This page was reviewed under our medical and editorial policy by
Maurie Markman, MD, President, Medicine & Science
This page was updated on June 8, 2022.
A thorough and accurate cancer diagnosis is required before developing a testicular cancer treatment plan. In some cases, this disease may be suspected due to the patient finding a testicular lump or other symptoms. In others, diagnostic testing may be prompted by results from a physical exam or incidental findings on lab or imaging tests.
A multidisciplinary team of cancer experts uses a variety of tools designed for diagnosing testicular cancer, evaluating the disease and developing the patient's individualized treatment plan.
The care team selects each patient's specific diagnostic testing plan based on factors including signs and symptoms, age, overall health and prior test results.
Tests designed for diagnosing testicular cancer include those listed below. Some of these tests are used to monitor progress and modify the testicular cancer treatment plan if needed.
A biopsy for testicular cancer is usually performed only after removing the affected testicle because of the danger of the cancer spreading into lymph nodes. When the testicle is removed, it is sent to a lab, where a pathologist performs tests for a more specific diagnosis.
Lab tests may be performed to determine the specific type of testicular cancer. These tests help identify proteins most frequently associated with testicular germ cell cancers.
They may include an evaluation of serum tumor markers, which may be present in the blood of some people who have cancer. These may include alpha-fetoprotein (AFP), beta human chorionic gonadotropin (beta-hCG) and other tumor marker tests.
Various imaging tests may be performed to help determine whether the testicular cancer has spread to other parts of the body or to monitor a patient’s treatment progress. Common imaging tests used to diagnose testicular cancer include those listed below.
Computed tomography (CT) scans are most frequently used to see if the cancer has spread to other areas of the body.
Magnetic resonance imaging (MRI) may be used to examine soft tissues within the body. Unlike X-rays and CT scans, an MRI uses radiofrequency waves and powerful magnets to generate the images, so there is no radiation exposure. An MRI may help determine if cancer cells have spread to the brain or spinal cord.
Positron emission tomography (PET/CT) scans may help find small metastases or determine if enlarged lymph nodes contain cancer cells. Although PET scans are very sensitive, they do not show much detail. That's why they are often performed in combination with a CT scan (called PET/CT).
Ultrasound, also known as sonography, is a non-invasive procedure that uses the reflected echoes of high-frequency sound waves to produce images of internal organs. This can help doctors determine whether a lump in the testes is solid, or filled with fluid. Because malignant tumors often produce a pattern that is different from normal testicular tissues, this test may help doctors determine whether a lump is suspicious, and whether further tests should be performed.
X-rays of the chest may be performed to determine whether the cancer cells have spread to the lungs.
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