Kidney cancer doesn’t usually cause noticeable symptoms in its early stages. Many people are diagnosed after imaging tests are done for another reason. But if a tumor grows or affects nearby structures, symptoms can develop. These may include fatigue, loss of appetite, unexplained weight loss, and even changes to urination.

Some urinary symptoms may seem mild at first or easy to explain away. Others can be confusing because they overlap with common conditions.

Still, it’s important to pay attention to bladder symptoms. Recognizing these symptoms early and talking openly with your doctor can help you get the care you need.

Below are seven urinary symptoms of kidney cancer, including what they may feel like and how kidney cancer can cause them.

1. Blood in the Urine

Blood in the urine, called hematuria, is the most common urinary symptom of kidney cancer. The tumor in the kidney invades or erodes into the renal collecting system, causing blood to enter the urine. Even small amounts of blood can change the color of urine.

Blood in urine can appear as a variety of different colors, including:

• Pink
• Red
• Brown
• Cola-colored
• Normal, with blood only visible under a microscope

Hematuria can come and go. You might notice blood once, then not again for weeks or months. That doesn’t mean the problem has been resolved.

For some, this is the only symptom of kidney cancer. One member of MyKidneyCancerTeam shared, “My husband, who has metastatic kidney cancer, only has occasional blood in his urine and fatigue.”

Others list this among many other symptoms. “I’m having pain, vomiting, and lots of bloody urine,” shared another member.

Although blood in the urine is one of the most common kidney cancer signs, it can also be caused by other issues. These include infections, kidney stones, bladder cancer, prostate cancer, or other conditions.

Medical experts say that any blood in the urine should be treated as serious until proven otherwise. Evaluation by a healthcare professional, such as a urologist, is important. Never ignore blood in your urine, even if it happens only once or goes away.

2. Frequent Urination

Needing to urinate more often than usual, especially without drinking more fluids, can be another sign of kidney cancer. Frequent urination is not a common direct symptom of kidney cancer, but it may occur if the tumor affects nearby structures or as a result of conditions that can accompany kidney cancer.

Frequent urination can involve:

• Going to the bathroom more often during the day
• Passing only small amounts of urine at a time

This symptom overlaps with many other conditions, including diabetes, prostate problems, and urinary tract infections. Still, persistent changes in urination patterns deserve medical attention. If frequent urination is affecting your daily routine or sleep, discuss it with your care team.

3. Nighttime Urination

Waking up multiple times during the night to urinate is called nocturia. Nocturia is not a common direct symptom of kidney cancer, but it may occur secondary to other conditions associated with kidney cancer or its treatment.

Nocturia can disrupt sleep and contribute to fatigue, which may already be a concern during cancer treatment.

You might notice:

• Waking up two or more times each night to urinate
• Difficulty falling back asleep
• Feeling tired during the day

If nighttime urination is affecting your sleep, your care team may be able to help.

4. Pain or Burning During Urination

Pain, burning, or discomfort while urinating is also called dysuria. It can occur with kidney cancer, although it’s more commonly linked with infections. Most of the time, kidney cancer causes back, rib, or hip pain, not necessarily pain with urination.

“I have severe back pain all the time,” one member shared. However, other members notice pain more specifically when using the bathroom. “I feel like I’m losing my mind. The pain is so bad, and I can’t pee when I’m hurting like that,” shared a member.

Kidney cancer may cause pain with urination if:

• The tumor irritates the urinary tract
• Bleeding or inflammation occurs
• A urinary tract infection develops alongside cancer

Dysuria can feel like:

• Burning or stinging while urinating
• Pressure in the bladder or urethra
• Discomfort that continues after urination

This symptom overlaps strongly with urinary tract infections (UTIs). For that reason, it can be misinterpreted or treated repeatedly before cancer is diagnosed.

5. Recurrent or Persistent Urinary Tract Infections

A UTI is a common condition caused by bacteria entering the urinary system. But repeated UTIs, especially in adults who don’t usually get them, can sometimes be linked to kidney or bladder cancer. “My ribs hurt, and I feel a UTI coming on,” said one member whose kidney cancer had returned.

Kidney cancer and UTIs may be connected by a tumor:

• Blocking normal urine flow
• Causing irritation or inflammation
• Weakening the body’s defenses

Recurring UTIs or symptoms that return quickly after treatment may be a warning sign requiring further review. If you’re having frequent infections, it’s important to tell your care team. This is especially true if symptoms include blood in the urine, fever, or back pain.

6. Difficulty Urinating or Feeling Unable to Fully Empty the Bladder

Some people with kidney cancer have problems starting urination or feel like their bladder doesn’t empty completely. This symptom can occur if a tumor affects urine flow or presses on nearby structures.

You might notice:

• Straining to begin urination
• Weak urine stream
• Feeling the need to urinate again soon after finishing

These symptoms are not typical of early kidney cancer. They may occur in advanced cases where a large tumor causes significant compression of nearby structures, but are far more commonly caused by prostate enlargement or bladder conditions

7. Urinary Incontinence

Urinary incontinence (accidental leakage of urine) is more often a side effect of kidney cancer treatment than the cancer itself. For example, surgery in the abdominal or pelvic area, or the effects of anesthesia and prolonged immobility, may temporarily affect bladder function. Radiation therapy and certain medications may also cause incontinence.

Possible causes of kidney cancer incontinence include:

• Nerve damage during surgery
• Weak pelvic floor muscles
• Changes in bladder function

The good news is that incontinence is often manageable, with treatment options such as:

• Pelvic floor exercises
• Medications
• Bladder training
• Referral to a specialist

If you’re experiencing urinary leakage, know that this is a common and treatable issue. Your care team can help you find solutions that improve your comfort and confidence.

When To Talk With Your Care Team

Any new or worsening urinary symptom deserves attention. This is especially true if it persists, interferes with daily life, or causes concern.

Contact your healthcare provider promptly if you notice:

• Blood in your urine
• Repeated urinary infections
• Sudden changes in urination patterns
• Painful urination

Even symptoms that seem minor can affect quality of life. Speaking openly with your kidney cancer care team about symptoms and treatment side effects helps ensure you receive the right evaluation and support.

Paying attention to changes in your body and discussing them with your care team is one of the most important steps you can take. Early evaluation can help identify the cause, guide treatment, and improve your quality of life.

Join the Conversation

On MyKidneyCancerTeam, people share their experiences with kidney cancer, get advice, and find support from others who understand.

Have you experienced urinary changes from kidney cancer? Let others know in a comment below.