Diagnosing testicular cancer almost always involves surgical removal of the testicle (orchiectomy). An incision is made in the groin rather than the scrotum, to avoid possibly spreading cancer cells. A tissue sample from the testicle is examined under a microscope to determine the presence of cancer cells and the stage of the disease.
Special blood tests that detect certain protein "markers" are used to diagnose and stage testicular cancer both before and after orchiectomy. These tests include:
- Alpha-fetoprotein (AFP): elevated levels of this protein, which is normally produced by a fetus in the womb, may indicate the presence of a germ cell tumor in men. Beta human chorionic gonadotropin (b-HCG): increased levels of this protein, normally found in pregnant women, can indicate the presence of several types of cancer, including testicular cancer.
- Lactate dehydrogenase (LDH): this enzyme is related to increased energy production by the body's cells and tissues, which can sometimes indicate cancer. Ultrasound may also be used before surgery to determine the presence of a mass on the testicle.