Cancer screening exams can help find testicular cancer at its earliest stage when the chances for successful treatment, optimal outcomes and fewer side effects are greatest. These tests are usually done when a patient is healthy and has no specific symptoms.

Not only are expert cancer researchers at the OSUCCC – James continually working to detect and diagnose testicular cancer early, but they are also developing additional tests to detect and diagnose cancer even earlier, leading to improved outcomes, faster responses and fewer side effects.

Unlike with some cancers, there are currently no recommended screening exams for testicular cancer. Your doctor should examine your testicles as part of a physical exam and some doctors recommend that men examine their testicles once a month.

Testicular Cancer Risk Factors

A risk factor is anything that increases the chance of developing testicular cancer. These include:

  • having had an undescended testicle
  • having had abnormal development of the testicles
  • having a personal history of testicular cancer
  • having a family history of testicular cancer (especially in a father or brother)
  • being white

(Source: National Cancer Institute)

Not everyone with risk factors will get testicular cancer. But having certain risk factors may increase your risk of developing the disease. If you are at high risk for testicular cancer, talk to your doctor about tests to find out if you have early signs of the disease.

Doing a Testicular Self-Exam (TSE)

Testicular cancer is the most frequently diagnosed cancer in men 20 to 35 years old, but can happen in men at any age. It is a very curable cancer if found and treated early. The James recommends that men perform a testicular self-exam (TSE) monthly starting at age 14.

How to do a Testicular Self-Exam:


  • Do your self-exam once a month, after a warm bath or shower. The heat causes the scrotal skin to relax, making it easier to feel anything unusual.
  • Examine each testicle gently with both hands. Place your index and middle fingers under your testicles and your thumbs on top. Roll your testicles gently between your thumbs and fingers and feel for any features that were not there before. It is normal if one testicle feels longer than the other.

The Epididymis

The epididymis is a cord-like structure on the top and back of your testicles that stores and moves sperm. It may be tender to the touch. If you have a question about whether you are feeling epididymis or a lump, talk to your doctor.

Other Symptoms to Have Checked:


  • pain in the testicle
  • a significant change in the size of one of the testicles
  • a feeling of heaviness or pain in the scrotum
  • a feeling of fluid collecting in the scrotum
  • breast tenderness or increased breast size

If You Find a Lump

If you find anything unusual during your self-exam, call and schedule an appointment with your healthcare provider.

Diagnosing Testicular Cancer

During a physical examination, a doctor will check the testicles for lumps or other concerns. If testicular cancer is suspected, your OSUCCC – James expert may conduct the following tests to form a diagnosis:

Blood Tests

A sample of blood is drawn to measure for specific proteins and hormones (called tumor markers) that could indicate testicular cancer and its type. Measuring these substances in the blood can indicate testicular cancer and help identify the type of testicular cancer. Specifically, the experts are looking for increased levels of a protein called alpha-fetoprotein or a hormone called beta-human chorionic gonadotropin.

Ultrasound Exam

Ultrasound uses sound waves to evaluate organs and can help show whether if a lump appears to be a cancerous tumor or a noncancerous lump.

Inguinal Orchiectomy

A specially trained OSUCCC – James surgical oncologist removes an entire testicle through an opening made in the groin and takes a tissue sample for biopsy. If cancer is found, the cell type (seminoma or nonseminoma) is determined in order to help plan the most effective, personalized treatment.

Biopsy

A biopsy confirms a testicular cancer diagnosis. A specially trained OSUCCC – James pathologist analyzes sample tissue from the testicular tumor under a microscope. The pathologist will check for the presence of cancer cells.

Lymph Node Biopsy

A specially trained OSUCCC – James surgical oncologist may remove lymph nodes in the abdomen near the testicles to check for signs of cancer and to stop cancer cells from spreading.

Tests Used for Staging Testicular Cancer

If you receive a testicular cancer diagnosis, staging is just one of many ways your OSUCCC – James cancer experts can determine the amount and location of your cancer and can help them choose the most effective, personalized treatment options for you.

The following tests help your specialists stage cancer:

Imaging Exams

Most imaging exams for staging help determine whether or not testicular cancer has spread to other areas of your body.

Chest X-ray

X-rays show images the chest and lung area.

Computed Tomography (CT) Scan

A computer linked to an X-ray machine revolves around your body to create multidimensional images from different angles.

Magnetic Resonance Imaging

Magnetic resonance imaging (MRI) uses a high-powered magnet and radio waves to produce detailed images of the body.

Nuclear Medicine Scan

Also called a bone scan, this nuclear medicine examination often is used to check for cancer cells in the bone. The patient receives an injection of a small amount of radioactive dye, which highlights cancer cells on images taken with a special gamma camera.

PET (Positron Emission Tomography) Scan

A PET scan is an imaging examination used to find cancerous cells in the body. A small amount of radioactive tracer is injected into a vein and then a scanner rotates around your body to detect any areas where the tracer concentrated. These areas are more active and usually indicate cancerous cells.

Staging Testicular Cancer

If you receive a testicular cancer diagnosis, your specialized OSUCCC – James treatment team will determine the stage of your cancer, which is just one of the many ways they plan the most effective, personalized treatment for you.

Stage 0

Abnormal cells are found in the tiny tubes where sperm cells begin to develop. These abnormal cells may become cancer and spread into nearby normal tissue. All tumor marker levels are normal. Stage 0 is also called carcinoma in situ.

Stage I

Cancer has formed. Stage I is divided into stage IA, stage IB and stage IS and it is determined after the physician removes the abnormal testicle in a procedure called an inguinal orchiectomy.

Stage IA

  • Cancer is in the testicle and the epididymis, which is a narrow tube attached to the testicle.
  • The cancer may have spread to the inner layer of the membrane, the thin lining that surrounds the testicle.
  • All tumor marker levels are normal.

Stage IB

  • Cancer is in the testicle and the epididymis, and it has spread to the blood vessels or lymph vessels in the testicle; or
  • It has spread to the outer layer of the membrane surrounding the testicle; or
  • Is in the spermatic cord or the scrotum and may be in the blood vessels or lymph vessels of the testicle.
  • All tumor marker levels are normal.

Stage IS

  • Cancer is found anywhere within the testicle, spermatic cord or the scrotum, and either:
    • All tumor marker levels are slightly above normal; or
    • One or more tumor marker levels are moderately above normal or high

Stage II

Stage II is divided into stage IIA, stage IIB and stage IIC and is determined after a physician performs an inguinal orchiectomy.

Stage IIA

  • Cancer is anywhere within the testicle, spermatic cord or scrotum; and
  • It has spread to up to 5 lymph nodes in the abdomen, none larger than 2 centimeters.
  • All tumor marker levels are normal or slightly above normal.

Stage IIB

  • Cancer is anywhere within the testicle, spermatic cord or scrotum; and either:
    • Has spread to up to 5 lymph nodes in the abdomen; at least one of the lymph nodes is larger than 2 centimeters, but none are larger than 5 centimeters; or
    • Has spread to more than 5 lymph nodes; the lymph nodes are not larger than 5 centimeters.
  • All tumor marker levels are normal or slightly above normal.

Stage IIC

  • Cancer is anywhere within the testicle, spermatic cord or scrotum; and
  • It has spread to a lymph node in the abdomen that is larger than 5 centimeters.
  • All tumor marker levels are normal or slightly above normal.

Stage III

Stage III is divided into stage IIIA, stage IIIB and stage IIIC and is determined after an inguinal orchiectomy is done.

Stage IIIA

  • Cancer is anywhere within the testicle, spermatic cord or scrotum; and
  • It may have spread to one or more lymph nodes in the abdomen; and
  • Has spread to distant lymph nodes or to the lungs.
  • Tumor marker levels may range from normal to slightly above normal.

Stage IIIB

  • Cancer is anywhere within the testicle, spermatic cord or scrotum; and
  • It may have spread to one or more lymph nodes in the abdomen, to distant lymph nodes or to the lungs.
  • The level of one or more tumor markers is moderately above normal.

Stage IIIC

  • Cancer is anywhere within the testicle, spermatic cord or scrotum; and
  • It may have spread to one or more lymph nodes in the abdomen, to distant lymph nodes or to the lungs.
  • The level of one or more tumor markers is high, or cancer is:
    • Anywhere within the testicle, spermatic cord or scrotum; and
    • May have spread to one or more lymph nodes in the abdomen; and
    • Has not spread to distant lymph nodes or the lung but has spread to other parts of the body.
  • Tumor marker levels may range from normal to high.

(Source: National Cancer Institute)

If you’ve been diagnosed with testicular cancer, would like a second opinion or would like to speak with a testicular cancer specialist, please call The James Line at 800-293-5066 or 614-293-5066 to make an appointment.

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Patient Story

Patient Stories Charles Ruma

Charles Ruma

After Charles Ruma developed testicular cancer, he underwent treatment at the OSUCCC – James to remove it. And then he started a nonprofit organization to help raise funds for cancer research.

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