What Tests Are Done to Diagnose Testicular Cancer?

Medically Reviewed on 5/4/2021

Diagnose Testicular Cancer

Testicular cancer is generally discovered in its early stages.
Testicular cancer is generally discovered in its early stages.

Testicular cancer is generally discovered in its early stages. It may be felt as a lump during self-examination of the testes or accidentally. It may be also observed as swollen or enlarged testes. In other cases, the doctor may find a lump in the testicle during a routine physical examination. Rarely, testicular cancer may not show any signs till it is advanced or spread to other sites in the body. To determine whether a lump is a testicular cancer, the doctor may order tests.

Ultrasound of the testicles

An ultrasound of the testicles is usually the first test that looks at the nature of the lump. For this test, you need to lie down on your back. The doctor then applies a clear gel on the scrotum and moves a probe over it. The probe uses sound waves to reflect the changes in the scrotum and testicles in the form of moving images on the screen. With this test, the doctor can find out if the testicular lump is a solid mass or a fluid-filled cyst. They can also know if the lump is inside or outside the testicle.

In addition to ultrasound, the doctor may order other imaging tests after a testicular cancer diagnosis to:

  • Know how far the cancer might have spread.
  • Monitor if a particular cancer therapy is working.
  • Check if the cancer has come back after the treatment.

Imaging tests include:

  • Chest X-ray: A chest X-ray helps the doctor to see if cancer has spread to the lungs.
  • Computed tomography (CT) scan: A CT scan helps the doctor to know if testicular cancer has spread to the lymph nodes and other organs of the body.
  • Magnetic resonance imaging (MRI) scan: MRI scans give a detailed picture of the brain and spinal cord. If there is a strong suspicion that testicular cancer has spread to these areas, the doctor can order this imaging test.
  • Positron emission tomography (PET) scan: A PET scan involves injecting a dye into the vein or testes. The cancerous areas take up the dye and the highlighted areas are captured in the form of images. This test can help spot small areas of cancer cells anywhere in the body.
  • Bone scan: Testicular cancer can spread to the bones and result in symptoms such as bone pain. A bone scan helps to spot cancerous changes in the bone.

Blood tests

The levels of certain tumor markers in the blood can be studied using blood tests. Tumor markers are substances that are normally present in the blood. Their levels may increase in case of cancerous conditions, such as testicular cancer. However, having an elevated level does not always mean cancer.

After the doctor has carried out some of these tests, they determine the stage of testicular cancer based on the findings from the tests. The stages are stage I to IV. A higher stage means that the cancer has spread to other parts of the body.

Surgery to remove a testicle

If it is determined that the testicular lump may be cancerous, the doctor may recommend surgery to remove the testicle. This procedure is known as radical inguinal orchiectomy. The removed testes will be checked for the presence of cancerous cells.

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Medically Reviewed on 5/4/2021
References
Sachdeva K. Testicular Cancer. Medscape. https://emedicine.medscape.com/article/279007-overview