Testicular cancer tests
This page is about tests you might have to see if you have testicular cancer. There is information about
Testicular cancer tests
Usually you begin by seeing your GP who refers you to a hospital specialist for tests to see whether you have testicular cancer. At the hospital you will have
- A physical examination of the testicle
- An ultrasound scan of your testicles and scrotum
- Blood tests to look for hormones or proteins that may be produced by testicular cancer
Removing a testicle
If your ultrasound shows that the lump may be a cancer, your doctor will ask you to agree to have your testicle removed. This is called orchidectomy. A pathologist examines cells from the lump under a microscope to see if they are cancerous and if so, what type of cancer you have.
In this situation it is not possible to remove some tissue (a biopsy) without taking the whole testicle. Specialists think there is too high a risk of the cancer spreading with a biopsy. They will only remove a testicle when they are fairly sure there is a cancer there. The testicle would need to be removed anyway if cancer was found.
You usually have this operation as a day case. Occasionally you may need to stay in hospital overnight. You may have the operation under a general anaesthetic or a spinal anaesthetic (where you are awake but can't feel anything from the waist down). The surgeon makes a small cut in the groin and removes the testicle. If you like, the surgeon can put a false testicle (called a prosthesis or implant) into the scrotum.
Remember that removing one testicle does not affect your ability to have an erection or father children.
You can view and print the quick guides for all the pages in the Diagnosing testicular cancer section.
Usually you begin by seeing your GP who examines you and takes your medical details. Then your GP refers you to a hospital specialist for tests to see whether you have testicular cancer.
At the hospital, the specialist will examine you again and ask questions about your health and your family's health. They will ask you to have some blood tests and an ultrasound scan.
Testicular cancers often produce hormones that can be measured in the blood. Doctors call them markers. There are 3 different markers that testicular cancers can make
- AFP (alpha feta protein)
- HCG (human chorionic gonadotrophin)
- LDH (lactate dehydrogenase)
If you have abnormal levels of any of these markers in your blood, then you could have testicular cancer. But you could have a cancer without raised markers. Not all testicular cancers make these chemicals.
Raised markers are more common in some types of non seminomas than in pure seminomas. Your doctor may use the level of the markers to decide which treatment you should have. If your markers are at high levels, you may need more treatment.
Your doctor will test the level of the marker in your blood throughout your treatment and your follow up. This is because the marker will go down as your treatment works. Or it could rise again if your cancer comes back after you have finished treatment. Your doctor will test your blood for markers as part of your follow up, even if you have not had raised markers in the past.
MRI scans are not used very often as most testicular cancers can be diagnosed with an ultrasound scan. But if the ultrasound cannot show whether the lump is non cancerous (benign) or a cancer, your doctor may ask you to have an MRI scan. This type of scan uses magnetic fields to create a picture of body structures. We have information about having an MRI scan in the section about cancer tests.
If your scans and blood tests show that there may be cancer in your testicle, your doctor will ask you to agree to have your testicle removed. This is called orchidectomy (or sometimes orchiectomy). You should have this within 2 weeks of your ultrasound scan.
You may wonder why it is not possible to remove some tissue from the lump (a biopsy) without taking the whole testicle. This is because specialists think there is too high a risk of the cancer spreading with a biopsy.
Specialists will only remove a testicle when they are fairly sure there is a cancer there. Removing the affected testicle is the first treatment for testicular cancer and so you would need to have this anyway.
You will have your operation to remove the testicle as soon as possible after your initial tests. You may have the operation under a general anaesthetic, or a spinal anaesthetic (where you are awake but can't feel anything from the waist down). Your surgeon makes a small cut in the groin and removes the testicle. The operation normally takes about 30 minutes. Your surgeon can replace the testicle with a false one, called a prosthesis. This will mean that your scrotum appears normal after your operation.
You usually have this operation as a day case. Occasionally you may need to stay in hospital overnight.
After the operation, you will have a few stitches in your groin. Your groin and scrotum may be uncomfortable for a week or so and you may need to take mild painkillers.
The testicle that has been removed will be sent to the laboratory for examination under a microscope. The results of these tests could take a few days.
Remember that removing one testicle does not affect your ability to have an erection or father children. There is more about this in the section about your sex life and testicular cancer.
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