Testicular Cancer Diagnosis & Detection
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At Cancer Treatment Centers of America (CTCA), our first priority is to perform a thorough and accurate evaluation of your testicular cancer. This step is fundamental to developing a personalized treatment plan for you.
Within the first few days of your arrival at a CTCA hospital, we will perform a complete array of state-of-the-art diagnostic tests. Our clinicians will also review your medical records, including your health history, to ensure that you receive an accurate testicular cancer diagnosis. This information helps us formulate treatment recommendations for you.
Diagnostic Tools and Tests for Testicular Cancer
Your team of testicular cancer experts at CTCA will use advanced diagnostic tests and tools to monitor your response to therapy and modify your treatment when needed. In addition to taking your medical history and performing a physical examination, we may use a variety of tools and tests for testicular cancer, such as:
Several types of imaging tests may be used to detect if the cancer has spread and monitor your response to treatment:
- Ultrasound – Also known as sonography, this non-invasive procedure uses the reflected echoes of high-frequency sound waves to produce images of internal organs. This can help doctors determine if a lump is solid, or filled with fluid. Because malignant tumors often produce a pattern that is different from normal testicular tissues, this test can help doctors determine if a lump is suspicious, and if further tests should be performed.
- X-Ray – A standard X-ray of the chest may be performed to see if the cancer cells have spread to the lungs.
- Computed Tomography (CT) Scan – A CT scan is a special type of X-ray that generates three-dimensional, cross-sectional images throughout the body. Unlike a normal X-ray, CT scans can create detailed images of the internal organs, like the liver and lungs. This testicular cancer detection test is most frequently used to see if the cancer has spread to other areas of the body.
- Magnetic Resonance Imaging (MRI) – MRI is also used to examine soft tissues within the body, but 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 can be very effective for determining if cancer cells have spread to the brain or spinal cord.
- Positron Emission Tomography (PET) scan – This imaging technique is used to look at metabolic activity within different organs of the body. A radioactive dye, usually a form of the sugar glucose, is injected and a special camera is used to take a picture of radioactive areas within the body. Because cancer cells are growing rapidly and are often more metabolically active compared to normal cells, they absorb more of the radioactive sugar. Because of this phenomenon, PET scans can be very helpful in finding small metastases, or determining if enlarged lymph nodes contain cancer cells. PET scans are very sensitive, but they do not show much detail, so they will often be performed in combination with a CT scan (called PET/CT).
- Lymphangiogram – This is a special test to examine the lymph system, and to see if cancer cells have spread to lymph nodes. A dye is injected into a lymph vessel, and images of lymph nodes are produced using an X-ray monitor. CT scans are now used more frequently to evaluate lymph nodes, but lymphangiograms are still sometimes used to monitor patients with non-seminomas during treatment.
While imaging tests can be very helpful in evaluating whether or not testicular cancer may be present, the only way to know for certain is to examine a sample of the suspected tissue. In many cases, if the surgeon is certain a tumor is present, he/she will simply remove the entire tumor as well as the testicle and spermatic cord in a procedure known as a radical inguinal orchiectomy. However, if the diagnosis is uncertain, the surgeon may perform a biopsy. In this procedure, the surgeon removes a small portion of the suspicious tissue to get a sample of cells so that a pathologist (a doctor who specializes in diagnosing disease in a laboratory) can look at them under a microscope to see if they are cancerous.
Sometimes, testicular cancers secrete large amounts of certain proteins, known as tumor markers. Blood tests for these proteins can help in diagnosing testicular tumors and determining the subtype of the cancer, or to monitor response during therapy. The proteins most frequently associated with testicular germ cell cancers are alpha-fetoprotein (non-seminomas only), and human chorionic gonadotropin (both seminomas and non-seminomas). Another protein, lactate dehydrogenase, may also be elevated when cancer is present, but increased levels of this enzyme can occur in other conditions, so it is used more frequently to evaluate the extent of disease and to monitor response after a testicular cancer diagnosis has been made.
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