How is Testicular Cancer Diagnosed?

Testicular Self-Exam

The best time to do a testicular self-exam is after a warm bath or shower, while standing, when the scrotum is relaxed. It only takes a few minutes. To start:

  1. Check each testicle. Gently but firmly roll each testicle between the thumb and forefingers. Feel the whole surface. The firmness of the testis should be the same all around. It’s normal for one testis to be slightly larger than the other.
  2. Find the epididymis and vas deferens. These are soft, tube-like structures above and behind the testicle. These tubes collect and carry sperm. Just become familiar with how these cords feel.
  3. Look for lumps, swelling or things that don’t seem right. Lumps or bumps are not normal (even if they cause no pain). Pain is not normal.
  4. Check yourself at least once per month. Always look for any changes in size, shape, or texture.

If you notice a lump or any changes over time, you should seek medical help. It may be nothing, but if it is testicular cancer, it can spread very quickly. When found early, testicular cancer is very curable. If you have any questions or concerns, talk to your urologist.

Medical Exam

  • Health record and physical exam: Your urologist will talk with you about your health. They will examine your scrotum, belly (abdomen), lymph nodes, and other parts to look for signs of cancer. They will look for lumps, firmness or signs of swelling. Tell them if you have a history of undescended testes.
  • Testicular ultrasound: This imaging test is used to see inside the scrotum and to check a suspicious lump. Other scans or x-rays may be done if your doctor would like to see inside your chest or abdomen. This is done to see if cancer has spread to lymph nodes, the lungs or liver. MRIs are rarely used, but needed in some cases to check the brain and spinal cord.
  • Blood test: A blood test is taken to check tumor markers. These are proteins and hormones made by some testicular cancers. AFP, ACG and LDH tumor markers rise with some cancers but many testicular cancers will not produce tumor markers. In other words, just because tumor markers are normal does not mean that you are free of cancer. It’s of great value to ask your doctor about your tumor maker levels and learn what’s normal vs. not normal.
    • Serum Tumor Marker Test: Tumor markers (AFP, HCG, and LDH) should be measured before any treatment, such as surgery. If cancer is found, tumor marker tests will be repeated after treatment to track how well you’re doing over time. Some medicines and marijuana can create false positive levels of HCG. Tell your doctor about your medicine and/or marijuana use.
      • Pure seminomas can raise HCG levels but never AFP levels.
      • Non-seminomas often raise AFP and/or HCG levels.
      • Over the counter urinary pregnancy tests do check for HCG levels in the urine but are not reliable tests for testicular cancer.