Bladder Cancer (cont.)

The most common symptom of bladder cancer is bleeding in the urine (hematuria). Most often the bleeding is "gross" (visible to the naked eye), episodic (occurs in episodes), and is not associated with pain (painless hematuria). However, sometimes the bleeding may only be visible under a microscope (microscopic hematuria) or may be associated with pain due to the blockage of urine by formation of blood clots. There may be no symptoms or bleeding for prolonged periods of time between episodes, lulling the patient into a false sense of security ("I don't know what the problem was, but it is fine now!"). Some types of bladder cancer may cause irritative symptoms of the bladder with little or no bleeding. The patients may have the desire to urinate small amounts in short intervals (frequency), inability to hold the urine for any length of time after the initial desire to void (urgency), or burning sensation while passing urine (dysuria). These symptoms occur more commonly in patients with high-grade, flat urothelial cancers called "carcinoma in situ" or "CIS" (described subsequently in the section on staging of bladder cancer).

Rarely, patients may present with signs and symptoms of more advanced disease such as a distended bladder (due to obstruction by a tumor at the bladder neck), pain in the flanks (due to obstruction of urine flow from kidney to the bladder by the growing tumor mass in the bladder), bone pains, or cough/blood in the phlegm (due to spread to cancer cells to bones or lungs).

Source: MedicineNet.com
http://www.medicinenet.com/bladder_cancer/article.htm