How testicular cancer is diagnosed

The specialist will usually be a urologist 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. If your scan results show that the lump is highly likely to be cancer, the only way of confirming this is to do an operation to remove the testicle|.

Your doctor will also take blood from you which will be tested 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.

Ultrasound  Back to top

This test can help to tell whether a lump is a cancer, or due to other causes such as a cyst (harmless lump filled with fluid). Ultrasound uses sound waves to build up a picture of the testes and scrotum. 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.

If your scan results show that cancer is highly likely, you'll have an operation to remove the testicle.

Removing the testicle (orchidectomy)   Back to top

Removing the testicle is the only way to definitely diagnose testicular cancer. An expert in examining cells and diagnosing the type of cancer (pathologist) will then examine the testicle under a microscope. 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 this may be the only treatment you’ll need. 

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 operation

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) through the lower tummy (abdomen) in the groin on your affected side. The testicle is pushed up from the scrotum and removed through the incision on your lower tummy. 

During the operation the surgeon can insert an artificial testicle (known as an implant or prosthesis) into your scrotum so that it looks the same as before. Your specialist can give you more details about this.

After the operation

After the operation you’ll probably feel a bit sore, but you’ll be given painkillers to take regularly until the pain settles down. You’ll be encouraged to get up and about and start walking as soon as possible. About 5–10 days after your operation your stitches will be removed, unless they’re the self-dissolving type.

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. But in some men it may always feel a little different to the other side.

Your specialist will advise you not to drive or do any heavy lifting for a few 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 might worry that the operation may make you feel less of a man. The operation doesn’t make you infertile (unable to father a child), or unable to have sex|. It’s not unusual to go off sex for a while 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. 

Some men may be offered sperm banking| (storing samples of sperm) before their operation. The sperm is frozen and can be used later if treatment has affected your ability to father a child.