Tests Diagnosis of testicular cancer begins with a physical examination and may include laboratory tests for
tumor markers such as:
AFP (alpha-fetoprotein) and
hCG (human chorionic gonadotropin). One or the other of these proteins is elevated in about 85% of nonseminoma cancers. These tests can be used to help diagnose testicular cancer and, if the levels are initially elevated, they can be used to monitor response to treatment and to watch for recurrence. While AFP and hCG are only elevated in certain types of testicular cancer,
LDH (lactate dehydrogenase) may be elevated in most of them. LDH is an
enzyme found in many body tissues that is released into the bloodstream when cellular damage occurs. It is not specific for testicular cancer but can give your doctor additional information.
An ultrasound also may be done during an initial evaluation. This technology uses sound waves to visualize the presence, size, and consistency of a testicular mass (tumor) and is used to help differentiate cancer from other conditions, such as infection.
The only way to be sure whether a testicular mass is cancerous is to do a
biopsy. If a mass is found in the testes, they are usually removed and submitted to a pathologist for examination. An incision is made in the groin and the testicle and spermatic cord (which contains the vas deferens) are taken out of the scrotum. In some rare cases, a tissue sample can be tested immediately and the testicle returned to the body if the condition is not cancerous; however, in most cases, the affected testicle and spermatic cord are permanently removed.
If the lump is cancerous, a pathologist will establish what type(s) of testicular cancer is present and assist in staging the cancer (determining how far the cancer has spread). Treatment options will depend on the type(s) and stage of cancer.
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