial Chemicals

Certain jobs expose individuals to cancer-causing chemicals. Industries like dye, rubber, leather, textile, and printing may involve prolonged contact with substances such as:

• Aromatic amines (e.g., benzidine, β-naphthylamine)
• Polycyclic aromatic hydrocarbons
• Diesel exhaust
  Workers in these environments have a significantly higher risk of bladder cancer due to chronic chemical exposure.

3. Chronic Bladder Irritation or Infection

Repeated or long-term irritation of the bladder lining increases cancer risk. Causes include:

• Chronic urinary tract infections (UTIs)
• Long-term use of urinary catheters
• Bladder stones
• Schistosomiasis (a parasitic infection common in some tropical regions)
  These conditions may lead to inflammation and cellular changes that can progress to cancer, especially squamous cell carcinoma.

4. Radiation and Chemotherapy to the Pelvic Region

Patients who have undergone radiation therapy for pelvic cancers (like cervical or prostate cancer) have an elevated risk of bladder cancer due to radiation-induced DNA damage.

Similarly, the chemotherapy drug cyclophosphamide is known to be toxic to the bladder lining and may increase cancer risk if not properly managed.

5. Family History and Genetic Factors

A family history of bladder cancer may point to inherited genetic mutations or shared environmental exposures.

Specific gene mutations (such as NAT2 and GSTM1) can influence how the body processes carcinogens, impacting individual risk levels.

6. Age and Gender

• Age: Most bladder cancers occur in people over 55.
• Gender: Men are about four times more likely to develop bladder cancer than women, possibly due to higher smoking rates and occupational exposures.

7. Certain Medications and Water Contaminants

• Long-term use of the diabetes drug pioglitazone has been linked to increased risk.
• Arsenic in drinking water, especially in certain geographical areas, is also a known bladder carcinogen.

Bladder Cancer Types

Bladder cancer is classified based on the type of cells where the cancer originates. The main types include:

1. Urothelial Carcinoma (Transitional Cell Carcinoma)

• Most common type (90% of cases in developed countries)
• Originates from the urothelial cells lining the inside of the bladder
• Can also occur in the ureters and renal pelvis
• Often linked to smoking and chemical exposure

2. Squamous Cell Carcinoma

• Accounts for about 5% of bladder cancers in developed countries but higher in regions with chronic schistosomiasis
• Arises from chronic irritation or inflammation (e.g., from infections or catheters)
• Typically more aggressive

3. Adenocarcinoma

• Rare (1-2% of cases)
• Develops from glandular (mucus-producing) cells
• Associated with bladder exstrophy or long-term inflammation

4. Small Cell Carcinoma

• Very rare and highly aggressive
• Composed of neuroendocrine cells
• Often treated with chemotherapy similar to small cell lung cancer

5. Sarcomatoid Carcinoma

• Extremely rare and aggressive
• Contains both epithelial and mesenchymal (connective tissue) elements
• Poor prognosis due to its rapid growth and spread

Stage 1-4 Bladder Cancer Symptoms

Bladder cancer is typically classified by how deeply it invades the bladder wall:

🟢 Stage 0–1: Non-Muscle-Invasive Bladder Cancer (Early Stage)

• Often no pain.
• Blood in urine may be intermittent and easily missed.
• Mild urinary irritation (burning, urgency) may occur.

🟠 Stage 2–3: Muscle-Invasive Bladder Cancer

• More noticeable pelvic pain or pain during urination.
• Frequent UTIs that don’t respond well to antibiotics.
• Possible lower back pain, especially on one side.

🔴 Stage 4: Metastatic Bladder Cancer

• Cancer has spread to lymph nodes, bones, lungs, or other organs.
• Systemic symptoms: fatigue, weight loss, bone pain, swelling in legs, difficulty breathing.

Bladder Cancer Treatment Options

Bladder cancer treatment varies based on the stage, type, and individual patient factors. Here’s a breakdown of the most common approaches:

🔪 Bladder Cancer Surgery

• TURBT (Transurethral Resection of Bladder Tumor)
  • ✅ Used for: Early-stage, non-muscle-invasive bladder cancer
  • 💡 How it works: A scope is inserted through the urethra to remove tumors from the bladder lining.
• Cystectomy
  • ✅ Used for: Muscle-invasive or high-risk bladder cancer
  • 🧩 Types:
    • Partial Cystectomy: Only part of the bladder is removed
    • Radical Cystectomy: Entire bladder and nearby lymph nodes/organs are removed
  • 🛠 Often followed by: Reconstruction of a urinary diversion (e.g., urostomy)

🧬 Immunotherapy

• BCG Therapy (Bacillus Calmette-Guerin)
  • ✅ Used for: Non-muscle-invasive bladder cancer
  • 💉 How it works: A live, weakened bacterium is placed directly into the bladder to stimulate the immune system to fight cancer cells.

💊 Chemotherapy & Radiation

• ✅ Used for:
  • Muscle-invasive cancer
  • After surgery (adjuvant therapy)
  • Patients who cannot undergo surgery
• 💥 Goal: Kill rapidly dividing cancer cells and reduce recurrence

🎯 Targeted Therapy & Checkpoint Inhibitors

• ✅ Used for: Advanced or recurrent bladder cancer
• Checkpoint Inhibitors (e.g., Atezolizumab, Nivolumab): Help the immune system recognize and attack cancer cells
• Targeted Therapy (e.g., Erdafitinib): Targets specific genetic mutations (like FGFR alterations)

💊 Medcine Therapy

In recent years, several innovative therapies have emerged to improve outcomes for patients with bladder cancer and related malignancies:

Enfortumab vedotin is an antibody-drug conjugate (ADC) designed specifically for advanced or metastatic urothelial carcinoma.

Gemcitabine hydrochloride is a broad-spectrum chemotherapy agent commonly used to treat pancreatic cancer, but also effective in bladder cancer, especially in combination with cisplatin.

Each treatment plan is tailored to the individual. Early detection and staging are crucial to selecting the best options.

🚻 Do Symptoms Differ Between Men and Women?

Yes. Bladder Urinary Cancer affects men more commonly, but women often face delayed diagnosis due to symptom overlap with other conditions:

👨 In Men:

• More likely to seek medical help quickly when seeing blood in urine.
• Often misattributed to prostate issues in older men.

👩 Signs of Bladder Cancer in Females:

• Early symptoms like burning or frequency are often mistaken for urinary tract infections (UTIs).
• As a result, diagnosis may be delayed, and cancer is often found at a more advanced stage.

💡 Key Note: Any urinary symptoms in adults, especially recurrent UTIs or blood in urine, should be further evaluated, not dismissed.

Final Thoughts

Bladder cancer can be silent at first, but your body often gives early clues.

If you or someone you love experiences unexplained urinary symptoms, don’t ignore them.

Early diagnosis can make all the difference in treatment success and long-term survival.

Stay informed. Get regular checkups. And share Dengyuemed‘s blog—what are the 5 warning signs of bladder cancer—it might help someone recognize the signs early.

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