Diagnosis of Testicular Cancer
Most often with testicular cancer, you will find a painless mass in your scrotum. At other times, either the mass will be discovered during a routine health check-up or it will be painful. Painful masses are likely to be infections (
Your doctor will ask about your symptoms and medical history and perform a physical exam, including a careful exam of your testes.
Diagnostic Tests for Testicular Cancer
Your doctor may do some of the following tests:
Blood Tests —A sample of your blood is taken and the levels of certain tumor markers are measured. Tumor markers are chemicals that sometimes appear in the blood if cancer is present in the body.
Testicular cancer produces two markers: alpha fetoprotein (AFP) and human chorionic gonadotropin (hCG). These chemicals not only help diagnose the disease, they are also used to monitor the success of treatment.
Another substance in the blood, the liver enzyme LDH, is usually elevated in advanced cases of cancer. It may be measured to help diagnosis and to monitor the success of treatments.
Ultrasonography —Ultrasound is the key test in diagnosing testicular cancer. It uses sound waves to find tumors. If it shows a mass that is solid, the testicle will most likely be removed.
—This test provides detailed computerized x-ray images of any part of your body and can be used to help determine if the cancer has spread.
The CT scan is usually taken of the
Staging of Testicular Cancer
If cancer is found, the treatment and chance for cure depend on the tumor type, location, size, stage of the cancer, and your general health. For most stages of disease the cure rate is currently over 90%.
Ninety-five percent of testicular cancers are of a type called germ cell tumors. There are two major types of germ cell tumors: seminomas and nonseminomas. There are several types of nonseminomas, all of which tend to be more aggressive than most seminomas. They are distinguished with microscopic examination as well as by blood tests for tumor markers. Some tumors may have more than one cell type. Nonseminomas are less easily cured than seminomas.
Staging is a careful attempt to determine whether the cancer has spread and, if it has, what body parts are affected. Staging of testicular cancer considers both the growth of the tumor and the involvement of the lymph nodes. The following stages are used to classify testicular cancer:
Tis ( in situ )—The cancer is very localized and has not spread to other areas.
T1 —The tumor is limited to the testis and epididymis, without having spread to nearby blood vessels.
T2 —The tumor is limited to the testis and epididymis and has spread to the blood vessels or into the thin skin surrounding the inside of the scrotum (called the tunica vaginalis).
T3 —The tumor has spread to the spermatic cord.
T4 —The tumor has spread into the wall of the scrotum.
N1 —lymph node with 2 centimeters (cm) or less of cancer
N2 —lymph node with 2-5 cm of cancer
N3 —lymph node with more than 5 cm of cancer
Columbia Presbyterian Medical Center website. Available at: http://cpmcnet.columbia.edu/ . Accessed January 31, 2006.
Fauci AS, Braunwald E, Isselbacher KJ, et al. Harrison's Principles of Internal Medicine. 14th ed. New York, NY: The McGraw-Hill Companies; 2000.
Last reviewed November 2009 by
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