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Fatigue & Weakness

Some patients who are diagnosed with bladder cancer experience the symptoms of fatigue and weakness.1,2 However, those symptoms are not very commonly caused by bladder cancer, and when they are, they tend to occur more often among patients diagnosed with advanced bladder cancer than patients with early stage bladder cancer.

In most cases, bladder cancer cells start to grow in the urothelium, which is the thin layer of cells that line the inside of the bladder. The cancer cells can gather to form tumors, and in early stage or non-muscle invasive bladder cancer, the tumors are located only in the bladder lining. In more advanced bladder cancer, the tumors may have grown into the muscles of the bladder (called muscle-invasive bladder cancer) or the bladder cancer cells may have spread to other organs or parts of the body, which is called metastatic bladder cancer.

The most common symptom of bladder cancer is blood in the urine that is visible to the eye, which occurs in between 80% and 90% of patients diagnosed. It is usually the first symptom and may be the only symptom that a person experiences. Around 20% to 30% of patients diagnosed with bladder cancer experience problems or changes related to urination, such as

Tell your healthcare provider if you experience fatigue and weakness, especially if you notice blood in your urine or have any of the other symptoms related to urination. While bladder cancer is not usually the cause of fatigue and weakness, it is important to diagnose and treat whatever is causing it.

How are fatigue and weakness evaluated?

Fatigue is not the same thing as normal tiredness.3 Fatigue is chronic lack of energy on a regular basis, and it is not remedied by resting or a good night’s sleep. Fatigue can make it very difficult to carry out your normal, day-to-day activities. It can happen very quickly and often does not seem to have a specific reason.

To understand what may be causing the symptoms of fatigue and weakness, your healthcare provider will carry out a physical exam. If you also have symptoms related to urination, then your healthcare provider will probably test a sample of your urine for signs of infection or other problems. A procedure called cystoscopy may be used to examine and take tissue samples from the inside of the bladder and the urethra, which is the hollow tube-like organ that allows urine to flow out of the bladder during urination.

If you are diagnosed with bladder cancer, then further testing (such as CT/CAT scans, MRIs, x-rays, and bone scans) may be used to see if the cancer has spread to other parts of the body, which may be part of the cause of your tiredness and fatigue.

What causes fatigue and weakness?

Patients with advanced bladder cancer may experience the symptoms of fatigue and weakness.3,4 One reason is that cancer cells use up many of the nutrients in the body, which can prevent healthy cells from growing and functioning as they should. The cancer cells may also be affecting the function of other organs and systems in the body, such as the lymph nodes, kidney, liver, or lungs. Fatigue and weakness can also be symptoms of bladder cancer treatments, such as chemotherapy, radiation therapy, and biological therapies.

Fatigue and weakness can have many other possible causes, however. It can be the result of lifestyle factors such as alcohol or drug use, too much or too little physical activity, lack of sleep, and certain types of medications. Mental health issues such as depression and anxiety are also linked to fatigue, as are a range of other health conditions. Your healthcare provider will talk with you about your specific symptoms in order to make a diagnosis and find the most effective way to treat the underlying cause or causes.

Written by Anna Nicholson | Last review date: September 2017.
  1. Signs and Symptoms of Bladder Cancer. American Cancer Society. Accessed September 2017
  2. Bladder Cancer Treatment. National Cancer Institute. Accessed September 2017.
  3. Cancer Related Fatigue Management. Accessed September 2017.
  4. Fatigue. Mayo Clinic. Accessed September 2017.