Bladder Cancer
Painless blood in the urine is bladder cancer’s calling card. It’s often something harmless, but it always needs checking, even if it happens just once. Smoking causes about half of bladder cancers.
Blood in your wee is never ‘probably nothing’ until someone has actually looked.
See your GP soon if you see blood in your urine, even once and even without pain. Don’t wait to see if it comes back.
Signs
- Blood in the urine, often painless and on and off: pink, red or cola-coloured
- Needing to pass urine often or urgently, or burning, with no infection found or that doesn’t settle
- Later: pelvic or back pain, weight loss
Risk factors
- Smoking, the biggest one: about half of cases
- Older age; men are affected about 3 times as often as women
- Workplace chemicals: some dyes, rubber, leather, paint and aluminium industries
- Past pelvic radiotherapy, cyclophosphamide, long-term catheters, and schistosomiasis (a parasite in some countries)
Why women are often diagnosed later
- Blood in the urine is often put down to a urine infection or periods. If an infection is treated and blood persists, or there’s no infection, it needs further tests.
Tests and treatment
- Tests: urine tests, a CT scan of the kidneys and bladder, and a cystoscopy (a camera into the bladder).
- Early (non-muscle-invasive) cancer: removal through a cystoscope, often followed by medicine put into the bladder (BCG or chemotherapy) to prevent return. Regular checks follow.
- Muscle-invasive cancer: bladder removal or chemoradiotherapy, often with chemotherapy first.
- Advanced cancer: chemotherapy, immunotherapy and newer targeted treatments.
- Quitting smoking lowers the chance of the cancer coming back.
Common questions
Is blood in the urine always serious?
No, it often has a harmless cause such as an infection. But it should always be checked, even if it happens once, because it’s the main warning sign of bladder and kidney cancer.
What causes bladder cancer?
Smoking causes about half. Other risks include older age, being male, some workplace chemicals and past pelvic radiotherapy.
How is bladder cancer treated?
Early cancers are removed through a cystoscope, often followed by BCG or chemotherapy into the bladder. Cancers that have grown into the muscle may need bladder removal or chemoradiotherapy.
Helpful resources
- Cancer Council 13 11 20Information and support line. Free.
- Quitline 13 7848Free help to quit smoking.
Evidence and more information
maladywise.com/bladder-cancer/