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.
Unlike with some cancers, there are currently no universally recommended screening exams for testicular cancer. Nonetheless, consider doing a self-examination of your testicles once a month in a warm shower. If you notice any abnormalities, contact your doctor.
Doing a testicular self-exam (TSE)
Testicular cancer is the most frequently diagnosed cancer in those with male reproductive systems from ages 20 to 35, but it can happen at any age. It is a very curable cancer if found early and treated appropriately. The James recommends that you perform a testicular self-exam (TSE) monthly starting at age 14.
How to perform 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 the epididymis or a lump, talk to your doctor.
If you find a lump
If you find anything unusual during your self-exam, call and schedule an appointment with your health care provider.
Other symptoms to have checked
If you have any additional symptoms, you should see your doctor to rule out the cause.
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 doctor 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 (AFP) or a hormone called beta-human chorionic gonadotropin (BHCG).
Ultrasound exam
Ultrasound uses sound waves to evaluate organs and can help show whether a lump appears to be a cancerous tumor or a noncancerous lump. View video about ultrasound exams.
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 option.
Lymph node biopsy
A 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 the experts at the OSUCCC – James determine an effective and personalized treatment option for you.
The following tests help your specialists stage cancer:
- X-ray
- Computed tomography (CT) scan
- Magnetic resonance imaging
- Nuclear medicine scan
- Positron emission tomography (PET) scan
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 IC 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 IC
- 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 five 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 five lymph nodes in the abdomen, and 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 five lymph nodes, and 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
- 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
- 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
- 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.
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.
Related resources
Testicular Cancer Prevention
Testicular Cancer Symptoms and Causes
Testicular Cancer Treatment
Testicular Cancer Treatment Team