Virginia Commonwealth University

VCU Massey Cancer Center

How is testicular cancer diagnosed?

In addition to a complete medical history and physical examination, diagnostic procedures for testicular cancer may include the following:

  • Ultrasound – a diagnostic technique that uses high-frequency sound waves to create an image of the internal organs.
  • Blood tests – assessment of blood samples to check for increased levels of certain proteins and enzymes (also called serum tumor markers) to determine if cancerous cells are present, or to determine how much cancer is present. Tumor markers that may be used to detect testicular cancer include alpha-fetoprotein (AFP), lactase dehydrogenase and human chorionic gonadotropin (HCG).
  • Biopsy – a procedure in which tissue samples are removed (with a needle or during surgery) from the body for examination under a microscope to determine if cancer or other abnormal cells are present.

When testicular tumors are present, the entire tumor, as well as the testicle and spermatic cord, may be removed to prevent the spread of cancerous cells through the blood and lymph systems.

Staging of testicular cancer

When testicular cancer is diagnosed, tests will be performed to determine how much cancer is present and if the cancer has spread from the testis to other parts of the body. This step is called staging and is an important step toward planning a treatment program.

As defined by the National Cancer Institute, the stages of testicular cancer include the following:

  • Stage I -  The cancer is limited to the testis.
  • Stage II - The cancer involves the testis and has spread to lymph nodes in the lower abdomen.
  • Stage III - The cancer has spread to lymph nodes outside of the lower abdomen, to the lungs or to another organ.

Procedures for determining stage include the following:

  • Computed tomography scan (also called a CT or CAT scan) – a diagnostic imaging procedure that uses a combination of X-rays and computer technology to produce cross-sectional images (often called slices), both horizontally and vertically, of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat and organs. CT scans are more detailed than general X-rays.
  • Lymphangiography – images of the lymph system in which dye is injected into a lymph vessel to improve images. 
  • Magnetic resonance imaging (MRI) – a diagnostic procedure that uses a combination of large magnets, radio frequencies and a computer to produce detailed images of organs and structures within the body.

In addition to these imaging procedures, chest X-rays, bone scans or other scans may be requested.