What are the symptoms of bladder cancer?

1. Early symptoms

1. The most common symptom of bladder cancer is hematuria that can be seen with the naked eye without any feeling. This is a unique "abnormal urination signal" of bladder cancer. Almost every bladder cancer patient will experience it, and about 85% of bladder cancer patients seek medical treatment for this reason. There are two types of hematuria: macroscopic hematuria and microscopic hematuria. Macroscopic hematuria refers to bloody urine that can be seen directly with the eyes, and microscopic hematuria refers to red blood cells that can be found in the urine under a microscope. Hematuria caused by bladder cancer is mostly painless and intermittent. Most cases are full-course hematuria, and a few are terminal hematuria. Hematuria accompanied by frequent urination and urgency is less common.

2. Frequent and urgent urination: If the tumor grows in the bladder triangle, bladder irritation may appear earlier. If urination pain occurs, it is no longer in the early stage. In short, if unexplained hematuria suddenly appears, it is the earliest sign of bladder cancer.

3. If the tumor invades widely and deeply, pain may occur, which is aggravated by bladder contraction and urine retention. If the tumor is located at the bladder neck, it may cause urethral obstruction and even urinary retention. If the tumor invades the ureteral orifice, hydronephrosis and ascending infection may occur. Severe patients may develop sepsis and uremia, and cachexia may occur in the late stage.

Second, mid-term symptoms

Early bladder cancer patients often have no special positive signs, and gross hematuria is often transient or intermittent. Most patients do not pay attention to it. When the hematuria becomes more obvious or severe, the disease is often in the middle and late stages. For example, when the superficial lymph nodes metastasize, the lymph nodes are enlarged; when the lungs metastasize, the lung breath sounds are weakened, or dry and wet rales are combined; when the liver metastases, the liver border is enlarged, the capsule is not bright, or jaundice is seen; when the bones metastasize, the metastatic site is tender. When the whole body fails and manifests as cachexia, the positive signs such as weight loss and anemia are more obvious.

When the tumor infiltrates into the muscle layer, pain symptoms may occur. If the tumor is large and affects the bladder capacity, or the tumor occurs in the bladder neck, or severe bleeding forms blood clots that affect urine flow, it may cause difficulty in urination or even urinary retention.

Late stage symptoms

1. Hematuria. Hematuria is the most typical symptom of bladder cancer from early to late stages, and more than 90% of patients have this symptom. Hematuria is divided into two types: macroscopic hematuria and microscopic hematuria. Macroscopic hematuria refers to bloody urine that can be seen directly, while microscopic hematuria refers to red blood cells mixed in the urine that can only be found under a microscope. Hematuria occurs intermittently, and once it occurs, it can be whole-course hematuria or terminal hematuria.

2. A palpable mass appears in the lower abdomen.

3. Urinary tract irritation. Urinary tract irritation combined with hematuria will cause the discharge of slough-like substances, lumps, and blood clots.

4. Painful, frequent, and urgent urination.

5. Long-term chronic symptoms of urinary tract infection.

6. Others. If the tumor invades the ureteral orifice or grows at the ureteral orifice, it will cause ureteral dilatation, leading to hydronephrosis and kidney enlargement. When the tumor metastasizes to the lungs, liver, and bones, symptoms such as coughing, shortness of breath, abnormal liver function, pain in the liver area, and bone pain will occur.

7. In addition to the symptoms described above, there are some atypical signs in the late stage of bladder cancer, such as weight loss, anemia, swollen lymph nodes, weakened breath sounds, jaundice, cachexia, and some signs of metastasis, such as chest pain and dyspnea after lung metastasis; headache after brain metastasis; liver pain, jaundice, and liver function decline after liver metastasis.

If the tumor infiltrates into the ureteral orifice or grows at the ureteral orifice, it can cause ureteral dilation, leading to hydronephrosis and enlarged kidney size. When bladder cancer metastasizes to the lungs, liver, and bones, corresponding symptoms will appear, such as cough, shortness of breath, abnormal liver function, pain in the liver area, and bone pain somewhere. A systematic examination should be conducted to make a timely diagnosis and early treatment.