Bladder cancer in women: why symptoms get missed

Based on reporting by ABC Health & Wellbeing, October 2026

Four years of being told it was an infection

Andrea Harris first went to her GP with what looked like a bladder infection. Four years passed before she was diagnosed with advanced, muscle-invasive bladder cancer.

In that time she went back to the doctor again and again. Each course of antibiotics would settle things for six or seven weeks, then the symptoms returned. At one point she sat in the doctor's office in tears, pressing for more extensive testing. By the time she was diagnosed in March 2024, her cancer had reached stage three.

Her story is not unusual. Specialists say it reflects a pattern: bladder cancer in women is often picked up late, because its early symptoms look so much like something far more common.

The numbers behind the delay

About 3,345 bladder cancer diagnoses were estimated in Australia last year, and three in four of them were men. Bladder cancer has long been thought of as an older man's disease, which may be part of the problem.

But the survival figures tell a different story for women. Most cancers have seen survival improve over time. Bladder cancer has gone the other way: the five-year survival rate has dropped since 1987. Today, women diagnosed with bladder cancer have roughly a 50 per cent chance of living five years, while for men it is almost 60 per cent.

Medical oncologist Dr Alison Zhang of Macquarie University Hospital says women tend to present later, with more advanced disease. That, she says, is a real problem, and one that experts want to see addressed.

Why the symptoms are so easy to miss

The warning signs of bladder cancer are largely the same in women and men. Blood in the urine and a frequent need to wee are the best known. In women, though, both are easily put down to a urinary tract infection (UTI), or to perimenopause.

Dr Magdalena Simonis, a GP and women's health expert at the University of Melbourne, explains the difference in how patients are treated. UTIs are far less common in men, so when a man has blood in his urine, whether visible or only found under a microscope, he is typically sent straight for further investigation. A woman with the same symptom, along with burning when she urinates, looks like a typical UTI patient.

The result is that men's symptoms are escalated quickly, while women can spend months or years cycling through antibiotics.

Three women, three delays

Christine La Rose, now a patient and support lead for the advocacy group BEAT Bladder Cancer Australia, was an otherwise fit and healthy 49-year-old when she was diagnosed. She was initially told the blood in her urine was caused by a UTI. Her delay was short, but she knows how much it could have mattered. She now has a neo-bladder, built by a surgeon from a piece of her intestine, and says she is grateful to be able to empty it easily and to have a good quality of life.

"I know that if I'd waited any longer, the outcome could have been much much worse," she says.

Margaret Blake saw three different GPs over six months, worried about needing to urinate frequently and finding blood in her urine. It was the third GP who first took her symptoms seriously and referred her for the tests that led to her diagnosis.

All three women, Harris, La Rose and Blake, live with the ongoing effects of their treatment.

What experts say needs to change

There is broad agreement about where to start.

More community awareness. Dr Zhang says the first step is for people to know bladder cancer is a possibility, and to know the symptoms.

Better referral pathways. Dr Simonis says women with recurrent UTIs need a closer look. That means more than two infections within six months, or three within a year. In those cases she recommends further testing, a referral to a urologist, or both.

Taking risk factors into account. Smoking and age matter. If a woman who smokes has ongoing or recurring symptoms, Dr Simonis says, the alarm bells should ring much earlier.

Taking women's pain seriously. Dr Simonis notes that women have traditionally been dismissed when they report pain or ongoing symptoms. Any discomfort that keeps happening, she says, is not something to simply put up with.

Symptoms worth getting checked

According to the experts quoted in the reporting, these are worth raising with a doctor:

• Blood in the urine

• A frequent need to wee

• A sudden change in urine colour

• Loss of appetite or weight loss

• Recurrent UTIs: more than two in six months, or three in a year

La Rose is blunt about the first one: "Blood in the urine should never be ignored; it should always be investigated."

She also points out that bladder cancer is not only a disease of older people. She has met women in their 20s, 30s and 40s who have been diagnosed.

Advocating for yourself

Both La Rose and the clinicians in the article return to the same advice. You know your body best. If something doesn't feel right, get it checked. If the answer doesn't make sense, go back or get a second opinion, and push for answers.

That is a lot to ask of someone who is already unwell, and it shouldn't have to fall on patients alone. But for now, it is the advice that people who have been through it want others to hear.

Keeping a record

One practical way to make that advocacy easier is to keep a clear record of what you are experiencing: when symptoms start, how often they come back, what treatment you were given and how long it helped. A timeline like this gives a doctor something concrete to work with, and it makes it harder for a pattern to be missed. Ovum is built for exactly this, helping you track your symptoms, cycles and medical history in one place so you can walk into appointments with a clear picture.

This article is general information, not medical advice. If you have blood in your urine or symptoms that keep coming back, speak to a doctor.

Source: ABC Health & Wellbeing, "Women's bladder cancer symptoms dismissed as UTIs, perimenopause amid calls for more awareness", by Lauren Roberts, October 2026.