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How do you diagnose it?
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Patients who present to their doctor with symptoms of testicular cancer typically undergo a number of diagnostic tests before a definitive diagnosis of cancer can be made. John Muir Health offers the full spectrum of advanced technology used in diagnosing and staging testicular cancer.
Ultrasound is usually the first test ordered if a physical examination should reveal any abnormalities. Ultrasound is a non-invasive test that uses sound waves to form images of any structural abnormalities, enabling the physician to determine if the lump originated in the testicle or the scrotum. When a solid testicular mass is detected by ultrasound, it is presumed to be cancerous.
Additionally, several advanced "tumor marker" blood tests for testicular cancer are now available at John Muir Health. These blood tests - including alpha-fetoprotein and human chorionic gonadotropin (HCG) - detect levels of certain proteins or hormone "markers" in the blood, which are present in individuals with cancer. These blood tests are useful both for diagnosing testicular cancer as well as monitoring treatment effectiveness. Detectable levels after treatment may indicate recurrence of cancer.
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Some patients may undergo a CT scan (computed tomography) to determine if the cancer has spread to other organs. CT is a computer-enhanced x-ray procedure, which provides a high level of structural detail by recording cross-sectional images from many different angles.
Occasionally, if diagnostic tests should prove inconclusive, your physician may wish to perform a biopsy. A biopsy is a minimally invasive surgical procedure performed under local anesthesia, in which tissue samples are collected for examination. The definitive diagnosis of testicular cancer is made by microscopic evaluation of these specimens by our board-certified pathologists.
Once a definitive diagnosis of testicular cancer has been reached, your physician will need to "stage" your cancer - or determine how far the tumor has spread - to devise the best treatment plan. Staging is based on information gathered from the diagnostic tests described above, or any other tests that may have been ordered, including routine laboratory tests. Testicular cancer staging is based on the TNM classification system, which assesses the extent of the primary tumor, lymph node involvement, and any distant metastases. Classification ranges from Stage 0 (early-stage cancer) to Stage III (metastatic cancer). (Unlike the staging system for most other cancers, there is no Stage IV classification in testicular cancer.) A detailed discussion of the various stages of testicular cancer and the appropriate treatment options for each can be found at: http://www.cancer.gov/cancerinfo/pdq/treatment/testicular/patient/.
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