Bladder Cancer Warning Signs and Symptoms: 5 Early Warning Signs You Shouldn’t Ignore 

The most common early sign of bladder cancer is blood in the urine (hematuria). Other early symptoms include painful urination, frequent urination, urgency without infection, and difficulty emptying the bladder. Recognizing these symptoms can help catch bladder cancer early and improve treatment outcomes. 

What are early signs of bladder cancer?

The most common early symptoms of bladder cancer include: 

• Blood in the urine (hematuria) 

• Painful urination 

• Frequent urination 

• Urgency without a urinary tract infection (UTI) 

• Difficulty emptying the bladder 

The most important early warning sign is blood in the urine, even if it happens only once. 

Blood in the urine (hematuria)

Blood in the urine is the most common early warning sign of bladder cancer. Even a single episode of blood in the urine should never be ignored.

• It may look pink, red or brown. Sometimes a urine test is the only way to detect blood (microscopic hematuria). 

• Blood may come and go and is often painless. 

• Even a single episode should be evaluated. 

For bladder cancer survivor Nancy, blood in her urine was the first thing she noticed. Read her story.  

Watch our short video explaining blood in the urine (hematuria).

Painful urination

Pain during urination can sometimes be a symptom of bladder cancer. 

• Often accompanied by urgency or frequency 

• May persist even when no infection is found 

These symptoms are sometimes mistaken for a urinary tract infection. If antibiotics do not help, your doctor may do more tests. 

Urgency to urinate without a urinary tract infection (UTI)

A strong, sudden need to urinate—even when your bladder isn’t full—can be a warning sign of bladder cancer.  Especially if there’s no UTI present.  

Frequent urination (including at night)

Needing to urinate more often than usual may be an early symptom of bladder cancer. 

This includes: 

• Increased daytime frequency 

• Waking up at night to urinate (nocturia) 

Frequent urination may be more concerning if: 

• Tests show no infection. 
• Symptoms continue or worsen over time. 

Difficulty emptying the bladder

Sometimes, the urgent need to urinate is accompanied by the inability to empty your bladder. The need but inability to urinate is likely to be cause by something other than bladder cancer, but it is still very important to get checked out by your doctor.

When should you see a doctor for bladder cancer symptoms? 

You should see a doctor or urologist (doctor who specializes in diagnosing and treating problems with the urinary system) if you notice: 

• Any blood in your urine (even if it only happens once).

• Urinary symptoms that do not go away such as pain, urgency, or frequent urination.

• Symptoms that return after treatment for a urinary tract infection (UTI).. 

Testing may include: 

• Urine tests. 

• Imaging tests, such as a CT urogram or ultrasound.

• Cystoscopy (a test to examine the bladder). 

Frequently asked questions about bladder cancer symptoms

What is the first sign of bladder cancer? 

The most common sign of bladder cancer is blood in the urine (hematuria). It may appear pink, red or brown. 

What are the risk factors for bladder cancer?

Risk factors for bladder cancer include smoking (the leading risk factor), exposure to industrial chemicals, age over 55, male gender and chronic bladder inflammation. 

What are warning signs of bladder cancer in women?

The most common warning sign is blood in the urine.  Women may also notice symptoms like frequent urination, burning, pelvic or back pain, and unexplained fatigue. Women are frequently treated for UTIs first, which can delay diagnosis.

Can bladder cancer be mistaken for a urinary tract infection (UTI)?

Yes, bladder cancer can be mistaken for a UTI, especially in women. Make sure to see a doctor if you have frequent UTIs and antibiotics don’t seem to help.  

Does blood in urine always mean bladder cancer? 

No. Many conditions can cause blood in the urine, but you should always see a doctor. 

What are other symptoms of bladder cancer besides blood in the urine?

Other symptoms are: 

• Abdominal pain. 

• Fatigue. 

• Lower back pain (not related to injury). 

• Unexplained weight loss or loss of appetite. 

Source:  

• National Cancer Institute 

Related Topics 

• Bladder cancer causes and risk factors

• Bladder cancer stages

• Bladder cancer prognosis

• Treatment options for bladder cancer