Symptoms, Risk and Diagnosis of Bladder Cancer

Bladder cancer forms in the cells of the lining of the urinary bladder. Depending on the type of cell affected, it may be transitional cell, squamous cell or adenocarcinoma. The main goal at the Siteman Cancer Center is to get a correct diagnosis of your condition and decide on the proper treatment. Specialists at Siteman excel in using technology and their experience to make an accurate diagnosis, often down to the genetic level so the best treatment options may be identified.

Estimate your risk for bladder cancer.

Symptoms of Bladder Cancer

  • Urgency and frequency of urination.
  • Blood in the urine (slightly rusty to bright red in color).
  • Frequent urination.
  • Pain during urination.
  • Lower back pain.

These symptoms are similar to those experienced during a bladder or urinary tract infection.

Staging of Bladder Cancer

Staging defines the extent of the cancer either locally in the bladder or advanced to other areas. Grading defines how aggressive the tumor is. Stage and grade are important factors in treatment options.


The prognosis (chance of recovery) depends on the following:

  • The stage of the cancer: localized or metastatic.
  • Grade of cancer: type of cells and how they look under a microscope.
  • Whether there is cancer in other parts of the bladder.
  • The patient’s age and general health.

If the cancer is superficial, prognosis also depends on how many tumors there are, the size of the tumors and whether the tumor has come back after treatment.

Bladder cancer in the early stages can often be cured. Clinical trials are a good option for getting the latest treatment.

Risk Factors

  • Using tobacco, especially smoking cigarettes.
  • Having a family history of bladder cancer.
  • Having certain gene changes linked to bladder cancer.
  • Being exposed to certain chemicals in the workplace.
  • Past treatment with certain anticancer drugs or radiation therapy to the pelvis.
  • Drinking well water that has high levels of arsenic.
  • Drinking water that has been treated with chlorine.
  • Having a history of bladder infections.
  • Using urinary catheters for a long time.

Making a diagnosis of bladder cancer may involve different approaches. The following tests and procedures may be used:

  1. Physical exam and history: The specialist carefully examines the patient’s past illnesses and treatments, and any signs of disease, or abnormalities.
  2. Digital rectal or vaginal exam: The doctor or nurse inserts a gloved finger into the rectum or vagina to check for lumps or abnormal areas.
  3. Urinalysis: This test looks at a urine sample for its color and content, such as sugar, protein, red and white blood cells.
  4. Urine cytology: A urine sample is examined under a microscope for abnormal cells.
  5. Cystoscopy: A cystoscope is inserted through the urethra into the bladder to check for abnormal areas. The thin, tube-like instrument has a light and a lens for viewing, and may also have a tool to remove (biopsy) suspicious tissue samples, which are checked under a microscope for signs of cancer.
  6. Intravenous pyelogram (IVP): A contrast dye is injected into a vein and a series of x-rays are taken of the kidneys, ureters, and bladder to find out if cancer is present in these organs. As the contrast dye moves through the kidneys, ureters, and bladder, x-rays can also visualize any blockages.

After bladder cancer has been diagnosed, additional tests may be done to determine if the cancer has spread to other parts of the body. However, staging tests may not be done unless the patient has symptoms or signs that the cancer has spread.