Dear Dr. Garner,
I am very scared. When I got up to go to the bathroom today, my urine looked bloody.
I never had anything like this before. It really doesn’t hurt. It is more the sight of it that bothers me.
I am 58 years old, and aside from smoking, I am fine with no problems.
Do you think I have cancer? I am afraid to even call my doctor for an appointment. I am hoping it just goes away.
Please help me. How worried should I be?
Red Urine in Red Hook

Dear Red Urine,
Before addressing your question, I would like to bring our readers up to date on the Ask the Doctor TV Show.
We will be returning early September, for all new shows in season number 17.
For those who need an extra “fix” of the show, I will be doing an Ask the Doctor session at the Health Fair that my good friend, Dr. Emil Baccash, organizes each year at the Virgin Mary Church, 216 Eighth Ave., Park Slope – 11215, at 1 p.m. on Sunday, May 6.  It will be great to see who can come.
Bleeding in the urine is known as hematuria (hē-mə-t(y)ur-ē-ə\).
There are two types of hematuria. In one type, the urine looks normal and a microscope is required to detect the blood cells.  In the second type, there is bleeding that changes the color of the urine, and is known as gross hematuria.
In some cases the bleeding may go away on its own. An example of this is urine in the blood that comes from strenuous exercise.
It takes very little blood to cause the urine to change colors. It usually isn’t painful and there may be no other symptoms present.  Blood can come from any part of the urinary system, which includes the kidneys, bladder and ureter (tubes that carry urine from the kidneys to the bladder), and in men, the prostate, as well.
Some causes of blood in the urine include:
1. Urinary tract infections – The symptoms present include an urge to urinate, pain or burning with urination and a peculiar smell to the urine.
2. Bladder or kidney stone – The stones can cause either gross or microscopic blood in the urine, and usually has pain associated with it.
3. Enlarged prostate – There may be difficulty urinating, whether gross or microscopic blood is in the urine. Infection of the prostate known as prostitis can cause the same signs and symptoms.
4. Kidney diseases – Certain infections can cause the kidney cells to inflame. With the swelling of the kidney, the blood vessels become swollen as well, and blood can leak into the urine.
5. Cancer – yes, the dreaded “c” word can be a cause, although not that common.
6. Kidney injuries – this usually happens as a result of a car accident, fall, or sports injury.  There can be      microscopic blood or bright red bleeding in the urine.
7. Medication – aspirin, penicillin, heparin blood thinners, and certain anti-cancer drugs can cause blood in the urine.
8. Strenuous exercise can cause gross or microscopic bleeding.
9. Certain medications or food can cause the urine to change colors.  Examples of this are beets, berries, and rhubarb.  There is no blood in the urine in this instance.
It is important to see your doctor at once should you see any evidence of blood in the urine.
To help diagnose the problem, your doctor, may order urine tests, as well as a CT scan, sonogram, or MRI, to get a good look at the whole urinary system, including the kidneys, bladder, and ureters.
Sometimes the doctor will use a mini camera that goes directly into the bladder to determine if there are any tumors, infection, or pre-cancerous growth.
The treatment for hematuria will depend on the underlying condition.  An example would be treating an infection of the kidneys with antibiotics.
Sometimes no treatment is necessary and the condition resolves on its own.
The bottom line is that your bleeding is most likely not caused by cancer, but you do need to have the problem checked out.  Best of luck  and please keep me informed of your condition.
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Dr. Garner, a Fidelis Care provider is affiliated with New York Methodist Hospital, Park Slope.  He also is the host of “Ask the Doctor”