Blood in the urine (hematuria) is the most common sign of bladder cancer. This is a warning sign of bladder cancer for all genders, and for non-muscle invasive (NMIBC) and invasive bladder cancer. Muscle invasive bladder cancer means the cancer is in the muscle of the bladder. Most bladder cancer is non-muscle invasive when it’s diagnosed.

There are other symptoms to watch for as well. They may be caused by something other than bladder cancer. It’s important to have them checked out by your healthcare provider.

For females, it can be hard to know the difference between bladder cancer symptoms and urinary system problems.

Learn more about what women can do to recognize and prevent bladder cancer.

Signs of bladder cancer

Blood in the urine (hematuria)

The blood can be very faint, with a pink look to it. Or, your urine (pee) can look bloody.

• You often will not have pain or other urinary symptoms.
• You may not have blood in your urine all the time. It can come and go.
• A urine test can find blood that you can’t see.

What women should know about blood in their urine

In women, blood in your urine is often overlooked as a possible sign of bladder cancer. It can be mistaken for the most common causes of blood in the urine:

• A urinary tract infection (UTI)
• Postmenopausal uterine bleeding

Many women who have blood in their urine think they have a UTI. This may delay a visit to their healthcare provider. Other times, their healthcare provider may assume the blood is from more common causes, not bladder cancer. As a result, women often are diagnosed with bladder cancer at a later stage, when it’s harder to treat or cure.

Irritation, pain, or burning while urinating

Feeling pain or burning sometimes when you urinate (pee) could be a sign of bladder cancer.

Urgency even without a full bladder

You may feel like you need to urinate right away, even though your bladder is not full.

Frequent trips to the toilet

You may need to urinate more often than usual.

Having to urinate at night

You may wake up at night with a very strong need to urinate.

Fatigue (feeling tired)

Feeling more tired or having less energy than usual is a common symptom of many kinds of cancer, including bladder cancer.

Flank (side) Pain

You may feel pain side of your back just below your rib cage and above your waist.

Loss of appetite (not feeling hungry)

Bladder cancer can make it uncomfortable to eat. It can make you feel like you don’t want to eat at all.

Weight loss

Weight loss is a common symptom of many kinds of cancer, including bladder cancer.