Bladder Cancer Awareness: Know the Symptoms, Risks, and Care

By: John G. Mancini, MD

When University of Colorado football coach Deion Sanders was diagnosed with an aggressive form of bladder cancer in the spring of 2025, he was one of 1,200 Coloradans to learn they had the disease. Yet by the end of that summer, “Coach Prime’s” doctors declared him cancer-free following robotic surgery.

This places him among the 79% of bladder cancer patients who survive at least five years.

Indeed, death rates from bladder cancer have been slightly declining in recent years, and cases of the disease are down by about 1% annually. The improved numbers could be a result of raised awareness, possibly from cases such as Sanders’ as well as efforts like Bladder Health Awareness Month (November).

How certain are you that you would recognize the symptoms of bladder cancer?

Visit our Bladder Cancer web page

Bladder Basics: Where It Is and What It Does

Your bladder is a hollow, expandable organ in your lower abdomen with one role: to store and release urine. It receives the urine from your kidneys through two tubes called ureters, slowly stretching it to capacity (about 6 inches).

When your bladder nears full, roughly 1.5 cups to 2 cups of urine on average, it receives signals from your brain to contract its muscular walls and push the urine out. At the same time, your brain alerts you that it’s time to go. This cycle repeats seven to eight times a day.

Typically, a healthy bladder can hold urine for three to five hours comfortably and without harm, so you should have time to locate a bathroom. That is, unless an irregularity in nerve function or other abnormality causes the bladder to involuntarily push out urine.

Bladder Cancer Causes, Forms, and Risk Factors

Cancer forms when the DNA in your cells mutates and the genetic information the DNA carries goes off course. These mutations might be inherited, or they may develop from chemical or toxin exposure. Sometimes, mistakes just occur when the cells divide.

Your body usually can fix these changes, but if the DNA mutation persists and builds up, normal cells will begin to divide uncontrollably and without dying, growing into tumors that invade your organs and tissues. These cells have transformed into cancer cells.

In cases of bladder cancer, the tumor grows in the bladder lining or urethra. It takes two forms: non-muscle invasive bladder cancer (NMIBC), in which the cancer has not penetrated the bladder wall muscle; and muscle-invasive bladder cancer (MIBC), when the cancer has spread into the muscle.

Both forms are classified by aggressiveness (grade) and the extent of their growth within or outside the bladder wall (stage). Your risks of bladder cancer may contribute to the form, stage, and grade. Risk factors include:

• Being male – Bladder cancer is the fourth most common cancer in men, accounting for 75% of cases.
• Age – Nearly 90% of people diagnosed with bladder cancer are older than 55.
• Smoking – Smokers are at three-times greater risk of developing bladder cancer than non-smokers.
• Extended exposure to industrial chemicals – Professions in textiles, painting, machining, firefighting, truck driving, and hair salons are associated with bladder cancer, according to the American Cancer Society.
• Previous chemotherapy or radiation – Those who received chemotherapy or radiation near the bladder (including the prostate) may be more likely to develop bladder cancer.

Early- and Advanced-Stage Symptoms of Bladder Cancer

Bladder cancer does not often present noticeable symptoms in the early stages, so even mild changes in urination might warrant attention. All symptoms include:

• Pink to reddish urine (indicating blood)
• Having to urinate more frequently and urgently
• Straining to pass urine
• Pain in the lower pelvis or back
• Appetite loss (advanced cancer)
• Feeling weak and tired (advanced cancer)
• Bone pain (advanced cancer)

How Bladder Cancer Is Diagnosed and Staged

Should you experience any of the above symptoms, it is likely time to see a doctor. A urologist can perform the following diagnostic tests to detect bladder cancer:

• Screenings that can detect blood or an infection in the urine.
• A lab analysis that examines urine cells for cancer.
• Internal imaging through a CT scan, MRI, or a camera-equipped scope fed into the urethra (cystoscopy).

Test results should help indicate the cancer’s stage, or how far it has spread (metastasized). Early, non-invasive bladder cancer is categorized as Stage 0. The other stages are:

• Stage I – This form of non-muscle invasive bladder cancer exists only in the connective tissue of the bladder.
• Stage II – The tumor has grown into the bladder muscle, making it a muscle-invasive cancer.
• Stage III – The cancer has spread beyond the bladder muscle to surrounding tissue, including the prostate, uterus, vagina, and (potentially) lymph nodes.
• Stage IV (metastatic) – The cancer has reached the lymph nodes, pelvic wall, abdominal wall, and/or the lungs, bones, and liver.

How Your Doctor Treats Bladder Cancer: What to Expect

Depending on the bladder cancer stage, aggressiveness, and chances of recurrence, your doctor will advise the following advanced-treatment options:

Minimally-invasive (often non-muscle invasive bladder cancer) treatments:

• Surgical removal – The first step to treating early-stage bladder cancer is usually removal through a minimally invasive procedure called a transurethral resection of the bladder (TURB). Here, a slender tube is threaded into the urethra and is fed small surgical instruments to remove the tissue. This procedure might first be performed as part of a diagnosis.
• Drug treatments ­– Immunotherapy or chemotherapy drugs are introduced directly into the bladder, a process called intravesical therapy.

Stages II and III bladder cancer (often muscle-invasive) treatments:

• Partial or radical cystectomy ­– In this approach, the surgeon removes part or all of the bladder, depending on the tumor’s growth. Nearby lymph nodes and (possibly) organs might also be removed. The surgeon will then build an artificial bladder using part of your intestine. When performed robotically, a cystectomy requires smaller incisions for a faster recovery.
• Chemotherapy – Often, patients receive chemotherapy drug treatment before surgery to shrink the tumor and prevent it from recurring.
• Chemotherapy and radiation – Patients who cannot or do not want to undergo surgery can take a combination of chemotherapy and radiation to destroy cancer cells. Radiation therapy also may be introduced with other drug treatments.
• Immunotherapies – These drugs, delivered directly into the bladder, guide your own immune cells to destroy cancer cells.

Stage IV bladder cancer treatment:

• Chemotherapy – In cases where the cancer is too advanced to remove with surgery, the doctor will consider one of several chemotherapy drug options.

Your Bladder Cancer Awareness Can Help Others

Deion “Coach Prime” Sanders might have saved lives by raising bladder cancer awareness and encouraging others to get examined. You can do the same. Talk about the common symptoms and get checked yourself. You don’t have to be a star athlete, but you can become a star.

If you have questions about your bladder or overall urinary health, you can find a nearby provider at one of our two Colorado Springs locations here. Learn how to prepare for your visit at Colorado Springs Urology.