Is hematuria in bladder cancer a late stage symptom?

Written by Hu Zhong Dong
Medical Oncology
Updated on June 01, 2025
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Bladder cancer is a relatively common malignant tumor of the urinary system, with over 70% of bladder cancers presenting with hematuria in the early stages. However, about 10% of bladder cancer patients do not exhibit hematuria. For instance, when the bladder cancer is infiltrative, it is less likely to bleed, and when bleeding does occur, it is usually in the advanced stages. Frequent urination, painful urination, blood in urine, and cloudy urine can all be early signs of bladder issues. If someone experiences these symptoms, it is crucial to go to the hospital for relevant examinations early to detect bladder cancer at an early stage. Additionally, it is advisable not to hold in urine, to smoke less or quit smoking, and to drink more water to reduce the incidence of bladder cancer.

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Written by Liu Liang
Oncology
1min 7sec home-news-image

Does bladder cancer require the removal of the bladder?

Whether or not to remove the entire bladder in cases of bladder cancer depends on whether the tumor has invaded the base layer and whether there is distant metastasis. For non-muscle invasive bladder cancer, where the muscle layer is not invaded and there is no distant metastasis, typically found in stage 0 and stage 1 bladder cancer patients, there is no need for complete removal of the bladder. The standard treatment in such cases generally involves transurethral resection of the bladder tumor. If the tumor has invaded the base layer but there is no distant metastasis, termed muscle-invasive bladder cancer, patients in this category require radical cystectomy, which involves the removal of the entire bladder. If there is distant metastasis, termed metastatic bladder cancer, surgical treatment is not pursued; instead, palliative chemotherapy is the primary approach.

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Written by Liu Liang
Oncology
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What medicine is infused into the bladder for bladder cancer?

Postoperative intravesical chemotherapy infusion is very common in the treatment of bladder cancer. Common drugs used for infusion chemotherapy include mitomycin and anthracyclines such as epirubicin or pirarubicin. Gemcitabine is also frequently used for this purpose. The related side effects generally include irritation symptoms of the bladder, although some patients may experience relatively mild side effects.

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Written by Wang Shuai
Urology
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Could light bloody water on the paper after urinating be bladder cancer?

Firstly, it is not possible to determine the presence of bladder cancer in this way. If, after urinating, there is blood-tinged fluid when wiping the urinary opening with tissue, this may be considered hematuria. There are many causes of hematuria, such as urinary tract infections, or swelling, congestion, and erosion at the urinary opening, as well as kidney stones, all of which can lead to blood in the urine. Of course, tumors in the urinary system can also cause blood in the urine, but tumor-induced hematuria is often painless, and the color of the blood tends to be concentrated, making the urine appear red or like washed meat water. In such cases, it is important to promptly visit a hospital for routine urinalysis, ultrasonography, and even CT scans or cystoscopy to determine if it is bladder cancer.

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Written by Liu Mei Fen
Medical Oncology
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What is the best medicine for bladder cancer infusion?

Bladder perfusion chemotherapy involves infusing chemotherapy drugs directly into the bladder through a catheter to control tumor growth and reduce the recurrence rate after surgery. Generally, the drugs with significant effects on bladder perfusion fall into three categories. The first category is the anthracyclines, including doxorubicin, epirubicin, and pirarubicin. The second category includes platinum-based drugs such as cisplatin, carboplatin, and oxaliplatin. The third category is vinorelbine. According to current big data research, vinorelbine bladder perfusion tends to have a lower recurrence rate. Without postoperative bladder perfusion chemotherapy, 60%-70% of patients will eventually experience recurrence. With bladder perfusion chemotherapy, the recurrence rate can be reduced to 20%-30%.

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Written by Wang Jian
Urology
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Treatment of bladder cancer

For the treatment of bladder cancer, it is necessary first to confirm the diagnosis of bladder cancer through routine urine tests, ultrasonographic examination of the urinary system, cystoscopy, and imaging studies of the urinary system. It is important to determine the location, area, and malignancy of the bladder tumor. For early-stage superficial bladder tumors or tumors on the bladder wall with fewer numbers, minimally invasive surgery can be performed, followed by bladder perfusion to prevent recurrence of the bladder tumor. In the second scenario, if the bladder tumor is multiple and larger, and has a higher degree of malignancy in the bladder trigone area, then a radical cystectomy is required. Radical cystectomy involves the removal of the bladder along with the prostate in males or the uterus in females, followed by the creation of a urinary diversion, typically through these two treatment methods.