How is Testicular Cancer Diagnosed? | Dana-Farber Cancer Institute

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07/16/23

For more information about testicular cancer symptoms, diagnosis, treatment, and support, visit http://www.dana-farber.org/Adu....lt-Care/Treatment-an

Dr. Clair Beard, former Director of the Testicular Cancer Program at Dana-Farber/Brigham and Women's Cancer Center, describes common symptoms of testicular cancer and how it's diagnosed.

Transcription:

When someone notices that their testicle has a lump in it or it’s large or it’s swollen or it’s painful or uncomfortable or it’s just not like the other side, the process is generally to have an ultrasound, which is a painless test done in the ultrasound department—very straightforward, very easy, nothing to be embarrassed about. The ultrasonographer is perfectly accustomed to doing these. They do them all the time.

The ultrasound results go to either the primary care doctor or the urologist that ordered the test. Some blood work gets done, because if there is a testicular cancer, it sometimes creates proteins in the blood that can be elevated unique to testicular cancer. You would then go to the urologist. He would examine you. He would look at the ultrasound. He would look at your blood work, and he would talk to you about getting a biopsy.

Unlike other cancers, a testicular biopsy is not done by taking a needle and incising the testicle; they actually remove the testicle. It can be unsafe to leave the testicle behind, so it’s the kind of a tumor where really whole testicle in general has to be removed. And remember: you have a testicle on the other side.

People think, ‘Will I be OK with just one testicle left behind?’ and the fact of the matter is yes, absolutely. You’ll still be fertile. You’ll still have all the male hormone that you need, so it’s fine to have one testicle removed. The testicles are a paired organ, so the other one can do all the work of two, so that’s why it’s safe to have one removed. It’s a little bit disconcerting and discombobulating to think, ‘Wow, I’m going to have a testicle removed as part of the biopsy,’ but don’t forget: they won’t do that casually. They won’t remove the testicle unless they're really quite certain that it’s cancerous.

The testicle is sent to the pathology department where it’s looked at under the microscope with some special stains, and they determine what kind of testicular cancer you have. There are two main types of testicular cancer: one is seminoma one is non-seminoma. We divide them that way, because they're treated differently. Seminomas are generally treated one way. Non-seminomas are treated slightly differently. They're both generally very curable. People do extremely well both ways. A lot of them are cured just by removal of the testicle. You get your stage, so you know exactly what you have, and then there are choices that are made with regard to your treatment.