Bladder Cancer Support Program

Bladder cancer is a disease of the urinary tract. So, most bladder cancer symptoms will affect urination in some way.

“The most common bladder cancer symptom far and away is blood in the urine,” says urologic surgeon Thomas Smith, M.D.

Here, three survivors share their first bladder cancer symptoms, and Smith weighs in on when to see a doctor.

Blood in urine is often the first bladder cancer symptom

One day in 2018, Arthur Hamberger, M.D., noticed some blood in his urine. He describes it as ‘the slightest shade of pink you can imagine.’ And it only happened one time. But as a doctor and three-time cancer survivor, he knew not to ignore this symptom. So, he contacted his urologist and had a CT urogram, a scan of the urinary tract to check for disease.

“It showed I had a fairly large tumor in my bladder and a mass in my pancreas,” says Arthur, who was 73 at the time of his bladder cancer diagnosis.  

Now a six-time cancer survivor, Arthur is grateful he didn’t ignore that early symptom of bladder cancer. His doctor was able to remove his tumor while keeping his bladder intact. He also had surgery to remove the pancreatic cancer.

“If it were not for that little bit of blood in my urine, they would have never found the tumor in my pancreas,” he says.

Margo Wickersham also noticed blood in her urine. It happened one morning. And again the next morning. And then never again.

“It was just a little blood, and it was pink, not red,” recalls Margo. “But I was a 57-year-old woman and post-menopausal, so there were not a lot of reasons to explain it.”

A urine sample ruled out a urinary tract infection (UTI). But Margo decided to see a urologist after a nurse practitioner at her obstetrician’s office simply said, ‘We’ll keep an eye on it.’

A cystoscopy revealed a small tumor in her bladder. Margo was told she had highly aggressive stage I bladder cancer. She got a second opinion at MD Anderson, which confirmed the stage I bladder cancer diagnosis and also uncovered plasmacytoid cancer, an extremely rare type of bladder cancer known to come back.

“You can’t always go by how you feel. I felt completely fine, but I had blood in my urine,” says Margo, who has shown no evidence of disease after completing treatment at MD Anderson three years ago. “If your urine has blood in it, that’s a red flag. See a doctor.”

Pay attention to fatigue, other changes in your body

When Ron Speidel began experiencing fatigue in his early sixties, he chalked it up to changes in his diet and sleep patterns and just getting older.

“Unfortunately, that’s the case usually,” Ron’s urologist back home in McAllen, Texas, told him of the vague symptom. “We can’t do a CT scan for fatigue.”

It was actually Ron’s earliest symptom of bladder cancer. Several months later, he noticed blood in his urine. He had an appointment with his doctor the next day.

“By that time, my urine was almost completely blood,” he says. “In just one day.”

His urologist told him it was bladder cancer and referred him to MD Anderson for treatment.

“I was very fortunate to get an appointment at MD Anderson quickly,” says Ron, a retired police officer. “Doctors were able to treat my initial bladder cancer and even after it metastasized.”

Other symptoms of bladder cancer

Blood in the urine, or hematuria, is the most common symptom Smith sees in bladder cancer patients.

He also says many patients experience:

• a burning sensation while urinating
• more frequent urination
• a stronger urge to urinate

“These symptoms can also overlap with other bladder conditions, like a urinary tract infection,” says Smith. “So, it’s important to get them checked out.”

When to see a doctor for bladder cancer symptoms

Arthur, Margo and Ron are all glad they saw a doctor after noticing blood in their urine. It led them to bladder cancer diagnoses and successful treatment.

“I’ve had patients who had small blood clots in their urine and just had a small tumor in the bladder,” says Smith. “We were able to perform a simple endoscopic surgery to remove the tumor, and they’ve been good ever since. And I’ve had some patients with advanced bladder cancer who didn’t have symptoms that long.”

He stresses that finding blood in the urine and the amount of microscopic hematuria — which is blood visible only under a microscope — doesn’t always correlate with the stage and severity of the disease.

So, when should you see a doctor for bladder cancer symptoms?

“As soon as you notice them,” says Smith. “Never ignore a symptom, even if it seems minor or only happens one time.”

Request an appointment at MD Anderson online or call 1-877-632-6789.