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Testicular Cancer Diagnosis

If you have testicular cancer, it is important to get an accurate diagnosis to help increase your chances for successful treatment. At MD Anderson, our specialized experts use the most modern and accurate technology to diagnose testicular cancer and pinpoint the extent (stage) of the disease.

When an ultrasound shows a mass in your testicle, it is likely your doctor will perform a surgical removal of the testicle (orchiectomy). An incision is made in the groin rather than the scrotum, to avoid possibly spreading cancer cells. A tissue sample from the testicle is examined under a microscope to determine the presence of testicular cancer cells and the stage of the disease.

Other Testicular Cancer Diagnostic Tests

If you have symptoms that may signal testicular cancer, your doctor will perform a physical exam and ask you questions about your health, lifestyle, and family history.

One or more of the following tests may be used to find out if you have testicular cancer and if it has spread. These tests also may be used to find out if treatment is working.

Blood tests: Special blood tests that detect certain protein "markers" are used to diagnose and find out the extent of testicular cancer before and after orchiectomy. These tests include:

  • Alpha-fetoprotein (AFP): Elevated levels of this protein, which normally is produced by a fetus in the womb, may indicate the presence of a germ cell tumor in men.
  • Beta human chorionic gonadotropin (b-HCG): Increased levels of this protein, normally found in pregnant women, can indicate the presence of several types of cancer, including testicular cancer.
  • Lactate dehydrogenase (LDH): This enzyme is related to increased energy production by the body's cells and tissues, which sometimes can indicate cancer.

In rare cases, testicular cancer can be passed down from one generation to the next. Genetic counseling may be right for you. Visit our genetic testing page to learn more.

Testicular Cancer Staging

If you are diagnosed with testicular cancer, your doctor will determine the stage (or extent) of the disease. Staging is a way to determine how much disease is in the body and where it has spread when it is diagnosed.

This information is important because it helps your doctor determine the best type of treatment for you.

Once the staging classification is determined, it stays the same even if treatment is successful or the cancer spreads.

Testicular Cancer Stages

(source: National Cancer Institute)

Stage 0 (carcinoma in situ): Abnormal cells are found in the tiny tubules where sperm cells begin to develop. These abnormal cells may become cancer and spread into nearby normal tissue. All tumor marker levels are normal. Stage 0 is also called carcinoma in situ.

Stage IA: Cancer is in the testicle and epididymis (tube connecting ducts in rear of testicle to vas deferens) and may have spread to the inner layer of the membrane surrounding the testicle. All tumor marker levels are normal.

Stage IB: Cancer is one of the following:

  • In the testicle and epididymis and has spread to the blood or lymph vessels in the testicle
  • Spread to the outer layer of the membrane surrounding the testicle
  • In the spermatic cord or the scrotum and may be in the blood or lymph vessels of the testicle
  • All tumor marker levels are normal

Stage IS: Cancer is found anywhere within the testicle, spermatic cord or the scrotum and either:

  • All tumor marker levels are slightly above normal
  • One or more tumor marker levels are moderately above normal or high

Stage IIA: Cancer is one of the following:

  • Anywhere within the testicle, spermatic cord or scrotum
  • In up to five lymph nodes in the abdomen, none larger than 2 centimeters
  • All tumor marker levels are normal or slightly above normal

Stage IIB: Cancer is anywhere within the testicle, spermatic cord or scrotum and has spread to either:

  • Up to five lymph nodes in the abdomen; at least one of the lymph nodes is larger than 2 centimeters, but none is larger than 5 centimeters
  • More than five lymph nodes that are not larger than 5 centimeters
  • All tumor marker levels are normal or slightly above normal

Stage IIC: Cancer:

  • Is anywhere within the testicle, spermatic cord or scrotum and
  • Has spread to a lymph node in the abdomen and the tumor is larger than 5 centimeters
  • All tumor marker levels are normal or slightly above normal

Stage IIIA: Cancer is all of the following:

  • Anywhere within the testicle, spermatic cord or scrotum
  • Spread to one or more lymph nodes in the abdomen
  • Spread to distant lymph nodes or to the lungs
  • The level of one or more tumor markers may range from normal to slightly above normal

Stage IIIB: Cancer:

  • Is anywhere within the testicle, spermatic cord or scrotum
  • May have spread to one or more nearby or distant lymph nodes or to the lungs
  • The level of one or more tumor markers may range from normal to high

Stage IIIC: Cancer:

  • Is anywhere within the testicle, spermatic cord or scrotum
  • May have spread to one or more nearby or distant lymph nodes or to the lungs or anywhere else in the body
  • The level of one or more tumor markers may range from normal to very high

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Knowledge Center

Find the latest news and information about testicular cancer in our Knowledge Center, including blog posts, articles, videos, news releases and more.