Advanced Bladder Cancer: Lower Back and Abdomen Pain

Reviewed by: HU Medical Review Board | Last review date: September 2017.

In most patients diagnosed with bladder cancer, the cancer cells began to grow in the thin layer of cells that line the walls of the bladder, which is called the urothelium.1 Bladder cancer cells can gather together to form tumors and if the tumors are only located in the bladder lining, the diagnosis is non-muscle invasive bladder cancer. Muscle-invasive bladder cancer is diagnosed if the cancer cells have grown into the muscles that make up the wall of the bladder. If the bladder cancer cells have spread to other organs or parts of the body beyond the bladder, it is called metastatic bladder cancer.

Back pain and bladder cancer

Pain in the lower back and/or abdomen can sometimes be caused by bladder cancer, and it is more common in patients who are diagnosed with bladder cancer that is advanced or metastatic. The symptom is not usually experienced by patients who are diagnosed with bladder cancer that is considered early stage. The most common symptom of bladder cancer is blood in the urine that is visible to the eye, which is experienced by around 80% to 90% of patients diagnosed. Between 20% and 30% of patients diagnosed with bladder cancer experience other problems or changes related to urination, such as

  • The need to urinate more frequently than usual
  • Pain or burning before, during or after urination
  • Feeling the urgent need to urinate despite the bladder not being full
  • Being unable to urinate

If you experience lower back or abdominal pain as well as any of those symptoms related to urination—and especially if you have ever noticed blood in your urine — then you should let your healthcare provider know. If the symptoms are being caused by bladder cancer, then finding it out as soon as possible is important so you can begin treatment.

Evaluating lower back and abdominal pain

If a person experiences lower back and/or abdominal pain without any other symptoms, then it is not very likely that the cause is bladder cancer.2 However, if you experience symptoms related to urination as well as lower back or abdominal pain, then your healthcare provider will probably perform a series of tests to find out the cause. In patients with lower back or abdominal pain due to bladder cancer, the pain often occurs on only one side of the body.

A physical examination may include an examination of the vagina and/or rectum, and laboratory tests may include a urine test known as urinalysis, as well as other tests on samples of your urine to find out if the symptoms are being caused by an infection, for example. A procedure called cystoscopy may be needed, in which a thin tube-shaped instrument with a tiny camera is inserted into the bladder through the urethra (the tube-like organ that carries urine out of the body from the bladder). This can be used to view the inside of the urethra and bladder, and potentially to take small tissue samples if needed for a biopsy to check for signs of cancer cells.

If you are diagnosed with bladder cancer, then you may need to have further testing to find out if the bladder cancer cells have spread to other organs or other parts of the body. These may include a CT (CAT) scan, an MRI, x-rays, and bone scans.

Other causes

The symptom of lower back and/or abdominal pain usually has a cause other than bladder cancer.3 Strained muscles in the back are the most common cause of back pain in the United States, but other possible causes include:

  • A herniated (or “slipped”) disc between the bones in the spine
  • Fracture or other injury to the bones or muscles
  • Osteoarthritis
  • Kidney stones
  • Stomach ulcers
  • Infections

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