Key takeaways

  • Bladder cancer often starts with blood in the urine, and may cause burning or stinging while urinating. Pain typically appears with more advanced or metastatic disease.
  • Pain from bladder cancer can occur in the pelvis, lower back, or bones, and may range from mild to severe. Advanced cancer can also cause urination changes, bone pain, or pain during sex.
  • Managing bladder cancer pain may involve over-the-counter pain relievers, prescription medications, antispasmodics for bladder spasms, and complementary approaches such as acupuncture or meditation.

Bladder cancer usually starts in the innermost lining of the bladder, which holds urine. One of the most common symptoms of bladder cancer is pelvic pain or pain while urinating, which could be accompanied by other symptoms, too.

Bladder cancer can advance, growing into deeper layers of the bladder and eventually spreading to nearby lymph nodes, surrounding tissues, or even distant sites. This type of growth is called metastasis.

Several treatment methods can help you manage bladder cancer pain, but your treatment plan will depend on the severity of the cancer.

Keep reading to learn more about what bladder cancer pain may feel like, other symptoms, and how to manage them.

In its earliest stages, bladder cancer doesn’t usually cause much pain.

Most commonly, the first symptom is blood in the urine, which affects around 8 in 10 people. However, some people may experience sharp pain, stinging, or burning while urinating.

Bladder cancer pain is typically associated with metastatic bladder cancer, which is a more advanced disease. This may cause pain in the pelvic area, lower abdomen, or flanks (upper abdomen, back, and sides).

The pain can range from mild to severe. For instance, bone pain may feel dull, sharp, or severe.

Bladder cancer can cause lower back pain when it reaches a more advanced form of the disease. The pain is typically only on one side of the back but can be centrally located.

Lower back pain may occur as tumors grow or cancer cells spread to other parts of your body.

Bladder cancer can cause changes in urination. You might experience pain or a burning sensation when you urinate, and you may see blood in your urine.

You may also feel:

  • an urge to urinate more frequently than you used to
  • an urgent need to urinate even if your bladder isn’t full
  • an urge to urinate often throughout the night

Not being able to urinate can also be a sign of advanced bladder cancer.

Advanced bladder cancer can cause pain in your bones that can feel either dull or sharp.

In addition, it can sometimes cause pain in the hips and pelvis. This may occur if cancer spreads to an inner hip muscle called the iliopsoas and causes a condition known as malignant psoas syndrome.

While the outlook for this cancer-associated condition is less favorable, malignant psoas syndrome is rare.

Sex can become a painful experience while you undergo treatment for bladder cancer. Radiation can irritate the urethra of a penis, causing sharp pain during ejaculation. This pain usually resolves after treatment.

Bladder cancer surgery can also affect the ability to produce semen. This can lead to “dry orgasms,” where little or no semen comes out.

In some cases, removal of the front part of the vagina is part of urinary bladder removal. As a result, sex can become less comfortable for people with a vagina. What’s more, pelvic radiation can cause scarring, which may narrow the vagina and lead to painful sex.

Some people may also experience vaginal dryness during sex.

Sometimes, the pain associated with bladder cancer may be caused by treatment.

Research suggests that up to 6 in 10 people who undergo chemotherapy experience peripheral neuropathy, which may present as pain, numbness, tingling, or other sensations in the hands, arms, feet, or legs.

Surgery may also be a part of the treatment for bladder cancer, and this can sometimes cause pain.

Some home remedies, lifestyle changes, and medications could help you manage bladder cancer pain.

Over-the-counter (OTC) medication

Some OTC medications may help manage pain associated with bladder cancer.

However, it’s important to speak with a healthcare professional to determine the best treatment for you, as the source of the pain will guide the type of medication.

Some common examples of OTC medications for bladder cancer pain include:

  • pain relievers, such as acetaminophen (Tylenol), ibuprofen (Advil or Motrin), or aspirin, to manage mild to moderate aches and inflammation
  • capsaicin creams to help manage neuropathies
  • benzocaine (Orajel) to help manage mouth sores

Remember, it’s important to talk with a doctor before taking any medication, as some of these drugs can:

  • cause side effects and complications, such as stomach ulcers that may lead to pain and bleeding
  • interact with other medications you may be taking
  • cover up the signs of a possible infection
  • affect your cancer treatment

Prescription pain medication

In some cases, healthcare professionals may prescribe pain relievers to manage bladder cancer pain. Some examples include:

  • codeine
  • morphine
  • hydrocodone
  • oxycodone
  • diamorphine
  • fentanyl
  • buprenorphine
  • hydromorphone
  • methadone
  • tramadol

It’s crucial to speak with a healthcare professional about the risks of taking opioid pain relievers, as they can lead to dependence. They may also cause constipation and delay recovery after surgery, so they may not always be appropriate for every person with bladder cancer.

Anticonvulsants

A doctor may recommend antiseizure medications to help reduce tingling and burning sensations if you have neuropathy from cancer treatment.

Gabapentinoids, specifically gabapentin (Neurontin) and pregabalin (Lyrica, Lyrica CR), are medications that treat seizures, but they can also target nerve pain.

They’re becoming increasingly popular alternatives to opioids and may be useful for treating neuropathy that results from chemotherapy or tumor growth.

Bladder spasm medications

A bladder spasm occurs when the bladder’s muscles contract, causing a sudden, intense urge to urinate. Bladder control medications, called antispasmodics, work by blocking spasms in the bladder.

Antispasmodics are commonly prescribed to people with bladder cancer. They include:

They can help reduce the constant urge to urinate and relieve pressure in the pelvis.

Antidepressants

While antidepressants are primarily used to treat depression, some can also be used to manage tingling and burning pain.

This type of pain can often be caused by nerve damage from certain cancer treatments, such as surgery, chemotherapy, and radiation.

Other complementary pain management techniques

There is a range of complementary and alternative pain management techniques worth exploring. These include:

Many of these integrative methods haven’t been tested in scientific studies on people with bladder cancer. But they’re regarded as ways to improve your quality of life when you have a health condition.

While bladder cancer and treatment may cause discomfort and pain, there are ways to manage them.

Consider speaking with a healthcare professional if you experience pain, burning, or stinging while urinating, you have blood in your urine, or you experience other symptoms, such as pelvic pain.

A doctor can help develop an appropriate treatment plan for you or adjust your current plan to help relieve pain.

Whether you feel pain, where you feel it, and how often you feel it depends on the stage of your cancer and whether it has metastasized. It’s possible for the pain to come and go.

Signs that your bladder cancer is becoming more severe or has metastasized include bone pain, stomach pain, back pain, fatigue, or unexplained weight loss.

The most common first symptom of bladder cancer is blood in urine, also called hematuria.

Bladder cancer begins within the innermost lining of the bladder. As it spreads, it can penetrate into the deeper layers of the bladder and eventually invade muscles, bones, and other organs or tissues.

Pain often comes with this condition, so understanding what pain management treatments are available can help increase your comfort level while you’re undergoing treatment.

A healthcare professional can help develop an appropriate treatment plan tailored to your individual needs.