What is the most common presenting symptom of bladder cancer?

The most common presenting symptom of bladder cancer is painless intermittent gross hematuria, which is blood in the urine that can be visibly noticed. This symptom is significant because it is often one of the earliest indicators of bladder cancer, prompting individuals to seek medical evaluation. The blood may appear intermittently and can vary in appearance, which often leads patients to initially overlook or minimize the symptom until it becomes more prominent.

While other symptoms like painful urination, frequent urination at night, and lower abdominal pain can occur in individuals with bladder cancer, they are not as distinctively associated with the disease as hematuria. Painless hematuria tends to be more alarming and thus more likely to lead to a clinical diagnosis. The absence of pain is particularly notable, as many patients might not associate bladder issues with cancer until they observe this alarming symptom. This is why painless intermittent gross hematuria is the hallmark symptom of bladder cancer and is crucial for early detection and intervention.