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Usually you begin by seeing your family doctor (GP), who’ll examine you. If your GP suspects that you may have testicular cancer, you’ll be referred to a hospital specialist for further tests|.
The specialist will usually be a urologist – a doctor who is experienced in treating testicular, prostate, bladder and kidney problems.
They’ll give you a full physical examination and take your medical history. You’ll have an ultrasound examination of the scrotum and the testes, and blood tests. You may also have a chest x-ray to check that your lungs are healthy.
Occasionally, some men with testicular cancer that has spread are diagnosed when other tests are carried out to investigate their symptoms|. These tests may include a CT scan| or MRI scan|.
This test can help the doctors tell whether a lump is a cancer, or is due to other causes like a cyst (a harmless lump filled with fluid). Ultrasound uses sound waves to build up a picture of the scrotum and testes. It’s a painless test and only takes a few minutes.
Once you’re in a comfortable position, a gel is spread onto your scrotum and testes. A small device like a microphone, which produces sound waves, is then passed over this area. The sound waves are converted into a picture by a computer.
Your doctor will also take blood from you. This is to find out if you have raised levels of certain chemicals in the blood called tumour markers|. They are produced and released into the blood by some testicular tumours.
Other blood tests will also be taken to check your general health.
If your ultrasound scan results show that the lump is highly likely to be cancer, the only way of confirming this is an operation to remove the testicle. An expert in examining cells and diagnosing types of cancer (pathologist) will then examine cells from the lump under a microscope.
It’s natural to have concerns about having this operation. Your specialist will explain why it’s absolutely necessary and will talk things over with you. You may also be referred to a specialist nurse who can give you information and support.
The removal of one testicle won’t affect your ability to get an erection or to have children. You’ll be able to return to your normal sex life| once you’ve recovered from the operation.
Removing the affected testicle is the only way to definitely diagnose testicular cancer. You’ll only have this done if your specialist thinks you have cancer. The operation (orchidectomy) also treats the cancer by removing it. If the cancer hasn’t spread outside the testicle, and there’s a low risk of it coming back (recurrence), this may be the only treatment you’ll need.
During the operation, the surgeon can insert an artificial testicle (known as an implant or prosthesis) into your scrotum. Your specialist will give you more details about having an artificial testicle, and how it will look and feel afterwards.
Your operation will be carried out under a general anaesthetic. It may be done as day surgery or during a short hospital stay.
The surgeon will make a small cut (incision) in the groin on the affected side. The testicle is pushed up from the scrotum and removed through the incision.
After the operation, you’ll be encouraged to get up and start walking around as soon as possible.
It’s not unusual to have some discomfort around the scar for a couple of weeks, but this can be controlled with painkillers. Wearing supportive underpants and loose trousers might help you feel more comfortable.
You may have numbness around the area, but this usually gradually improves. However in some men, it may always feel a little different to the unaffected side.
Your stitches will be removed about 5–10 days after your operation, unless they’re the self-dissolving type. Your specialist will advise you not to drive or do any heavy lifting for two weeks after your operation. The amount of time you’ll need to take off work will depend on the type of work you do.
You may worry that the operation might make you feel less of a man. You’ll be able to get back to your normal sex life, but you may go off sex for a while after your surgery. This may happen if you’re in some discomfort and feeling anxious.
Most men find that any negative feelings gradually go away. After a while, if you’re still struggling with difficult feelings or problems with your sex life, your doctor or specialist nurse can suggest sources of help and support.
An orchidectomy won’t make you infertile| (unable to father a child). However, some men may be offered sperm banking before surgery if they already have fertility problems, or if their unaffected testicle is small and possibly producing less sperm.
Sperm banking involves freezing the sperm so that it can be used later. It’s explained in more detail in our section on sperm banking|.
The specialist will usually be a urologist - a doctor who is experienced in treating testicular, prostate, bladder and kidney problems.
They’ll give you a full physical examination and take your medical history. You’ll have an ultrasound examination of the scrotum and the testes, and blood tests. You may also have a chest x-ray to check that your lungs are healthy. You can find out more about these tests and others you may have on our desktop site.
We have more information about what this operation involves, and the possible side effects, on our desktop site.
For answers, support or just a chat, call the Macmillan Support Line free (Monday to Friday, 9am-8pm)
If you have any questions about cancer, need support or just want someone to talk to, ask Macmillan.