Tumor markers can help doctors diagnose testicular cancer, determine effective treatment, and monitor how well that treatment is working.

Doctors have been using tumor markers to help diagnose and manage testicular cancer since the 1970s. Tumor markers can be something:

  • present in cancer cells
  • produced by cancer cells
  • produced by your cells in response to cancer

The three main tumor markers doctors use to help diagnose and treat testicular cancer are:

Read on to learn about the role these tumor markers play in managing testicular cancer.

Testicular cancer fast facts

  • About 1 in 250 males develop testicular cancer in their lifetime.
  • The average age at the time of diagnosis is 33.
  • The 5-year relative survival rate of testicular cancer is 95% in the United States.
  • More than 99% of people with cancer contained in one testicle live at least 5 years after diagnosis.
  • Rates of testicular cancer have been rising in the United States over the past 45 years, likely due to improved detection rates.
  • Most people who develop testicular cancer have no known risk factors, but one of the main risk factors is having an undescended testicle as a baby.
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Doctors use three primary tumor markers for diagnosing and tracking the progress of testicular cancer. They can measure levels of these markers using blood tests.


Alpha-fetoprotein is a protein fetuses normally produce in the uterus. It’s usually undetectable in the blood of healthy adults.

Seeing alpha-fetoprotein in a blood test is highly suggestive of liver cancer or a germ cell tumor. Germ cell tumors are the most common type of testicular cancer.

Doctors typically measure alpha-fetoprotein with a blood test before surgically removing an affected testicle and after to see whether surgery successfully removed all of the cancer cells.

Beta-human chorionic gonadotropin (beta-HCG)

Beta-HCG is a hormone found in the blood and urine of pregnant people. It’s not normally detected in males without testicular cancer. Its detection on a blood test is almost always indicative of cancer.

The presence of beta-HCG can also suggest some other types of cancer, such as:

Lactate dehydrogenase (LDH)

LDH is an enzyme that helps your body turn sugar into energy. Elevated LDH levels on a blood test suggest cancer or another medical condition. All types of cancerous tumors produce LDH.

Other conditions that can raise LDH levels include:

According to the American Cancer Society, high LDH often indicates widespread cancer.

Many people with testicular cancer first visit their doctor after finding a concerning bump in or around their testicles.

If your doctor thinks you may have testicular cancer, they will likely order an ultrasound. An ultrasound can help doctors see if the lump is solid, which is a sign it may be cancer.

Doctors use tumor marker blood tests to support a testicular cancer diagnosis, but they’re not enough to diagnose testicular cancer by themselves.

Elevated alpha-fetoprotein and beta-HCG can help doctors figure out which subtype of testicular cancer you have.

Tumor markers and cancer subtype

The most common type of testicular cancer is called germ cell cancer. It develops in the cells that become sperm cells in males and eggs in females.

The two main subtypes of germ cell testicular cancer are seminoma and non-seminoma tumors.

According to the American Cancer Society:

  • Alpha-fetoprotein and beta-HCG levels often increase in non-seminoma tumors.
  • Beta-HCG levels sometimes increase with seminomas, but alpha-fetoprotein levels never rise.

According to the European Association of Urology:

  • up to 90% of non-seminoma tumors are associated with elevated levels of alpha-fetoprotein or beta-HCG
  • about 39% of non-seminoma tumors are associated with elevated levels of both alpha-fetoprotein and beta-HCG
  • about 30% of seminoma tumors are associated with a moderately increased level of beta-HCG

LDH is less specific than the other two main tumor markers, but elevated LDH levels can suggest that the cancer is large or has spread to other parts of the body.

Next steps

If your test results suggest that you likely have testicular cancer, the next steps are usually to remove the affected testicle to keep cancer from spreading and to test the testicle for cancer in a laboratory.

Doctors use tumor markers to:

  • see whether there are any residual cancer cells after treatment
  • monitor how well your treatment is working
  • judge how aggressive your treatment should be

Tumor markers are generally taken before and after testicle removal. It can take several weeks for levels of tumor markers to normalize even after surgery.

The primary treatments for testicular cancer are:

  • chemotherapy
  • surgery
  • radiation therapy

Learn more about testicular cancer treatment.

Doctors use three main tumor markers to help support a testicular cancer diagnosis and track how well treatment is working. Doctors often measure levels of these tumor markers with a blood test before and after surgery to remove your affected testicle.

Most people discover testicular cancer when they feel an abnormal lump in their testicles. Performing regular testicular self-exams can help you detect testicular cancer in the early stages.

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