In some cases men discover testicular cancer themselves, either unintentionally or while doing a testicular self-examination to check for lumps. In other cases, your doctor may detect a lump during a routine physical exam.
To determine whether a lump is testicular cancer, your doctor may recommend:
Ultrasound. A testicular ultrasound test uses sound waves to create an image of the scrotum and testicles. During an ultrasound you lie on your back with your legs spread. Your doctor then applies a clear gel to your scrotum. A hand-held probe is moved over your scrotum to make the ultrasound image.
An ultrasound test can help your doctor determine the nature of any testicular lumps, such as whether the lumps are solid or fluid-filled. An ultrasound also tells your doctor whether lumps are inside or outside of the testicle.
- Blood tests. Your doctor may order tests to determine the levels of tumor markers in your blood. Tumor markers are substances that occur normally in your blood, but the levels of these substances may be elevated in certain situations, including testicular cancer. A high level of a tumor marker in your blood doesn't mean you have cancer, but it may help your doctor in determining your diagnosis.
- Surgery to remove a testicle (radical inguinal orchiectomy). If it's determined that the lump on your testicle may be cancerous, surgery to remove the testicle may be recommended. Your removed testicle will be analyzed to determine if the lump is cancerous and, if so, what type of cancer.
Going over diagnosis for testicular cancer
A Mayo Clinic oncologist discusses aspects of testicular cancer diagnosis.
Determining the type of cancer
Your extracted testicle will be analyzed to determine the type of testicular cancer. The type of testicular cancer you have determines your treatment and your prognosis. In general, there are two types of testicular cancer:
- Seminoma. Seminoma tumors occur in all age groups, but if an older man develops testicular cancer, it is more likely to be seminoma. Seminomas, in general, aren't as aggressive as nonseminomas.
- Nonseminoma. Nonseminoma tumors tend to develop earlier in life and grow and spread rapidly. Several different types of nonseminoma tumors exist, including choriocarcinoma, embryonal carcinoma, teratoma and yolk sac tumor.
Staging the cancer
Once your doctor confirms your diagnosis, the next step is to determine the extent (stage) of the cancer. To determine whether cancer has spread outside of your testicle, you may undergo:
- Computerized tomography (CT) scan. CT scans take a series of X-ray images of your abdomen, chest and pelvis. Your doctor uses CT scans to look for signs that cancer has spread.
- Blood tests. Blood tests to look for elevated tumor markers can help your doctor understand whether cancer likely remains in your body after your testicle is removed.
After these tests, your testicular cancer is assigned a stage. The stage helps determine what treatments are best for you. The stages of testicular cancer are:
- Stage I. Cancer is limited to the testicle.
- Stage II. Cancer has spread to the lymph nodes in the abdomen.
- Stage III. Cancer has spread to other parts of the body. Testicular cancer most commonly spreads to the lungs and liver.
April 29, 2017
- Niederhuber JE, et al., eds. Testicular cancer. In: Abeloff's Clinical Oncology. 5th ed. Philadelphia, Pa.: Churchill Livingstone Elsevier; 2014. http://www.clinicalkey.com. Accessed Nov. 29, 2016.
- Testicular cancer. Fort Washington, Pa.: National Comprehensive Cancer Network. http://www.nccn.org/professionals/physician_gls/f_guidelines.asp. Accessed Dec. 14, 2016.
- Wein AJ, et al., eds. Neoplasms of the testis. In: Campbell-Walsh Urology. 11th ed. Philadelphia, Pa.: Elsevier; 2016. http://www.clinicalkey.com. Accessed Nov. 29, 2016.
- Testicular self-examination (TSE). Urology Care Foundation. http://www.urologyhealth.org/urology/index.cfm?article=101. Accessed Dec. 12, 2016.
- Ilic D, et al. Screening for testicular cancer. Cochrane Database of Systematic Reviews. 2011;CD007853. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD007853.pub2/abstract. Accessed Dec. 16, 2016.
- Riggin EA. Allscripts EPSi. Mayo Clinic, Rochester, Minn. October, 2016.
- Cheney SM, et al. Robot-assisted retroperitoneal lymph node dissection: Technique and initial case series of 18 patients. BJU International. http://onlinelibrary.wiley.com/doi/10.1111/bju.12804/full. Accessed Dec. 16, 2016.
- Costello BA (expert opinion). Mayo Clinic, Rochester, Minn. Jan. 29, 2017.
- Steele SS, et al. Clinical manifestations, diagnosis, and staging of testicular germ cell tumors. http://www.uptodate.com/home. Accessed Nov. 29, 2016.
- Anastasiou I, et al. Synchronous bilateral testicular tumors with different histopathology. Case Reports in Urology. 2015;492183:1.
- Rovito MJ, et al. From "D" to "I": A critique of the current United States Preventive Services Task Force recommendation for testicular cancer screening. Preventive Medicine Reports. 2016;3:361.