How is Testicular Cancer Diagnosed?
At first, you may discover a lump in your testicle, or your doctor may find it during a routine physical exam. To find out if a lump is cancerous, your doctor may recommend:
- A physical exam and health history to check your general health and look for signs of disease. Your doctor will examine the testicles to check for lumps, swelling, or pain. A history of past illnesses will also be taken.
- Blood tests to find out the levels of certain substances, called tumor markers, in your blood. Testicular cancers make high levels of specific proteins called tumor markers. A higher level than usual of a tumor marker may be a sign of testicular cancer. Non-seminoma cancers tend to have higher levels of blood markers than pure seminomas. The following tumor markers are used to detect testicular cancer:
- Alpha-fetoprotein (AFP)
- Beta-human chorionic gonadotropin (beta-hCG)
- Lactate dehydrogenase (LDH)
- An ultrasound scan uses sound waves to create an image of the scrotum and testicles that shows its location and properties
- CT (computed tomography) scans use X-rays to create detailed images of the inside of your body. You will have a CT scan of your pelvis, abdomen, and chest to check if testicular cancer has spread to lymph nodes or other parts of your body.
- MRI (Magnetic Resonance Imaging), an imaging technique in which a radio frequency pulse emitted from the scanner in a strong magnetic field creates detailed images of soft tissues in the body. It may show more clearly than ultrasound if a tumor is cancerous and if it has spread to other parts of your body.
Testicular cancer screening
Self-screening is considered a routine screening test for early detection of testicular cancer. Often patients find a lump in their testicle, or their doctor will find it during a routine physical exam.
How is Testicular Cancer Treated?
Testicular cancer treatment options depend on the type and stage of cancer. The primary treatment is surgery, which may be followed by chemotherapy or radiation therapy to destroy any cancer cells that remain in the body.
Certain treatments for testicular cancer can cause infertility. If you wish to have children, you may consider sperm banking before having treatment. Sperm banking is the process of freezing sperm and storing it for later use.
- Surgery to remove your testicle (radical inguinal orchiectomy) is the primary treatment for most types and stages of testicular cancer. To remove your testicle, your surgeon will make an incision in your groin and will extract the testicle. In cases of early-stage testicular cancer, surgical removal of the testicle may be the only treatment needed. A prosthetic testicle can be inserted.
- Surgery to remove lymph nodes (retroperitoneal lymph node dissection) is performed through an incision in your abdomen if needed
- Radiation therapy, a cancer treatment that uses high-energy X-rays directed toward the area with cancer, destroys the cancer cells and prevents them from re-growing
- Chemotherapy is a cancer treatment that uses drugs to kill cancer cells. Chemotherapy is often injected into a vein or taken in pill form. However, for testicular cancer, there is no pill form of chemo. The drugs reach cancer cells in the body through the bloodstream.
- High-dose chemotherapy with stem cell transplant helps to replace blood-forming cells that cancer treatment with high-dose chemotherapy has destroyed. Stem cells from your blood, bone marrow, or a donor’s, will be withdrawn and stored. The stem cells will be given to you by infusion after chemotherapy is completed. The stem cells will grow and restore your blood cells.
- After testicular cancer treatment, your doctor will monitor your condition closely. You will have certain exams and tests on a regular schedule to check for any early signs that cancer has returned.
- A fluorodeoxyglucose (FDG)-positron emission tomography (PET) is occasionally used after treatment to ensure cancer has not returned
Survival rates are the percentage of people with the same type and stage of cancer who are alive a certain amount of time (usually five years) after they were diagnosed. The five-year survival rate in the United States based on the stage of cancer, or how much it has spread is as follows:
|Overall - To all people with testicular
|Localized - The cancer has not spread outside of the testicles
|Regional -The cancer has spread to nearby lymph nodes nearby structures
|Distant - The cancer has spread to distant lymph nodes and other parts of the body, for example, lung or liver
Some men with testicular cancer have no symptoms. You may feel a lump in the testicle, or the testicle will become more swollen. You may feel a dull pain in your lower abdomen or groin.
You can perform a testicular self-exam at home:
- Hold your penis and examine each testicle separately
- Hold your testicle between your thumbs and fingers of both hands and roll it gently
- Look for changes in the size, shape, or feel of your testicles. Pay attention to any hard lumps or round masses.
Because testicular cancer exists inside the body, there is no change in outward appearance. You may feel a lump in the testicle.
The most common sign of testicular cancer is swelling or a lump in a testicle, which typically does not cause pain. If you notice any changes in your testicles, you should see a doctor who will examine you and order tests to find the cause of the changes and confirm a testicular cancer diagnosis.
The first symptom of testicular cancer is usually a lump in the testicle, or the testicle becomes swollen or larger without pain. You may feel a dull ache in your lower abdomen or groin.
Testicular cancer starts in germ cells, the cells that make sperm, in a testicle. Testicular cancer is treatable, even when the cancer has spread. When testicular cancer spreads, it often spreads to the lung and the lymph nodes of the chest, pelvis, and the base of the neck. In advanced stages, it may spread to the liver and bones.
Trust NewYork-Presbyterian for Testicular Cancer Treatment
At NewYork-Presbyterian, our testicular cancer specialists are highly experienced in diagnosing and treating testicular cancers. Our collaborative team of urologists, surgeons, pathologists, fertility and sexual health specialists, medical and radiation oncologists, and oncology nurses offers comprehensive care, choosing the most effective treatment course for you. Contact us to schedule an appointment.