Tests for testicular cancer

You usually have a number of tests to check for testicular cancer. The testicles are part of the male reproductive system . They produce sperm and the hormone testosterone.

The tests you might have to check for testicular cancer include:

• an examination of the testicles

• blood tests

• an ultrasound scan

Tests your GP might do

Most people with symptoms that could be due to cancer start by contacting their GP surgery. Your first appointment may be a telephone appointment. Your GP surgery then might arrange for you to go in and see a doctor or other healthcare professional.

Your GP can do some tests to help them decide whether you need to see a specialist. This usually includes:

• a physical examination
• blood tests including tumour markers 

After the examination, your GP might refer you straight to see a specialist. Or they may arrange for you to have an ultrasound scan of the testicles. You usually have this test at your local hospital.

Physical examination

A physical examination involves your doctor looking and feeling your:

• tummy (abdomen)
• pelvis
• testicles
• penis

They feel for any areas that are swollen or might not feel normal. And if you have pain, they will feel those areas.

They might also listen to your chest and abdomen to find out if they sound normal.

Some people find a physical examination uncomfortable and embarrassing. Your GP or specialist will try to make you as comfortable as possible.

You can ask for someone else to be in the room with you if you want, to act as a chaperone. A chaperone is a trained health professional such as a nurse. A friend or relative can also stay with you for support and comfort. They can be with you during the test or examination.

Blood tests

Blood tests can check your general health including:

• how well your liver and kidneys are working
• the number of blood cells in your blood such as white blood cells,  platelets and red blood cells.  You may hear this being called a full blood count
• if you have any signs of infection

Tests your specialist might do

Depending on the results of your tests, your GP may refer you to a specialist at the hospital. This is usually a urologist.

Your specialist usually does more tests. These include:

• ultrasound scan

• MRI scan

• CT scan

Ultrasound scan of the testicles

Ultrasound scans use high frequency sound waves to create a picture of a part of the body. The ultrasound scanner has a probe that gives off sound waves. The sound waves bounce off the organs inside your body, and the probe picks them up. The probe links to a computer that turns the sound waves into a picture on the screen.

To check for testicular cancer, you usually have an ultrasound scan of the testicles and scrotum . This can show if there is a:

• fluid filled cyst

• lump

If your doctor can't feel a lump on your testicle, they may still suggest you have an ultrasound scan. You might have it if you have other symptoms such as:

• swollen lymph nodes in the back of your abdomen. These are called retroperitoneal lymph nodes
• high levels of certain proteins called tumour markers

CT scan

A CT scan uses x-rays and a computer to create detailed pictures of the inside of your body. The computer puts them together to make a 3 dimensional (3D) image.

You might have a CT scan of your abdomen, chest and pelvis to find out if the cancer has spread to other parts of the body.    

MRI scan

MRI stands for magnetic resonance imaging. It uses magnetism and radio waves to take pictures of the inside of the body.

You might have an MRI scan of your abdomen, chest and pelvis. It can help your doctor to find out:

• more information if the ultrasound and CT scan does not show whether you have cancer

• whether the cancer has spread to other parts of the body

Tumour markers

Tumour markers are substances that are produced by:

• the cancer, or
• by other cells in response to the cancer

Tumour markers are usually proteins that can be found in the blood, urine or body tissues.

Some tumour markers are only produced by one type of cancer. Others can be made by several types.

Some people with testicular cancer have high levels of 3 different markers:

• alpha feta protein (AFP)

• human chorionic gonadotrophin (HCG)

• lactate dehydrogenase (LDH)

Not all testicular cancers make these chemicals. You could have testicular cancer without raised marker levels. Other conditions can raise tumour marker levels too. So this test can't diagnose testicular cancer on its own. You need to have other tests alongside it. 

Raised levels are also more common in some types of testicular cancer than others.

You have blood tests for these markers throughout your treatment and afterwards. These tests help to show how well treatment works and can show if the cancer has come back.

Treatment

The tests you have help your doctor find out if you have testicular cancer and how far it has grown. This is the stage of the cancer.

This is important because doctors recommend your treatment according to the stage of the cancer.

Coping with testicular cancer

Coping with a diagnosis of testicular cancer can be difficult. There is help and support available for you and your family.