Testicular cancer tests: What can you expect?

What testicular cancer tests are usually done?

Testing for infections

In some cases, a lump or swelling on your nuts could be caused by an infection. Your doctor might take a urine sample or use a swab (small cotton bud) to collect a sample of cells and fluid from your urethra (the tube that carries pee out of your body).

If there’s a chance you have a sexually transmitted infection (STI) you may be referred to a sexual health clinic.

Testicular cancer ultrasound

You may be asked to get an ultrasound on your nuts to check for testicular cancer. An ultrasound sends out sound waves, which echo when they encounter something dense like a tumour (in the same way it can detect a baby in a woman’s uterus). The ultrasound images are then projected onto a computer screen so you can create a picture of what’s beneath the skin.

In terms of what to expect, ultrasounds are usually painless and only take about 15 minutes. A gel will be spread over your scrotum and a small device called a transducer is pressed into the area.

Testicular cancer blood test

Your doctor may also ask you to get a blood test before your next appointment. This checks for something called “tumour markers” in your blood. If tumour markers are increased in your blood, it could be a hint that there’s a testicular tumour.

While these numbers will be pretty meaningless to you, your doctor will be able to use them to get a good indication of what’s going on.

How blood tests help diagnose testicular cancer

Let’s delve a bit deeper into how a blood test can help diagnose testicular cancer.

Many testicular cancers make high levels of certain proteins called tumor markers. When these tumor markers — like alpha-fetoprotein (AFP) and human chorionic gonadotropin (hCG) — are in the blood, it suggests that you could have a testicular tumor.

Rises in certain proteins can also help doctors tell which type of testicular cancer it might be:

• Non-seminomas often raise AFP and/or hCG levels.
• Pure seminomas occasionally raise hCG levels but never AFP levels, so any increase in AFP means that the tumor has a non-seminoma component. (Tumours can be mixed and have areas of seminoma and non-seminoma.)
• Sertoli and Leydig cell tumours don't make these substances.
• Some cancers are too small to elevate levels of these tumour markers.

lt sounds pretty confusing, right? That’s why it's best to talk through the test results with your doctor.

A testicular tumor might also increase the levels of an enzyme called lactate dehydrogenase (LDH). But LDH levels can also be increased in conditions other than cancer, such as other diseases.

Other reasons a tumour marker test could be used include:

• Estimating how much cancer is present.
• Following a patient’s response to treatment.
• Looking for signs a tumour might have returned.
  

What comes next after testicular cancer tests?

If tests indicate that you might have testicular cancer, your doctor might tell you this straight up, or they may refer you to a urologist to make a final call.