Blood in Urine (Hematuria) and Bladder Cancer
Reviewed by: HU Medical Review Board | Last review date: September 2017.
The most common symptom of bladder cancer is blood in the urine.1-4 In many patients diagnosed with bladder cancer, blood in the urine is the first symptom, and it may be the only symptom that some patients experience. Around 80% to 90% of patients diagnosed with bladder cancer have this symptom.
Most patients diagnosed with bladder cancer have cancer cells that begin to grow in the inner lining of the bladder. These cells can gather together and form tumors in the bladder lining, which can cause bleeding.
What is hematuria?
The medical term for the symptom of blood in the urine is “hematuria.” In patients diagnosed with bladder cancer, the most common symptom is having a large enough amount of blood in the urine that is visible and easy to see. This is called “gross hematuria.” Patients may notice that after urinating, the water in the toilet looks rust-colored, pink, orange, or red.
Sometimes blood in urine is the only symptom
When bladder cancer is at an early stage, it can cause blood in the urine but it might not cause any other symptoms, such as pain, burning, or other urinary symptoms. Sometimes patients diagnosed with bladder cancer, especially if it is at an early stage, may only have blood in their urine occasionally. It does not always occur every time the person urinates, and might not happen for weeks or even months at a time.
Even if you do not notice blood in the urine very often, it is important to let your healthcare provider know about the symptom. Treatment for bladder cancer tends to be more effective when it is diagnosed as early as possible.
Most patients diagnosed with bladder cancer have blood in their urine that they can see when they urinate.1,2,4 If you experience this symptom, then your healthcare provider will probably perform a physical examination and order a laboratory test called a urinalysis on a sample of your urine. Depending on the results of the urinalysis, the healthcare provider may recommend further tests to understand more about your symptom and to find out if the cause is bladder cancer or something else.
Is the blood always visible?
Not everyone diagnosed with bladder cancer has the symptom of blood in the urine that is easily visible, however. Some patients have blood in their urine that is not visible to the eye, because the amount of blood is very small. This symptom is called “microscopic hematuria,” because the blood is only visible using laboratory tests or a microscope to examine the urine sample. Some patients who are diagnosed with bladder cancer may never notice any symptoms, but their healthcare provider is able to detect the potential presence of blood in their urine during a general check-up, for example. However, this is a less common symptom than visible blood in the urine.
What are other possible causes?
If you notice that there is visible blood in your urine, it does not automatically mean that you have bladder cancer.1,4 In fact, there are several other non-cancerous causes of blood in the urine. However, it is important to talk with your healthcare provider if you have blood in your urine, especially if it has happened more than once. Identifying the cause— whether it is bladder cancer or something else—is the first step in treating the symptom.
In addition to bladder cancer, several different health conditions can cause the symptom of blood in the urine. These include:
- Urinary tract infection (UTI)
- Kidney infection
- Kidney disease
- Bladder stones or kidney stones
- Injury to some part of the urinary tract
- Enlarged prostate (benign prostatic hypertrophy)
- Other cancers, such as prostate cancer or kidney cancer
Certain medications can also cause blood in the urine, such as aspirin or other medications that thin the blood. Foods and drinks that contain certain ingredients can temporarily change the color of your urine. These include artificial dyes, beets, blackberries, or rhubarb.