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Testicular Cancer: Diagnosis

How is testicular cancer diagnosed?

If your healthcare provider thinks you might have testicular cancer, you will need certain exams and tests to be sure. Diagnosing testicular cancer starts with your healthcare provider asking you questions. He or she will likely ask you about your health history, your symptoms, risk factors, and family history of disease. 

Your provider will also give you a physical exam. During the exam, your doctor will feel your testicles for any swelling, tender areas, or lumps. If a lump is present, your doctor will note its size and location. The doctor may also look carefully at your belly (abdomen), groin, and other parts of your body. This is to find possible signs that any tumors may have spread. 

What tests might I need?

You may have one or more of these tests:

  • An ultrasound of the testicles. An ultrasound will often be the first test done if you have a lump on or near your testicle. This test uses sound waves to see if the lump is filled with fluid or is a solid mass. Solid lumps are more likely to be cancer.

  • Blood tests. Blood levels of certain proteins often change if you have testicular cancer. These proteins are called tumor markers. The main tumor markers for testicular cancer are alpha-fetoprotein (AFP) and human chorionic gonadotropin (HCG). Another marker is the enzyme lactate dehydrogenase (LDH). Your doctors may be able to tell what kind of testicular cancer you have based on these marker levels. If you have testicular cancer, your doctor may repeat these blood tests during and after treatment to see how well it is working. 

  • Surgery to remove the testicle. If a lump is found and the doctor thinks it is cancer, a surgeon will most likely try to remove all of it. The surgeon may also remove your testicle and your spermatic cord. This operation is called a radical inguinal orchiectomy. This is different from how many other types of cancer are diagnosed. For those, often only a small piece of a suspected tumor is removed (biopsied) to make the diagnosis. The surgeon removes the testicle and cord through a cut (incision) above your pubic area. The surgeon does not do this surgery through the scrotum. This is because if you have cancer, the surgery could spread the cancer onto your scrotum or your other testicle. The surgeon sends the removed testicle and spermatic cord to a pathologist for testing. A pathologist is a doctor who looks at cells under the microscope to tell whether or not they are cancer.

Getting your test results

When your healthcare provider has the results of your biopsy, he or she will contact you with the results. Your provider will talk with you about other tests you may need if testicular cancer is found. Make sure you understand the results and what follow-up you need.

Online Medical Reviewer: Alteri, Richard, MD
Online Medical Reviewer: MMI board-certified, academically affiliated clinician
Date Last Reviewed: 11/15/2015
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