When to worry about blood in urine with upper tract urothelial cancer

Upper tract urothelial cancer begins in the lining of the kidney or the tube carrying urine to the bladder. Tumour-related bleeding may be visible, pink, red, or tea-coloured, and it can come and go. Clots can form and may interfere with urine leaving the body. Burning, pain in the side, fever, or worsening tiredness can also point to infection, blockage, or another problem that needs assessment.

Contact your oncology or urology team when you first notice a change, even if the urine becomes clear again. Tell them the colour, whether clots are present, any side or abdominal pain, fever, dizziness, and whether you are passing urine normally. Follow the agreed plan for scans, urine tests, blood tests, and treatment; do not stop prescribed medicines without advice. Keep hydrated unless your clinician has given you a fluid restriction.

Seek emergency help if bleeding is heavy, clots prevent urine flow, you cannot pass urine, you feel faint or confused, or you have severe pain, fever, chills, or repeated vomiting. These signs can indicate significant blood loss, infection, or urinary obstruction. Take your medication list and cancer treatment details with you if possible.

Ask whether the bleeding could reflect tumour activity, infection, a clot, or treatment effects; which symptoms should trigger an emergency visit; and whether any medicines or activities should be adjusted while the bleeding is being assessed.