What are the signs and symptoms of bladder cancer?

Updated: Feb 23, 2021
  • Author: Kara N Babaian, MD, FACS; Chief Editor: Bradley Fields Schwartz, DO, FACS  more...
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Approximately 80-90% of patients with bladder cancer present with painless gross hematuria. Most patients with this classic presentation should be considered to have bladder cancer until proof to the contrary is found. 

Hematuria is not the only manifestation of an underlying bladder cancer. Irritative bladder symptoms such as dysuria, urgency, or frequency of urination occur in 20-30% of patients with bladder cancer. Although irritative symptoms may be related to more advanced muscle-invasive disease, carcinoma in situ (CIS) is the more likely cause. Therefore, patients presenting with unexplained or refractory irritative symptoms should be considered for cystoscopy and urine cytology. The threshold for doing so should be especially low in persons who smoke or have other risk factors.

Patients with advanced disease can present with pelvic or bony pain, lower-extremity edema from iliac vessel compression, or flank pain from ureteral obstruction.

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