Testing for Testicular Cancer

Testing for testicular cancer can be performed either as screening in men who are at risk for testicular cancer or in those who have some symptom or sign that is suggestive of a tumor of the testes. Screening for testicular cancer is generally recommended for all males but is particularly important for those who have some risk factor which increases their risk of developing this form of cancer. For example, males with a history of undescended testicle, abnormalities of testicular development, or Klinefelter's syndrome. These cancers are more common in white men in between the ages of 15 and 35, although it can occur in other age groups and ethnicities less commonly.

Testing for testicular cancer is generally first centered around a thorough physical examination. On self or doctor examination of the testes, most tumors present as a painless, firm nodule or lump in one of the testicles. Normal testes usually transilluminate, meaning that if you hold a flashlight up to the scrotum, you can see light through the testicle. However, most tumor masses in the testes do not transilluminate, light does not pass through it.

Once an abnormal mass is found in the testicle, confirmation of cancer and the type of testicular cancer can only be definitively confirmed by removal of the tumor tissue so that it can be evaluated by a pathologist.

Additional testing may be indicated both to help identify the type of testicular tumor as well as to look for any evidence of spread of the cancer. Ultrasound examination of the scrotum can help identify the mass. Additionally, some blood tests may be ordered that aim to identify tumor markers which may be produced by some types of testicular cancer, such as alpha fetoprotein (AFP), lactic dehydrogenase (LDH) and human chorionic gonadotrophin (beta HCG). To test for spread of the cancer, imaging tests such as a chest x-ray and/or abdominal and pelvic CT scanning may be performed.