Bladder cancer begins when cells in the urinary bladder’s inner lining, known as the urothelium, start to grow abnormally. The bladder is a hollow organ that collects and stores urine. Because the disease often begins with a noticeable physical symptom, recognizing this sign early is important for successful treatment outcomes. The tumor’s location means its presence can directly affect the urine it holds.
Hematuria: The Primary Symptom
The color change most frequently associated with bladder cancer is caused by blood, a condition known as hematuria. This is often one of the first indications of the disease, occurring when the cancerous growth causes bleeding into the urinary stream. The tumor is composed of delicate blood vessels that are prone to rupture as the bladder fills and empties.
The resulting urine color relates directly to the volume of blood present. Urine may appear light pink, rusty, or orange-tinged if only a small amount of blood is mixed in. If the bleeding is heavier, the urine can take on a bright red or dark, cola-colored appearance. This change in hue is frequently painless and may be intermittent, which can lead patients to delay seeking medical attention.
Visible vs. Non-Visible Blood
Hematuria presents in two main forms, classified by how easily the blood can be detected. Gross hematuria occurs when enough blood is present to visibly change the urine color to pink, red, or brown. This visible sign is an immediate prompt for medical evaluation.
Microscopic hematuria involves small amounts of blood that do not alter the urine’s visual appearance. The urine looks normal to the naked eye. The presence of blood is only confirmed through a laboratory test, such as a urinalysis, where a microscope reveals red blood cells. Both forms warrant a thorough medical investigation to determine the underlying cause.
Common Non-Cancer Causes of Urine Discoloration
While blood is the primary concern, various other factors can cause urine discoloration. Certain foods contain pigments that are excreted in the urine, leading to temporary color changes. For example, eating beets, rhubarb, or blackberries can cause urine to appear pink or reddish.
Certain medications are also well-known for producing vivid urine colors that are not indicative of disease. The pain reliever phenazopyridine often turns urine bright orange. Similarly, the tuberculosis medication rifampin can result in a reddish-orange hue, and some laxatives containing senna can produce a brownish color. Cloudiness or a milky appearance, particularly when accompanied by a strong odor, is usually a sign of a urinary tract infection.
Necessary Steps After Noticing Blood in Urine
Noticing blood in the urine requires prompt consultation with a healthcare provider, specifically a urologist. Do not dismiss the symptom, even if the color change was brief or the bleeding was painless. A doctor will typically begin the workup with a urinalysis to confirm the presence of red blood cells and rule out infection.
Following confirmation, the diagnostic process involves several steps to examine the urinary tract. A cystoscopy, where a thin tube with a camera is inserted into the bladder, allows the physician to visually inspect the bladder lining for tumors. Imaging of the upper urinary tract, such as a CT urogram, is also performed to evaluate the kidneys and ureters for sources of bleeding. These steps are essential for identifying the source of the hematuria and establishing a diagnosis.