MBBS, MRCS(EDIN), MMED(SURG), FRCS(UROL) (RCPSG), FAMS(UROL)
BSC(Monash), MBBS(NSW), FRCS(Glasgow), FRACS, MMED(Surgery), FAMS(Urol)
Urinary symptoms are common, particularly as people get older, and are often attributed to benign causes such as minor infections or age-related bladder changes. When these symptoms are mild or intermittent, they are easy to ignore. However, persistent or unexplained changes in urination warrant closer attention, especially in individuals aged 50 and above.
Bladder cancer is more likely to affect older adults and may present with early signs that are subtle and non-specific. Understanding which symptoms should prompt medical evaluation helps ensure timely assessment and appropriate urological care.
Key Bladder Cancer Symptoms That Require Urgent Attention
Early signs and symptoms of bladder cancer and lower urinary tract issues are often mistaken for less severe conditions, such as urinary tract infections (UTIs) or kidney stones. However, the presence of certain issues warrants immediate attention from a urologist:
Blood in Urine (Haematuria)
This is the single most common and important indicator of bladder cancer. Blood in the urine, known medically as haematuria, can manifest in two ways:
- Visible Haematuria (Gross Haematuria): The urine appears pink, red, or dark brown/cola-coloured. This may be intermittent or continuous. Crucially, the absence of pain when blood is present is a major red flag for bladder cancer and requires urgent investigation, even if it appears to resolve itself spontaneously.
- Non-Visible Haematuria (Microscopic Haematuria): Internal bleeding where the blood cells are only detectable via laboratory testing.
Painful Urination
Experiencing discomfort or a burning sensation while passing urine, a condition known as dysuria, is frequently associated with UTIs. However, if this painful urination persists despite antibiotic treatment, or if no infection is found upon testing, it could indicate irritation or obstruction caused by a tumour in the bladder.
Urinary Urgency
A sudden and difficult-to-control urge to pass urine is known as urinary urgency. When this occurs without evidence of a urinary tract infection, it may be linked to bladder irritation. In some cases, bladder tumours can irritate the bladder lining, creating a persistent sensation of fullness even when the bladder is empty. If urgency or bladder irritation continues without a clear cause, it is advisable to seek assessment from a bladder cancer specialist.
Frequent Urination
Needing to pass urine more often than usual can be a sign of bladder irritation. This increase in urinary frequency is commonly linked to conditions such as urinary tract infections, diabetes or an enlarged prostate in men. However, when it occurs alongside urgency or blood in the urine, or continues without an obvious cause, further medical assessment is advised. In some cases, a tumour within the bladder reduces its ability to store urine, leading to increased frequency. A common symptom is the need to wake up several times at night to urinate, known as nocturia.
Urinary Retention
In less common cases, particularly when a tumour is larger, it may obstruct the bladder neck or urethra. This can make it difficult or impossible to empty the bladder fully. Such obstruction can lead to urinary retention, which is a medical emergency and requires prompt assessment. In these situations, a urologist needs to intervene to relieve the blockage and prevent further complications.
Other Systemic Signs of Advanced Disease
When bladder cancer advances or spreads beyond the bladder wall, other general physical symptoms may become apparent. These are usually less specific than urinary symptoms but are highly noticeable due to the intense pain and disruption to daily life that they cause.
Persistent Abdominal Pain
Persistent pain in the pelvic or lower abdominal region can occur, especially if the tumour is large or affecting nearby organs. Prompt and accurate bladder cancer diagnosis is crucial at this stage.
Fatigue
General tiredness and weakness that is not relieved by rest is a common systemic symptom associated with many cancers. There is a possibility of fatigue being caused by metastatic bladder cancer, where the disease has spread to distant portions of the body.
Lower Back Pain
Pain in the flank or lower back area can indicate that the tumour is obstructing the flow of urine from the kidney to the bladder, causing hydronephrosis (swelling of the kidney). This necessitates urgent medical attention, as it could lead to immediate-term kidney failure.
Early Evaluation Matters for Bladder Cancer
If you notice blood in your urine, persistent urinary urgency, painful urination or difficulty emptying your bladder, do not wait for symptoms to go away. Consult a urologist promptly and seek early advice and proper evaluation, as these symptoms may be indicative of bladder cancer.
At Tan Urology, we strive to address and acknowledge the unique needs of each patient. Our experienced urologists, Dr Lincoln Tan and Dr Robert Tan, ensure that each case is treated with the utmost discretion and professionalism. Contact us today to schedule your consultation and take a proactive step towards safeguarding your health.
Meet Our Urologists
Dr Lincoln Tan
MBBS, MRCS(Edin), MMED(Surg), FRCS(Urol)(RCPSG), FAMS(Urol)
Dr Lincoln Tan is experienced in managing a wide range of urological conditions, with particular expertise in minimally invasive laparoscopic and robotic-assisted surgery. He is actively involved in advancing evidence-based approaches to improve diagnostic accuracy and clinical decision-making. As principal investigator in the first local study validating the Prostate Health Index for cancer risk assessment, he has contributed to reducing unnecessary biopsies and has been among the clinical leads introducing freehand, office-based transperineal biopsies in Singapore. Dr Tan is committed to comprehensive, patient-centred urological care.
Dr Robert Tan Tin Kiat
BSC(Monash), MBBS(NSW), FRCS(Glasgow), FRACS, MMED(Surgery), FAMS(Urol)
Dr Robert Tan has over 35 years of experience in the diagnosis and management of a wide range of urological conditions. As one of the first urologists in Singapore to perform transurethral resection of the prostate, he has played a key role in advancing minimally invasive urological care. A founding member of the Singapore Urological Association, Dr Tan is also a local pioneer in non-invasive urinary stone treatment, including extracorporeal shockwave lithotripsy. His practice emphasises careful assessment and personalised care supported by appropriate medical technology.