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Testing for testicular cancer
What to expect during your appointment: exam, blood test, and ultrasound
First, the doctor will examine your testicles for lumps or swelling.
A blood test will be performed to test for certain proteins in your blood. These proteins are called tumor markers and can be used to diagnose testicular cancer.
If the doctor thinks that you may have testicular cancer, the next step is to have an ultrasound, a quick and painless scan that looks at the inside of your testicles. Normal testicles are smooth and even. Shadows on the ultrasound
usually indicate that a cancer is present. The ultrasound also measures blood flow to the testicles, since blood flow is usually increased in the area of a cancer. The experienced ultrasound specialists at Dana-Farber/Brigham and Women's Cancer
Center (DF/BWCC) understand some men may have anxiety about having an ultrasound; they will explain the process and help to ease any anxiety.
If your blood test is positive for testicular cancer tumor markers, or if your ultrasound reveals a cancerous-appearing lump in your testicle, you will be referred to a specialist called a urologist. Urologists are surgeons who focus on the urinary tracts
of males and females, and on the reproductive system of males, including problems with the testicles. For patients with testicular cancer, a urologist will perform the surgery to remove your tumor.
Unlike other cancers for which a biopsy (the removal of a sample of cells for examination) is performed, when testicular cancer is suspected the entire testicle is removed in a procedure called an orchiectomy through an incision in the groin and pulling
the testicle up from the scrotum. A biopsy through the scrotum for testicular cancer runs the risk of spreading the cancer, and can complicate future treatment options. Removing the entire testicle out of the scrotum is the only safe way to diagnose
for testicular cancer. Only the cancer-containing testicle is removed, and it is important to do so promptly. Our urology team will make this a priority for you. If there is any uncertainty, the urologists can examine the testicle by pulling the testicle
out of the scrotum; if a condition other than testis cancer is found, the testicle is placed back into the scrotum.
This may sound frightening, but recovery is quick. And do not worry — the remaining testicle can do the work of two. Please understand that removal of the testicle will not make you sterile (unable to have children) and does not take away your ability
to enjoy sexual activity or have an erection.
The removed testicle will be sent to our pathology laboratory for a thorough examination under a microscope. A pathologist is a specially trained doctor who identifies cancerous cells and tumors. DF/BWCC pathologists are well-known for their expert evaluation
of testicular cancer. They will diagnose and classify your cancer quickly and competently.
Most testicular cancers are classified as germ cell tumors. This is not an infection. Instead, the term germ cell reflects the fact that testicles make sperm. Germ cell tumors are divided into two types: seminoma and nonseminoma.
In order to decide what treatment is best for you, it is important to know whether or not your testicular cancer has spread beyond the testicle. Another kind of scan can be used to look for cancer in other parts of the body:
Our experienced radiologists will review your scans to help determine the stage of your cancer.
Testicular cancer is divided — or staged — into groups based on how far the cancer has spread to other parts of the body. Here are the basic stages for testicular cancer:
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