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NHS Choices Condition

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Visiting your GP

If you notice a lump, or abnormality, in your testicles, you should first see your GP. Although most testicular lumps are not cancerous, it is essential for you to have the abnormality checked. This because the treatment for testicular cancer is much more effective the earlier the condition is diagnosed.

Physical examination

As well as asking you about your symptoms, and consulting your medical history, your GP will normally need to carry out a physical examination of your testicles.

Your GP may hold a small light, or torch, against the lump in your testicle, to see whether light passes through it. Cancerous lumps tend to be solid, and light cannot normally pass through them.

If your GP suspects that the lump in your testicle may be cancerous, you will be referred for further testing at a hospital. Some of the tests that you may have are outlined below.

Scrotal ultrasound

A scrotal ultrasound scan is a painless procedure which uses high frequency sound waves to produce an image of the inside of your testicles. This is one of the main ways in which your specialist will be able to determine whether or not your lump is cancerous.

During a scrotal ultrasound, your specialist will be able to determine the position and size of the abnormality in your testicle.

It will also give them a good indication of whether the lump is solid, or whether it is filled with fluid. A lump filled with fluid is known as a cyst, and is usually harmless. However, a more solid lump may be a sign that the swelling is cancerous.

Blood tests

To help confirm your diagnosis, you may require a series of blood tests. These tests will be used to detect certain hormones in your blood, which are known as 'markers'. Testicular cancer often produces these markers, so having them in your blood may be a strong indication that you have the condition.

The markers in your blood that will be tested for include:

  • AFP (alpha feta protein),
  • HCG (human chorionic gonadotrophin), and
  • LDH (lactate dehydrogenate).

It is important to remember that not all forms of testicular cancer produce these markers. There may still be a chance that you have testicular cancer, even if your blood test results come back normal.

Biopsy

The only way to definitively confirm a case of testicular cancer is to have a biopsy of the tumour taken. The cells from the tumour can then be examined in a laboratory to determine whether it is cancerous (malignant), or non-cancerous (benign).

Usually, a biopsy involves taking a small sample of cells from the tumour. Unfortunately, for most cases of testicular cancer, the only way to safely take a biopsy is to remove the affected testicle completely. This is because specialists often think that the risk of the cancer spreading is too high for a conventional biopsy to be taken.

Your specialist will only remove your testicle if they are relatively certain that your lump is cancerous. Losing a testicle will not affect your ability to have children, or your sex life. The main form of treatment for testicular cancer is to have the testicle removed, so it is likely that you will need to undergo this procedure at some point anyway.

The removal of a testicle is known as an orchidectomy. See the 'treatment' section for more information about the procedure.

Other tests

If your specialist feels it is necessary, you may require further tests to check whether your testicular cancer has spread to any other parts of your body. When cancer of the testicle spreads, it most commonly affects the lungs. This means that you may require a chest X-ray to check for any signs of a tumour.

You may also require a scan of your body, such as a magnetic resonance imaging (MRI) scan, or a computerised tomography (CT) scan to check for signs of the cancer spreading.

view information about Cancer of the testicle on www.nhs.co.uk »

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