Tests Diagnosis of testicular cancer begins with a physical examination and may include laboratory tests for
tumour markers, such as
AFP (alpha-fetoprotein) and
hCG (human chorionic gonadotropin). One or the other of these proteins is elevated in about 85% of non-seminoma 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 elevated only 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 technique uses sound waves to visualize the presence, size, and consistency of a testicular mass (tumour) 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. 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 vas deferens are permanently removed.
If the lump is cancerous, a pathologist will establish what type of testicular cancer is present and assist in determining how far the cancer has spread (staging the cancer). Treatment options will depend on the type and stage of cancer.