Bladder Cancer Symptoms

Bladder cancer symptoms may differ based on which type you have, although hematuria remains the top symptom for all bladder cancer types.

Urothelial carcinoma, also called transitional cell carcinoma (TCC), is the most common type of bladder cancer and originates in cells that line the inside of the bladder (called urothelial cells). Besides the general symptoms of bladder cancer, TCC can cause a lump in your kidney area (low back) and a low-grade fever.

Squamous cell carcinoma accounts for only 3 to 5 percent of all bladder cancers. These cells have a flat appearance when seen under a microscope. Symptoms of squamous cell carcinoma of the bladder are the same as overall bladder cancer symptoms.

Even more rare (1 to 2 percent of bladder cancers), adenocarcinomas grow in gland-forming cells that create mucus and other substances. Adenocarcinoma symptoms often include a lump you can feel in your lower abdomen.

Rare but aggressive, small cell carcinoma of the bladder accounts for less than one percent of bladder cancers. This bladder cancer type grows in nerve-like cells called neuroendocrine cells, and more frequently causes abdominal pain, painful urination, and urinary tract infections.

Bladder cancers usually start in the bladder’s inner lining, but as tumors grow, cancer can spread into the muscle layers of the bladder wall. The main symptom for non–muscle invasive bladder cancer is hematuria, but once the cancer becomes muscle-invasive, it can cause some of the advanced symptoms listed above, like not being able to pee, weight loss, and fatigue.

Non–muscle invasive bladder cancers have two subtypes: flat and papillary. Papillary bladder cancers have fingerlike projections that grow away from the bladder wall, toward the center of the bladder, while flat bladder cancers don’t. Either type can grow into the muscle wall, with symptoms that follow the same pattern as muscle- and non–muscle invasive types.