How Does My Doctor Know I Have Testicular Cancer?

If you have symptoms that could be caused by testicular cancer, your doctor will run a series of tests to find out.

The symptoms of testicular cancer can also be signs of less serious problems. Inflammation of the testicles (called orchitis) or of the epididimus (called epididimitis) have symptoms like those of testicular cancer. Inflammation is a much more common cause of pain and swelling of the testicles than testicular cancer. But if you have symptoms, don’t assume you do not have cancer. If you have any signs of testicular cancer, it is important to have your doctor check them out.

Your doctor is likely to refer you to a doctor who specializes in urinary problems, called an urologist. An urologist can identify different testicular diseases and conditions.

To find out if you have testicular cancer, your doctor will do a physical exam. The doctor will also ask about your personal and family medical history. During the exam, your doctor will feel your testicles for any swelling, tender areas, or lumps. If a lump is present, your doctor will note its size and location. You may also have one or more of these tests.

• An ultrasound. An ultrasound will be done if you have a lump. This test uses sound waves to see if the lump is filled with fluid or is a solid mass. Cancerous lumps are solid.

• Blood tests. Certain blood tests can find changes that occur when you have a tumor in your testicles. These are called tumor markers. Tumor-related markers for testicular cancer are the proteins alfa fetoprotein (AFP) and human chorionic gonadotropin (HCG). Another marker is the enzyme lactate dehydrogenase (LDH). Your doctors may be able to tell what kind of testicular cancer you have based on these protein levels. If you have testicular cancer, your doctor may repeat these blood tests after you have been treated. If these blood tests show your tumor markers are still higher than normal after treatment, your cancer may have returned.

• A biopsy. If a lump is found and the doctor thinks it’s cancer, a surgeon might try to remove all of it, along with your testicle and your spermatic cord, for a test called a biopsy. The surgeon does a biopsy through a cut (called an incision) in your groin area. The surgeon should not do a biopsy of your testicles through the scrotum. If you have cancer, this could spread the cancer onto your scrotum or your other testicle. The surgeon sends the removed testicle and spermatic cord to a pathologist for testing. A pathologist is a doctor who looks at cells under the microscope to tell whether they are cancerous.