Testicular Cancer Diagnosis

Testicular cancer may be spotted in a number of ways. Lumps on testicles may be noticed by men during their monthly testicular self exam (TSE). Infertility blood tests and ultrasound imaging may yield results that suggest cancer. Other times, diagnosis may begin with a complaint of pain, a swollen scrotum, or even lower back pain. No matter what the original complaint, a diagnosis of testicular cancer will begin with a physical examination of the testicles.

Ultrasound and Testicular Tumors

An ultrasound may be used to examine the interior of the testicles. The ultrasound uses high frequency sound waves that are delivered to the testicles through the scrotum. Ultrasound waves transmit an image of the testicles back to a monitor, where evidence of a tumor may be detected. An ultrasound is noninvasive and painless.

Measuring AFP and HCG Levels with Blood Tests

Testicular Self Exam (TSE)Blood tests are used to check for testicular cancer markers, most notably AFP and HCG levels. Blood tests are most helpful for diagnosing early stage testicular cancer, where physical exams and even ultrasound may be unable to detect tumors.

AFP stands for alpha-fetoprotein. Blood tests reveal high levels of AFP in 85 percent of non-seminoma testicular cancer. Along with AFP, blood tests may also reveal high HCG levels. HCG stands for human chorionic gonadotropin. High HCG levels can be responsible for breast tissue growth in certain types of testicular cancer.

Biopsy and Testicle Removal

Although ultrasound and blood tests can help make a diagnosis, the only way to determine definitively if testicular tumors are cancerous is to perform a biopsy. A biopsy removes a portion of tissue which is then examined by an urologist. An urologist specializes in the treatment and diagnosis of genital disorders.

Removing the entire testicle during biopsy is the usual practice. The testicle is then examined for evidence of malignant tumors, and whether the cancer has spread beyond the testicles. Although the removal of a testicle is disturbing to most men, sexual function and even reproduction are possible with only one testicle. By removing the entire testicle, the biopsy often halts the spread of the disease.

Staging Testicular Cancer

Once a diagnosis of cancer is confirmed, the urologist can determine the stage of the disease. The stage of testicular cancer determines which treatments to pursue. The three stages of testicular cancer are

Stage I: The cancer is confined to the testicle.

Stage II: The cancer has spread from the testicle to local lymph nodes.

Stage III: Distant metastasis has occurred.


Beers, M. H.