How is testicular cancer diagnosed?

Testicular cancer is usually diagnosed after the man notices a lump or other change in a testicle. When an abnormality is suspected, an ultrasound is usually ordered, which is a painless medical test that helps the doctor to see whether there are abnormalities in the testicle. If the ultrasound shows evidence of cancer, then surgery is performed to remove the testicle and it is examined under a microscope to see whether cancer is present and, if so, what type of cancer. Thus, testicular cancer is only diagnosed after the testicle is removed and examined. Biopsies, which involve the removal of a small amount of tissue using a needle or other medical tool, are NOT performed on testicles because penetrating the testicle can make it more difficult to treat a cancer if one is discovered.

Tests to help diagnose testicular cancer can include:

  • Ultrasound — This is a procedure that uses high-energy sound waves to form pictures of body tissues.
  • A physical exam and history — A physical exam and medical history can help the doctor look for problems that might be related to testicular cancer.
  • A serum tumor marker test — This procedure examines a blood sample to measure the amounts of certain substances linked to specific types of cancers. These substances are called tumor markers. The tumor markers that are often elevated in testicular cancer are alpha-fetoprotein (AFP), human chorionic gonadotrophin (HCG or beta-HCG) and lactate dehydrongenase (LDH).
  • Inguinal orchiectomy and biopsy — This procedure involves the removal of the entire testicle through an incision in the groin. A tissue sample from the testicle is then checked for cancer cells.
  • CT scans and X-rays — A CT scan is a medical test that uses X-rays to form pictures of the inside of the body. When a cancer is diagnosed or suspected, a CT scan (also referred to as a CAT scan) is performed to see whether cancer can be seen elsewhere in the body. In testis cancer, a CT scan is performed of the abdomen and pelvis. Images of the chest are taken using either a CT scan or a regular X-ray.

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