After a physical exam, a doctor may order an ultrasound and blood tests to confirm a testicular cancer diagnosis. A confirmed diagnosis usually results in the removal of the testicle for further lab analysis.

If you have a lump or swelling in one of your testicles, a doctor might recommend further testing. Testicular cancer could be a cause.

Read on to learn more about how doctors diagnose testicular cancer and why early detection is essential.

When to contact a doctor

The National Health Service (NHS) recommends seeing a doctor as soon as possible if you notice any of the following in one of your testicles:

  • swelling
  • a lump
  • other concerning changes
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The diagnostic process for testicular cancer often starts by visiting a primary care physician. They’ll review your medical history for potential risk factors and perform a physical exam. One of the main risk factors is an undescended testicle in childhood.

During a physical exam, a healthcare professional will feel your testicles to monitor their:

  • size
  • shape
  • consistency

During the exam, a doctor may shine a small light against your scrotum to see if it passes through. Testicular lumps are usually solid, and light will not be able to pass through.

Ultrasound is often the first test you’ll receive if a doctor suspects testicular cancer. It allows the doctor to see your testicle’s internal structure.

Doctors can use the results of an ultrasound to help them differentiate testicular cancer from noncancerous conditions like cysts.

Blood tests play a crucial role in helping doctors diagnose testicular cancer by measuring levels of tumor markers that relate to testicular cancer. These markers include:

Tumor markers for subtypes of testicular cancer

More than 90% of testicular cancers are germ cell tumors, which include seminoma and nonseminoma tumors.

According to the American Cancer Society, nonseminomas often raise either AFP and HCG or both. Seminomas raise HCG but not AFP.

Elevated LDH often indicates widespread cancer.

A biopsy is a small tissue sample taken so a pathologist can examine cancer cells under a microscope. Doctors rarely perform a biopsy to check for testicular cancer because it risks spreading the cancer.

After blood tests and ultrasound imaging, doctors often know with relative certainty if your tumor is cancerous. The next step is often to remove your entire testicle. Surgery to remove a testicle is called an orchiectomy.

A pathologist will then examine the cells in your removed testicle to confirm your diagnosis and determine your subtype of cancer.

Other imaging tests that help show how far your cancer has spread include:

  • CT scans to help determine the extent of your cancer
  • MRI scans to look for spread to your brain or spinal cord
  • chest X-rays to look for spread to your lungs
  • PET scans to see if there is cancer cell activity in your body
  • bone scans to show if cancer has spread to your bones

The American Joint Committee on Cancer’s TNM staging system is the most common staging system for testicular cancer. It categorizes tumors based on the following factors:

  • tumor: the size and extent of the tumor
  • nodes: involvement of nearby lymph nodes
  • metastasis: spread to distant organs
  • serum: levels of blood tumor markers

Learn more about how testicular cancer is staged.

After you receive a testicular cancer diagnosis, your cancer team can help you decide on the best treatment. Treatment options may include:

Your healthcare team can give you the best idea of what to expect and address your concerns. You’ll have regular follow-up appointments to monitor the effectiveness of your treatment and help detect any potential recurrence early.

Symptoms of testicular cancer

Symptoms of testicular cancer include:

  • a lump or swelling, usually in one testicle
  • changes in the size, shape, or texture of your testicle
  • fluid accumulation in your scrotum (hydrocele)
  • heaviness or aching in your lower abdomen or groin
  • pain in your testicles or scrotum
  • enlargement or tenderness of your breast (gynecomastia)
  • fatigue
  • rarely, pain without a lump or swelling
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Here are some frequently asked questions people have about testicular cancer.

How long does it take to diagnose testicular cancer?

A primary care doctor will usually refer you to a urologist within a few weeks for further testing and to confirm a diagnosis. A study in Poland reported that half of people were diagnosed within 10 weeks of noticing symptoms.

Can I check for testicular cancer at home?

You can check for testicular cancer by gently rolling each testicle between your thumb and fingers and feeling for any unusual lumps or changes in texture. The best time to check your testicles is after a warm shower or bath when your scrotum is relaxed.

Learn more about how to perform a testicular self-exam.

How quickly can testicular cancer spread?

The speed at which your cancer spreads depends on your subtype of testicular cancer. It often takes years for it to reach distant body parts.

What is the survival rate for testicular cancer?

People diagnosed with testicular cancer in the United States between 2012 and 2018 lived at least 5 years about 95% as often as people without testicular cancer.

Learn more about survival rates for testicular cancer.

The main tests for testicular cancer are blood tests and an ultrasound. If these tests are highly suggestive of testicular cancer, your doctor may recommend having your testicle removed. It will then be examined further to determine the subtype.

Testicular cancer has a better outlook the earlier it’s diagnosed. It’s important to see a doctor promptly if you notice any changes to your testicle, such as a lump or swelling.