Bladder cancer
Bladder cancer symptoms and risks
Understand the symptoms and key risk factors of bladder cancer so you know when to follow up with your GP.
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Sources and references 
What are the symptoms of bladder cancer?
Sometimes bladder cancer doesn’t have many symptoms and is found when a urine test is done for another reason. However, most people with bladder cancer do have some symptoms. These can include:
Blood in the urine (haematuria) – This is the most common symptom of bladder cancer. It often happens suddenly but is usually not painful. There may be only a small amount of blood in the urine, and it may look red or brown. The blood may come and go, or it may appear only once or twice.
Changes in bladder habits – Changes may include a burning feeling when urinating (weeing or peeing), needing to pass urine more often or urgently, not being able to urinate when you feel the urge, and pain while urinating.
Other symptoms – Less commonly, people may have pain in one side of their lower abdomen (belly) or back. They may also lose their appetite and lose weight.
Not everyone with these symptoms has bladder cancer, but if you have any of these symptoms or are concerned, see your doctor as soon as possible.
What are the different types of bladder cancers?
There are 3 main types of bladder cancer. They are named after the cells they start in.
Urothelial carcinoma
- starts in the urothelial cells lining the bladder wall
- most common type (80–90% of all bladder cancers)
- also called transitional cell carcinoma or TCC
- includes 2 rare subtypes (plasmacytoid and micropapillary), which are more aggressive.
Squamous cell carcinoma (SCC)
- starts in thin, flat squamous cells in the bladder lining
- accounts for 1–2% of all bladder cancers
- more likely to be invasive.
Adenocarcinoma
- develops from the glandular cells in the bladder
- makes up about 1% of all bladder cancers
- usually invasive.
There are also rarer types of bladder cancer, including an aggressive form called small cell carcinoma, and sarcomas, which start in the muscle.
Risk factors for bladder cancer
Research shows that people with certain risk factors are more likely to develop bladder cancer. These risk factors include:
Smoking – People who smoke are up to 3 times more likely than non-smokers to develop bladder cancer.
Older age – About 90% of people diagnosed with bladder cancer in Australia are aged over 60.
Being male – Men are about 3 times more likely than women to develop bladder cancer.
Chemical exposure at work – Chemicals called aromatic amines, benzene products and aniline dyes are linked to bladder cancer. These chemicals are used in rubber and plastics manufacturing, in the dye industry, and sometimes in the work of painters, machinists, printers, hairdressers, firefighters and truck drivers.
Parasitic bladder infections – One of the rarer types of bladder cancer (squamous cell carcinoma of the bladder) has been linked to a parasitic bladder infection called schistosomiasis. This is very rare in people born in Australia; it is caused by a parasite found in fresh water in parts of Africa, Asia, South America and the Caribbean.
Long-term catheter use – Using urinary catheters over a long period may be linked with squamous cell carcinoma of the bladder.
Previous cancer treatments – These include the chemotherapy drug cyclophosphamide and radiation therapy to the pelvic area.
Diabetes treatment – The diabetes drug pioglitazone can increase the risk of bladder cancer.
Personal or family history – Most people with bladder cancer do not have a family history. However, having one or more close blood relatives diagnosed with bladder cancer, or having inherited a gene linked to bladder cancer, slightly increases the risk of bladder cancer.
Sources and references
Acknowledgments
This edition has been developed by Cancer Council NSW on behalf of all other state and territory Cancer Councils as part of a National Cancer Information Subcommittee initiative. We thank the reviewers of this booklet: Dr Malinda Itchins, Thoracic Medical Oncologist, Royal North Shore Hospital and Chris O’Brien Lifehouse, NSW; Dr Cynleen Kai, Radiation Oncologist, GenesisCare, VIC; Dr Naveed Alam, Thoracic Surgeon, St Vincent’s Hospital, Epworth Richmond, and Monash Medical Centre, VIC; Helen Benny, Consumer; Dr Rachael Dodd, Senior Research Fellow, The Daffodil Centre, NSW; Kim Greco, Specialist bladder Cancer Nurse Consultant, Flinders Medical Centre, SA; Caitriona Nienaber, 13 11 20 Consultant, Cancer Council WA; Marco Salvador, Consumer; Janene Shelton, bladder Foundation Australia – Specialist bladder Cancer Nurse, Darling Downs Health, QLD; Prof Emily Stone, Respiratory Physician, Department of Thoracic Medicine and bladder Transplantation, St Vincent’s Hospital Sydney, NSW; A/Prof Marianne Weber, Stream Lead, bladder Cancer Policy and Evaluation, The Daffodil Centre, NSW. We would also like to thank the health professionals, consumers and editorial teams who have worked on previous editions of this title.
Bladder cancer
Cancer Council 13 11 20
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