3. Painful urination (dysuria)
   Pain and burning during urination, also known as dysuria, are another sign of bladder cancer. It occurs because the cancer affects the lining of the bladder, causing irritation and inflammation. Pain can vary in intensity and range from a mild discomfort to a sharp, stinging sensation.

Painful urination is often associated with a urinary tract infection or sexually transmitted infection, but persistent or unexplained urination should be evaluated to rule out a more serious condition, such as bladder cancer.

4. Lower back pain
   Lower back pain, especially on one side of the body, can be a symptom of bladder cancer progression. As the cancer grows, it begins to affect the surrounding tissues and organs, which causes discomfort and pain in the pelvis and back.

Back pain requires further investigation by a health care provider if it is accompanied by muscle strain, kidney problems, persistent or unusual back pain, especially other urinary symptoms.

5. Urinary incontinence or difficulty urinating
   Bladder cancer can sometimes block the flow of urine, making it difficult to start or maintain a flow of urine. This condition can be caused by a tumor blocking the urethra or the bladder’s inability to empty properly. In severe cases, this can lead to complete urinary incontinence, requiring immediate medical attention.