When to Suspect Bladder Cancer?

Bladder cancer is one of the commonest genitourinary tract malignancies. It can be treated and sometimes be cured, if you identify it early. The symptoms of bladder cancer can sometimes be very non specific. Therefore, there should be a high degree of clinical suspicion to identify this disease condition. So, what are the features of bladder cancer?

The most common and highly suspicious clinical presentation of bladder cancer is hematuria. Even a single episode of hematuria is highly indicative of bladder cancer. The other clinical presentations of bladder cancer include,

• Storage symptoms - Storage symptoms include, frequency, urgency, urge incontinence, nocturia and nocturnal enuresis. These symptoms are very non specific and can be the result of other benign conditions of the urinary tract, such as benign prostatic hyperplasia, but urologist always suspect bladder cancer because it is very common and can be cured completely if identified early.
• Dysuria without evidence of infection - Some people with bladder cancer can present with dysuria without evidence of any infection. Evidence of infection include fever with chills and rigors. They complain of pain or burning sensation when passing urine. 
• Recurrent urinary tract infections is another feature of bladder cancer. 
• Microscopic hematuria - Many people with bladder cancer pass red cells with their urine, but the number of red cells in the urine is not enough to give red colour to the urine to be seen in naked eye. These people are sed to have microscopic hematuria. These people are usually detected when a urine full report is performed when they present with any other urinary tract symptom. 
• Pathological fracture - Some people can stay un-noticed for years without developing any symptoms. These people can have advanced bladder carcinoma. The cancer may have spread to distal organs. Bones are a very common site of bladder cancer metastasis. Such people can first present with pathological fractures. The radiographs will show a metastatic lesion and a bladder tumor can be found when looked for a primary site.  
• Obstructive uropathy - Obstructive uropathy is the outcome of obstruction of the urinary tract. One of both ureters can be obstructed due to the tumor. As a result the hydronephroreters develops and the post-renal renal failure can occur. The patient can present with features of renal failure such as generalised body swelling, especially peri-orbital swelling in the morning. 
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