Exams and Tests

Most abnormalities of the testes are found during a self-examination or routine physical exam by a doctor. If testicular cancer is suspected, your doctor may want to perform other tests, including:

• Testicular ultrasound. This test may be used to rule out other possible causes of an enlarged or painful testicle before the testicle is removed. Ultrasound is a test that uses reflected sound waves to produce an image of organs and other structures in the body. Unlike many other imaging tests, an ultrasound does not use X-rays or other types of possibly harmful radiation.
• Blood tests, which are often performed in order to measure the levels of tumor markers in your blood. Tumor markers are substances that appear in your bloodstream when cancer is present. Tumor marker levels are monitored at all stages of treatment for testicular cancer.
• Imaging tests, such as chest X-ray and CT scan of the chest, abdomen, and pelvis.

If the testicular ultrasound and blood tests suggest testicular cancer, a doctor will surgically remove your affected testicle. This procedure, called a radical inguinal orchiectomy, is done to confirm a diagnosis of testicular cancer. Following orchiectomy, a pathologist will examine tissue from the testicle under a microscope (biopsy). If cancer is found, you may have other imaging tests to see whether your cancer has spread beyond the testes. The tests may be X-rays, CT scans, or MRIs of the abdomen, chest, and head.

Ongoing exams and tests

During your treatment for testicular cancer, your doctor will schedule a thorough follow-up program to monitor your recovery, especially if you participate in a surveillance program after your initial treatment. These exams and tests may continue for several years following your treatment. In addition to physical exams, your specific follow-up program may include:

• Periodic imaging tests such as chest X-rays or CT scans.
• Blood tests to check the levels of tumor markers in your blood. Tumor marker levels that are stable or that increase after you've had treatment may be a sign of more cancer.

Early detection

A genital exam is an important part of a routine physical exam for every adolescent boy and man.

Testicular self-examination (TSE) may also detect testicular cancer at an early stage. Many testicular cancers are first discovered as a painless lump or an enlarged testicle during self-examination.

Some doctors recommend that men ages 15 to 40 perform monthly testicular self-examination. But this is controversial. Many doctors do not believe monthly TSE is needed for men who are at average risk for testicular cancer. Monthly TSE may be recommended for men who are at high risk for testicular cancer. This includes men with a history of an undescended testicle or a family or personal history of testicular cancer.