Testicular cancer, in many cases, is discovered by the patient either by chance or when the person does self-examination of testis for lumps. Many cases are diagnosed by a doctor while examining the person for some other problem such as during a routine physical exam , ultrasound test or biopsy for diagnosis of infertility. If a lump or growth is detected or you have any other symptoms suggestive of testicular carcinoma, your doctor may recommend tests to determine whether the lump is testicular cancer or not.
- Medical history and examination: During check-up, your doctor will ask questions pertaining to symptoms such as feeling of heaviness in the scrotum, pelvic pain or back pain. The doctor will do physical examination to check for mass, look if the lymph nodes in the groin are enlarged or if there is any fluid in the scrotum.
- Ultrasound: This is a painless and non-invasive test, which uses high-frequency sound waves to test structures inside the body. The sound waves cannot be heard by human ears. The pattern of the echoes produced when the sound waves are reflected from the internal structure creates a picture called a sonogram. The radiologist can differentiate healthy tissues and abnormal pattern on this picture. When a testicular ultrasound test is done, an image of the scrotum and testicles is formed. During this procedure, clear gel is applied to the scrotum and then a hand-held probe is moved over your scrotum to obtain pictures. It can help to diagnose the nature of any testicular lump/s (like if the lumps are solid or fluid filled) and the location of the lump (if it is inside or outside the testicle) etc.
- Blood tests: Certain blood tests to determine the levels of tumour markers in your blood such as human chorionic gonadotropin hormone (HCG) may be done. In some types of testicular cancer, certain tumour markers may be elevated. Increase in the level of a tumour marker does not mean that you have cancer. Your doctor may recommend other tests to confirm the diagnosis.
- Surgery to remove a testicle: If the lump or growth is suspected to be cancer, surgery to remove the testicle may be done. The testicles will be then sent to the laboratory for histopathological examination. Tissue from the testis is examined under a microscope by the pathologist for cancer cells and the type of cancer. Some cases may have both types of cancer (seminomas and nonseminomas) in a tumor. Such cases are treated as nonseminoma.
These are some tests that are done if testicular cancer is suspected. Your doctor will recommend other tests, if needed.
Staging of cancer
If testicular cancer is diagnosed by tests, your doctor will try to determine the extent, or stage of your cancer. Staging of cancer is done using imaging procedures (such as CT scan and MRI scan), blood tests and other lab tests. CT scan (computed tomography scan) is a painless and non-invasive test that takes a series of detailed pictures of the part of the body that is being examined. Both MRI and CT scan can show if the cancerous growth has involved the regional lymph nodes and other nearby structures. Staging is done to determine the extent of disease (size and spread of cancer) as it is needed to decide the treatment and predict the prognosis.