Bladder cancer is one of the most dangerous malignancies. However, if prevented, detected, and treated early, the disease can be controlled.

Urinary tract cancer is among the 7 most common cancers worldwide, with bladder cancer accounting for the highest proportion—80–90%. In Vietnam, bladder cancer ranks among the top 10 most common cancers in men.

Bladder cancer is a type of cancer that occurs in the bladder—a hollow organ located in the lower abdomen that stores urine excreted by the kidneys. The inner lining of the bladder consists of transitional cells and squamous cells.

According to Dr. Do Anh Tu, K Hospital (Hanoi), bladder cancer is the most common malignancy of the urinary tract. The disease usually affects people aged 60–70, with about 75% of cases occurring after age 65. It is rare in those under 40 and more common in men than women (approximately 3 times higher).

The symptoms of bladder cancer are often difficult to recognize. However, there are certain signs that may help patients detect the disease early and seek timely medical examination:

• Fatigue, weight loss, loss of appetite

• Blood in the urine (the most common sign), which may appear intermittently, visibly, or throughout urination

• Painful urination

• Frequent, difficult, or involuntary urination, and dark-colored urine—early symptoms caused by bladder irritation or reduced bladder capacity

• Symptoms of urinary tract infection, or urinary obstruction due to tumor invasion or blood clots

Treatment depends on the tumor location and stage but mainly involves surgery, which may be combined with chemotherapy, radiotherapy, biological therapy, photodynamic therapy, or immunotherapy.

For early-stage bladder cancer, treatment is mainly tumor resection or bladder removal. Adjuvant treatments may include intravesical drug instillation, systemic chemotherapy, or radiotherapy depending on the stage. For advanced bladder cancer, treatment primarily focuses on controlling local symptoms and palliative chemotherapy, Dr. Tu noted.

Ultrasound is a simple, quick, inexpensive, and effective method to detect bladder lesions, but it requires the bladder to be full before examination. However, ultrasound alone cannot provide a definitive diagnosis of bladder tumors. Cystoscopy is required—a procedure that inserts a scope through the urethra, which may cause discomfort, pain, urethral injury, or risk of urinary tract infection. Therefore, cystoscopy is only indicated when ultrasound shows a bladder mass or there is suspicion of one.

In addition, computed tomography (CT) scans also play an important role in diagnosing bladder cancer, as they can assess tumor invasion beyond the bladder wall and lymph node metastasis.

To prevent bladder cancer, experts recommend the following measures:

• Do not smoke and avoid exposure to cigarette smoke.

• If working in environments with toxic chemicals, strictly follow occupational safety guidelines.

• Test household water sources to check for heavy metals and harmful substances before use.

• Drink at least 2 liters of water daily to help flush out toxins.

• Improve diet by consuming vegetables rich in fiber, vitamins, and antioxidants.

Have regular health check-ups every 6 months to detect and treat diseases early, protecting overall health.

Bladder Cancer: Warning Signs, Risk Factors, Diagnosis, and What Everyone Should Know

Why Early Detection Matters

Bladder cancer can be a serious disease, but a diagnosis does not automatically mean that the cancer is advanced or untreatable. Many bladder tumors are discovered before they have invaded the muscle layer of the bladder. When detected at an early stage, treatment can often control the disease, although continued monitoring is important because bladder cancer can return.

One of the greatest challenges is that the earliest warning sign may be painless blood in the urine. Because it may disappear on its own, people sometimes assume that the problem has resolved. Unfortunately, the disappearance of visible blood does not necessarily mean that its underlying cause has gone away.

Recognizing warning signs, understanding personal risk factors, and seeking medical advice promptly can make a meaningful difference. No home remedy, dietary change, or drinking routine can guarantee prevention, and no symptom checklist can replace a medical evaluation.

1. Blood in the Urine Should Never Be Ignored

Blood in the urine, medically known as hematuria, is the most common warning sign of bladder cancer. It may appear bright red, pink, or brownish. In some cases, the amount of blood is so small that it can only be detected through laboratory testing.

A particularly misleading feature is that bleeding may occur intermittently. Someone might notice discolored urine one morning, see normal-looking urine for several days, and then experience the same symptom again.

This pattern should not be used as reassurance.

Blood in the urine can have many causes, including urinary tract infections, kidney stones, certain medications, and other disorders of the urinary system. Bladder cancer is only one possible explanation. Nevertheless, it is important to investigate the symptom rather than guess at its cause.

Seek prompt medical assessment if you notice blood in your urine, even if:

• It happens only once.

• There is no pain or burning.

• The amount of blood appears very small.

• The urine returns to its usual color.

• You have no other noticeable symptoms.