Testicular Cancer Diagnosis

If testicular cancer is suspected, your doctor may perform one or more of the following to confirm a diagnosis:

  • Physical exam. Your doctor will check for general signs of health, including examining the testicles for lumps, swelling, pain or anything else that seems unusual.
  • Ultrasound. A testicular ultrasound is an imaging procedure that examines the testicles and other parts inside the scrotum. The ultrasound machine sends out high-frequency sound waves, which reflect off areas in the scrotum to create a picture.
  • Serum tumor marker tests. A sample of blood is examined to measure the amounts of certain substances released into the blood by organs, tissues, or tumor cells in the body. Certain substances are linked to specific types of cancer when found in increased levels in the blood. These are called tumor markers. The following three tumor markers are used to detect testicular cancer:
    • Alpha-fetoprotein (AFP) is a protein that’s normally produced by a fetus and is usually undetectable in the blood of healthy adult men or women (who are not pregnant). An elevated level of AFP suggests the presence of either a primary liver cancer or germ cell tumor.
    • Beta-human chorionic gonadotropin (β-hCG) is a hormone normally found in the blood and urine of women during pregnancy. It may also be produced by some tumor cells. An increased level of beta-human chorionic gonadotropin may be a sign of cancer of the testis, uterus, ovary, liver, stomach, pancreas, or lung. Beta-human chorionic gonadotropin may also be produced in response to certain conditions that are not cancer.
    • Lactate dehydrogenase (LDH) is one of a group of enzymes found in the blood and other body tissues and involved in energy production in cells. An increased amount of lactate dehydrogenase in the blood may be a sign of tissue damage and some types of cancer or other diseases. Also called lactic acid dehydrogenase and LDH.

Why no biopsy?

With many tumor types, a biopsy to remove a sample of tissue or cells from the tumor, is performed so that a pathologist can examine it under a microscope to determine whether the cells are indeed cancer. With testicular cancer however, taking a biopsy of the tumor can cause the cancer cells to spread. Therefore, surgery to remove the entire testicle is performed rather than a biopsy.

Can testicular cancer spread?

Like other cancers, testicular cancer can spread beyond the primary tumor site. Your physician team will use one or more of the following to learn whether the cancer remains confined to the testicles or has spread elsewhere, to lymph nodes, lungs, bones or other areas.

  • Chest X-ray. A chest x-ray is an x-ray of the chest, lungs, heart, large arteries, ribs, and diaphragm.
  • CT scan (CAT scan). An x-ray machine linked to a computer takes a series of detailed pictures of the urinary tract and any tumors present. The patient may receive an injection of dye so the bladder and urethra show up clearly.
  • MRI (Magnetic Resonance Imaging). MRI uses a large magnet, a computer, and radio waves to look inside your body.
  • Radionuclide bone scan. A bone scan identifies changes or problem areas in the bones of your body. The bone scan is a painless test in which images of all the bones in your body are taken by using a small amount of radioactive material and special scanning equipment.

How is testicular cancer treated?Testicular cancer staging