8 Causes of Bladder Cancer Pain and What to Do About It

Pain with bladder cancer differs from case to case. An early alert of bladder cancer may be discomfort in your pelvis. A burning feeling when you pee can flag a condition related to bladder cancer, such as a urinary tract infection (UTI). Bladder cancer causes a tumor that, as it grows, can press against other body organs and trigger pain in your stomach or back. Here are eight common causes of bladder cancer pain and some ways to manage it. 

An abnormal growth called a tumor in your bladder can push against body parts near it, such as your ureters. These are tubes that take urine from your kidneys to your bladder. The pressing can trigger pain in your back or pelvis as the tumor grows. You likely will need surgery. It’s common to have some pain and a burning sensation when you pee for up to a month after surgery. Drinking lots of fluids will help you heal faster.

Muscle-invasive bladder cancer (MIBC) is an advanced stage in which the cancer reaches deep into your bladder wall to a muscle called the detrusor muscle. It’s common for the cancer to spread to tissues and fatty layers or organs beyond your bladder. You might feel pain in your bones, in one side of your lower back, or in your stomach. Treatments for MIBC include chemotherapy, surgery, or radiotherapy. 

Bladder inflammation is called cystitis. The swelling can harm the layer of cells that line and protect your bladder. Each time your body makes new cells to replace them, there’s another chance for cells to mutate and cause bladder cancer. Radiation therapy used to treat bladder cancer also can cause cystitis. You might have some pain when you pee, abdominal pressure, or pain in your pelvis.

Bladder cancer can cause irritation. You might feel burning or pain when you go, have to use the toilet a lot more, or feel an urgent need to pee when your bladder isn’t full. The symptoms might be triggered by a UTI, an overactive bladder, or bladder stones. Check with your doctor so they can find out the cause, though. Radiation therapy for bladder cancer can also irritate your bladder, too. Staying well hydrated will help ease symptoms.

Most UTIs happen in your bladder and urethra, the lower part of your urinary tract. UTI symptoms are like bladder irritation. Since bladder cancer symptoms can be similar, your doctor will likely do a cystoscopy – passing a hollow tube through your urethra to look at your bladder – to make a diagnosis.  If your UTIs are bladder cancer related, you can be treated with electrosurgery called fulguration, or electrofulguration. It uses heat and electrical currents to get rid of abnormal cells. 

Malignant psoas syndrome (MPS) is a rare condition that happens when a bladder cancer tumor advances to the iliopsoas muscle, which controls large motions such as hip flexing. MPS can cause severe pain in your back and legs. Medications can help muscle and nerve pain and spasms, such as opioids, including morphine; muscle relaxers; and anti-inflammatory meds. Your doctor might also recommend surgery, chemotherapy, radiotherapy, or in the case of extreme pain, nerve blocks.

Metastasis means the cancer has spread to another body area than your urinary tract. Metastatic bladder cancer, aka advanced bladder cancer, most often spreads to your bones, liver, lungs, or lymph nodes in your pelvis and abdominal area. You might have pain where the cancer has spread. Treatments vary based on the target area. They include chemotherapy, radiotherapy, surgery to remove cancer or unblock your urinary tract, targeted drugs and immunotherapy, and bone-strengthening drugs.  

Most medical treatments that help stop or slow bladder cancer, or keep it from coming back, come with side effects, including pain and discomfort. Besides surgery and radiotherapy, treatments that might be painful include:

• Chemotherapy-induced peripheral neuropathy (CIPN) happens if there’s nerve damage during treatment. It can cause nerve pain in your arms and legs. 
• Bacillus Calmette-Guerin (BCG) treatment is an early-stage immunotherapy that directly zeroes in on cancer cells in your bladder. Side effects include muscle or joint pain.