Typically the first symptom, the first indication that a patient might have a bladder tumor is noticing visible blood in the urine. The urine might look pink, red, or actual blood color, or the patient may notice passage of a blood clot. Very important to understand that this might only happen one time and then never happen again. If a patient notices blood in the urine, only once, it still requires an evaluation. Typically passing blood will not be painful. If a bladder tumor doesn’t cause blood in the urine, sometimes it causes a feeling of very strong urges to urinate or having to urinate very frequently. Where the pattern of urination has changed from what it was previously. So there’s two broad ways that symptoms can occur. Either blood or increased urinary irritation.