Symptoms:

Symptoms of bladder cancer can include:

• Abdominal pain
• Blood in the urine
• Bone pain or tenderness
• Fatigue
• Painful urination
• Urinary frequency
• Urinary urgency
• Urine leakage (incontinence)
• Weight loss

Note: Other diseases and conditions can cause similiar symptoms. It is important to see a doctor to rule out all other possible causes.

Signs and tests:

The health care provider will perform a physical examination, including a rectal and pelvic exam.

Tests that may be done include:

• Abdominal CT scan
• Bladder biopsy (usually performed during cystoscopy)
• Cystoscopy (examining the inside of the bladder with a camera)
• Intravenous pyelogram - IVP
• Pelvic CT scan
• Urinalysis
• Urine cytology

If tests confirm you have bladder cancer, additional tests will be done to see if the cancer has spread. This is called staging. Staging helps guide future treatment and follow-up and gives you some idea of what to expect in the future.

The TNM (Tumor, Nodes, Metastasis) staging system categorizes bladder cancer using the following scale:

• Stage 0 -- Noninvasive tumors that are only in the bladder lining
• Stage I -- Tumor goes through the bladder lining, but does not reach the muscle layer of the bladder
• Stage II -- Tumor goes into the muscle layer of the bladder
• Stage III -- Tumor goes past the muscle layer into tissue surrounding the bladder
• Stage IV -- Tumor has spread to neighboring lymph nodes or to distant sites (metastatic disease)

Bladder cancer can spread into nearby areas, including the:

• Prostate
• Rectum
• Ureters
• Uterus
• Vagina

It can also spread to lymph nodes in the pelvis, or to other parts of the body, such as:

• Bones
• Liver
• Lungs