Testicular Cancer

We start by getting to know you. At your first in-person appointment, your provider will ask about your symptoms, talk with you about your medical history and do a physical exam that focuses on your testicles and lymph nodes. Then, they’ll do some tests to help confirm a diagnosis and help them figure out how big your tumor is and if your cancer has spread to your organs or lymph nodes. This is called cancer staging.

Imaging tests

Imaging tests allow us to get a closer look at any tumors. They also help us see if cancer has spread to other parts of your body, like your lungs, liver, spine and brain. You may have:

• Ultrasound.
• Chest X-ray.
• CT scan.
• MRI.

Tissue diagnosis

If imaging tests show anything that looks like cancer in your testicles, your provider will likely recommend removing the affected testicle (inguinal orchiectomy). This is done through a small cut (incision) in your groin just above where your leg joins your body.

A pathologist at our lab will look at the tissue under a microscope to check for cancer cells and make a diagnosis. If we find cancer, removing the affected testicle usually eliminates the cancer — if other tests don’t show signs it has spread.

Tumor marker tests

Your provider may also take a blood sample to test for tumor markers. These are substances linked to different kinds, including testicular cancer. If these markers are high, there’s a good chance you have cancer. These markers also sometimes show if the cancer has spread and how it’s responding to treatment. The tumor markers for testicular cancer are:

• Alpha-fetoprotein (AFP).
• Beta-human chorionic gonadotropin (BHCG).
• Lactate dehydrogenase (LDH or LD).

Getting a second opinion for testicular cancer

Testicular cancer is certainly not a diagnosis you want to hear. It can be unexpected, scary and overwhelming. But having the best cancer care team on your side is the first important step toward an excellent outcome. Testicular cancer management is complicated, and sometimes overtreatment may occur if your provider is not as experienced with treating this condition. Our experts can make sure your recommended treatment plan is appropriate or provide additional options to consider. That’s why at Cleveland Clinic, we believe in getting a second opinion. Our trusted and experienced testicular cancer specialists are here to help make sense of your diagnosis and give you advice on treatment options.

And we’ll never do anything to harm your relationship with your provider if you reach out to us. We regularly offer second opinions for cancer diagnoses and work with other providers to make sure you get the best treatment.

We also know that cancer waits for no one. So as soon as you contact us, we’ll work hard to get you in to see one of our specialists as soon as possible. Feeling in control of your care is important, and a second opinion can give you peace of mind knowing you’re in the most capable compassionate hands as you navigate your cancer journey.

Meet Our Testicular Cancer Care Team

At Cleveland Clinic, you’ll have an experienced team of providers from different specialties helping you, including urologists and oncologists. They’ll work with you to create a highly personalized care plan that takes your unique needs into account. Your providers could include:

• Radiation Oncologists.
• Radiologists (imaging specialists).
• Pathologists (body tissue specialists).
• Social workers.
• Nurse practitioners.
• Physician assistants.

Once your care team has finished your exam and testing, they’ll let you know for sure if you have testicular cancer. And if you do, they’ll start working with you to design a personalized treatment plan. Depending on your cancer’s stage and other factors, you might have surgery or a combination of surgery and other treatments. Throughout your treatment journey, you’re providers will be there to answer all of your questions. 

Testicular cancer surgery

Surgery is the most common treatment for testicular cancer. If your provider didn’t remove the affected testicle during your tissue diagnosis, they’ll do an orchiectomy and remove the testicle through a cut in your groin.

They might also do a retroperitoneal lymph node dissection (RPLND) to remove the lymph nodes behind your abdomen to test them and see if any of the cancer has spread there. This surgical procedure is also used to treat cancer in some cases. Minimally invasive RPLND, which uses smaller incisions and shortens recovery time, may also be an option.

Radiation therapy

This treatment uses high doses of X-rays to kill your cancer cells. Radiation therapy is most often used after surgery to keep your tumor from returning (recurring).

Chemotherapy

Chemotherapy uses of drugs to destroy cancer cells and improve survival rates. Sometimes, providers will decide you might not need surgery and will do chemotherapy instead. This depends on the type of cancer you have. Or, they might have you do chemo after surgery or if your cancer has come back.

Fertility considerations

If you plan to have biological children in the future, we encourage sperm banking before surgery. This increases your chances of being able to conceive and having a family after you recover.

Taking the Next Step

Surgery. Chemo. Radiation. You didn’t expect to find yourself facing all of this, but here you are. It’s a lot to digest, but you don’t have to go through any of it alone. At Cleveland Clinic, you’ll have the support of some of the world’s best cancer providers on your side to help you tackle this challenging (but highly treatable) diagnosis. We’re here to help you get back to feeling like yourself again.