Understanding Testicular Cancer Diagnosis

Diagnosing testicular cancer typically involves a thorough examination by a healthcare provider, who may then recommend an ultrasound and blood tests to confirm the presence of cancer. If cancer is suspected, the usual next steps include the removal of the affected testicle followed by laboratory analysis for a definitive diagnosis.

Should you notice a lump or swelling in one of your testicles, it’s essential to consult a healthcare professional as soon as possible to rule out testicular cancer. This article provides a comprehensive overview of the diagnostic process and underscores the importance of early detection.

When to Seek Medical Advice

It is crucial to contact a healthcare provider promptly if you observe any of the following signs in your testicles:

• Swelling
• A noticeable lump
• Other unusual changes

Initial Evaluation: Medical History and Physical Examination

The diagnosis of testicular cancer often starts with a visit to your primary care doctor. They will review your medical history for risk factors, such as a history of undescended testicles during childhood. During the physical exam, the physician will assess the size, shape, and consistency of your testicles. They may also shine a light against the scrotum; solid lumps will typically block light from passing through.

Ultrasound: A Key Diagnostic Tool

If testicular cancer is suspected, an ultrasound is usually the first imaging test performed. This non-invasive procedure enables the doctor to visualize the internal structure of the testicular tissue and helps differentiate cancer from non-cancerous conditions, such as cysts.

Blood Tests for Tumor Markers

Blood tests are an essential component of diagnosing testicular cancer. They measure levels of specific tumor markers, including:

• Alpha-fetoprotein (AFP)
• Human chorionic gonadotropin (HCG)
• Lactate dehydrogenase (LDH)

Tumor Markers and Cancer Subtypes

Over 90% of testicular cancers are germ cell tumors, which include seminomas and non-seminomas. According to data from the American Cancer Society, non-seminomas often elevate either AFP, HCG, or both. In contrast, seminomas typically increase HCG but not AFP. An elevated LDH level can frequently indicate more widespread cancer.

Surgical Biopsy and Further Testing

While a biopsy, which involves taking a small tissue sample for examination by a pathologist, is common in many cancers, it is rarely performed for testicular cancer due to the risk of spreading the disease. Following ultrasound and blood tests that strongly suggest cancer, the next step typically involves an orchiectomy, or removal of the affected testicle. The removed tissue is then analyzed to confirm the diagnosis and assess the cancer type.

Advanced Imaging Techniques

To determine the extent of cancer spread, doctors may recommend additional imaging tests, which may include:

• CT scans to assess the extent of cancer
• MRI scans for potential spread to the brain or spinal cord
• Chest X-rays to check for lung involvement
• PET scans to evaluate cancer cell activity
• Bone scans for signs of metastasis to the bones

Staging Testicular Cancer

The American Joint Committee on Cancer uses the TNM staging system to categorize testicular cancer based on:

• Tumor: Size and extent of the tumor
• Nodes: Involvement of nearby lymph nodes
• Metastasis: Spread to distant organs
• Serum: Levels of tumor markers in the blood

What to Expect After a Diagnosis

Upon receiving a testicular cancer diagnosis, your healthcare team will guide you in selecting the most appropriate treatment approach, which may involve:

• Surgery
• Chemotherapy
• Radiation therapy
• Active surveillance

The healthcare team will help address any questions you have and will schedule regular follow-ups to monitor treatment effectiveness and identify any potential recurrence as early as possible.

Symptoms to Watch for

Common symptoms of testicular cancer may include:

• A lump or swelling in one testicle
• Alterations in size, shape, or texture of the testicle
• Fluid buildup in the scrotum (hydrocele)
• Aching or heaviness in the lower abdomen or groin
• Pain in the testicles or scrotum
• Breast enlargement or tenderness (gynecomastia)
• Fatigue
• In rare cases, pain without any accompanying lump or swelling

Frequently Asked Questions

How long does it take to diagnose testicular cancer?

A typical referral to a urologist for further testing is made within a few weeks. According to a Polish study, half of the patients noted symptoms and were diagnosed within 10 weeks.

Can I check for testicular cancer at home?

Yes, you can perform a self-exam by gently rolling each testicle between your thumb and fingers. The best time for examination is after a warm shower when the scrotum is relaxed. This helps you feel for any unusual lumps or changes in texture.

What is the speed of cancer spread in testicular cancer?

The speed of cancer progression varies based on the type of testicular cancer, but it typically takes years for it to spread to distant areas of the body.

What are the survival rates for testicular cancer?

Data from the United States indicates that individuals diagnosed with testicular cancer between 2012 and 2018 had a five-year survival rate of about 95%, comparable to those without the disease.

Conclusion

Blood tests and ultrasound imaging are integral in diagnosing testicular cancer. If these tests suggest cancer, surgery to remove the testicle will likely follow, allowing for further analysis. The prognosis for testicular cancer improves significantly with early detection, making it crucial to consult a healthcare provider if you notice any suspicious changes in your testicles.