Diagnosing Testicular Cancer

Several different tests are used to detect testicular cancer:
  • Physical exam and history
  • Blood tests:  Blood tests measure the levels of tumor markers, which are substances often found in higher-than-normal amounts when cancer is present. Tumor markers such as alpha-fetoprotein, Beta-human chorionic gonadotropin and lactate dehydrogenase may suggest the presence of a testicular tumor, even if it is too small to be detected by physical exams or imaging.
  • Ultrasound:  This test uses high-frequency sound waves to produce a picture called a sonogram. Ultrasound of the scrotum can show the presence and size of a mass in the testicle. It is also helpful in ruling out other conditions such as swelling due to infection or a collection of fluid unrelated to cancer.
  • Biopsy:  A biopsy is a microscopic examination of testicular tissue by a pathologist to determine whether cancer is present. In nearly all cases of suspected cancer, the entire affected testicle is removed through an incision in the groin. This procedure is called radical inguinal orchiectomy. In rare cases (for example, when a man has only one testicle), the surgeon performs an inguinal biopsy, removing a sample of tissue from the testicle through an incision in the groin and proceeding with orchiectomy only if the pathologist finds cancer cells. (The surgeon does not cut through the scrotum to remove tissue. If the problem is cancer, this procedure could cause the disease to spread.)