Symptoms of metastatic bladder cancer

Metastatic bladder cancer means that a cancer that began in the bladder has spread to another part of your body. It is also called advanced bladder cancer.

If your bladder cancer has spread you might:

  • have bone, back or tummy pain
  • feel very tired (fatigue)
  • feel generally unwell
  • have weight loss for no known reason

You might have specific symptoms depending on where the cancer has spread to. These symptoms can also be caused by other medical conditions so might not be a sign that the cancer has spread.

You should contact your doctor if you're concerned about any symptoms.

Where does bladder cancer spread?

Bladder cancer is most likely to spread to the structures close to the bladder, such as the ureters, urethra, prostate, vagina, or into the pelvis. This is called local spread or locally advanced cancer. The ureters are the tubes which carry urine from the kidneys to the bladder. The urethra is the tube which carries urine from the bladder to the outside of the body.

Diagram of the male urinary system
Diagram showing the female urinary system

Bladder cancer can also spread to another part of the body. This is secondary cancer or metastasis. The places it's most likely to spread to are your:

  • lymph nodes in the pelvis and tummy (abdomen)
  • lungs
  • liver
  • bones
Diagram showing metastatic bladder cancer

Symptoms of locally advanced cancer

Large tumours in the bladder can press on the ureters and spread to other nearby structures. You might find that that you have:

  • problems passing urine such as difficulty weeing or frequency
  • blood in your urine
  • pain in your back
  • pain in your tummy (abdomen) or pelvis
  • problems with how well your kidneys work

Symptoms if bladder cancer has spread to your lymph nodes

Lymph nodes are part of a system of tubes and glands in the body that filters body fluid and fights infection. 

There are lots of lymph nodes in the tummy (abdomen) and groin area, which is close to the bladder. Bladder cancer can spread to these, or to lymph nodes in other parts of the body. The most common symptoms are swelling and pain around the area where the cancer has spread.

Cancer cells can stop lymph fluid from draining away. This might lead to swelling in the legs due to fluid build up in that area. The swelling is called lymphoedema.

Symptoms if bladder cancer has spread to your bones

Bladder cancer can spread to the bones.

The most common symptom if cancer has spread to the bone is bone pain. It is usually there most of the time and can wake you up at night. The pain can be a dull ache or stabbing pain.

Your bones might also become weaker and more likely to break (fracture).

If bladder cancer spreads to the spine, it can put pressure on the spinal cord Open a glossary item and cause spinal cord compression. This stops the nerves from being able to work properly. Back pain is usually the first symptom of spinal cord compression. 

Spinal cord compression is an emergency. You should contact your treatment team immediately if you are worried you might have spinal cord compression.

Symptoms if bladder cancer has spread to your liver

You might have any of the following symptoms if your cancer has spread to the liver:

  • discomfort or pain on the right side of your tummy (abdomen)
  • feeling sick
  • poor appetite and weight loss
  • a swollen tummy (called ascites)
  • yellowing of the skin and whites of the eyes (jaundice)
  • itchy skin

Symptoms if bladder cancer has spread to your lungs

You may have any of these symptoms if cancer has spread to your lungs:

  • a cough that doesn’t go away (often worse at night)
  • breathlessness
  • ongoing chest infections
  • coughing up blood
  • a build up of fluid between the chest wall and the lung (a pleural effusion)

Symptom control team

There are symptom control teams in most cancer units. They are also called the palliative care team. They can help you to stay as well as possible for as long as possible. They are also in hospices and many general hospitals.

Most symptom control teams have home care services so they can visit you at home.

How you might feel

When bladder cancer has spread, it can no longer be cured. But treatment can control it for some time and help to relieve symptoms.

Finding out that your cancer can’t be cured is distressing and can be a shock. It’s common to feel uncertain and anxious. It's normal not to be able to think about anything else.

Lots of information and support are available to you, your family and your friends. It can help to find out more about your cancer and the treatments you might have. Many people find that knowing more about their situation can make it easier to cope.

Talk to your doctor or nurse to understand:

  • what your diagnosis means
  • what is likely to happen
  • what treatment is available
  • how treatment can help you
  • Pulmonary manifestations of urothelial carcinoma of the bladder
    A Agrawal and others
    Respiratory Medicine, 2017 volume 128, pages 65-69

  • The role of palliative radiotherapy in bladder cancer: a narrative review
    S Raby and others
    Annals of Palliative Medicine 2020, volume 9, number 6, page 4294 – 4299

  • Bladder cancer: diagnosis and management
    National Institute for Health and Care Excellence, 2015

  • EAU Guidelines on Muscle-invasive and Metastatic Bladder Cancer
    J A Witjes and others
    European Association of Urology, 2022

  • Bladder cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up.
    T Powles and others
    Annals of oncology, 2022 Volume 33, Issue 3, Page 244 - 258

  • The information on this page is based on literature searches and specialist checking. We used many references and there are too many to list here. Please contact with details of the particular issue you are interested in if you need additional references for this information.

Last reviewed: 
14 Mar 2023
Next review due: 
14 Mar 2026

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