Diagnosing testicular cancer

A thorough and accurate cancer diagnosis is required before developing a testicular cancer treatment plan. At City of Hope, a multidisciplinary team of cancer experts will use a variety of tools designed for diagnosing testicular cancer, evaluating the disease and developing your individualized treatment plan.

Some of these tests also will be used to monitor progress and modify the treatment plan if needed. Tests designed for diagnosing testicular cancer include:

Biopsy: Biopsies for testicular cancer are 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 the lab, where a pathologist will perform tests for a more specific diagnosis.

Lab tests: Tests may be performed in the laboratory to determine the specific type of testicular cancer. These tests help identify proteins most frequently associated with testicular germ cell cancers.

Imaging tests: Various imaging procedures 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:

• CT scans are most frequently used to see if the cancer has spread to other areas of the body.
• MRI may be 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 may help determine if cancer cells have spread to the brain or spinal cord.
• 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.

Next topic: How is testicular cancer treated?