Testicular Cancer Diagnosis: Right from the Start

  • Thomas Schwaab, MD, PhD, diagnoses and treats testicular cancer along with a team of multidisciplinary specialists.

If testicular cancer is suspected, your doctor may perform one or more of the following procedures:

  • Physical exam: The doctor checks general signs of health, including checking 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 test: A procedure in which 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): A protein normally produced by a fetus. AFP levels are 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): A hormone normally found in the blood and urine 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): 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.

Classifying Your Cancer

The following tests may be performed to evaluate whether the cancer has spread beyond the testicles:

  • 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 reliable and 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.