Further tests for testicular cancer

Occasionally some men with testicular cancer that has spread are diagnosed through scans to investigate their symptoms.

You may have one or more of the following tests:

• blood tests - to check general health and to look for specific signs of cancer
• a chest x-ray - to check the health of your heart and lungs
• a CT scan - uses a computer to build up detailed, three-dimensional views of the inside of the body
• an MRI scan - uses magnetic fields to build up a series of cross-sectional pictures of the body
• a PET scan - a scan that shows how tissues inside your body are working.

What the tests involve

Blood tests

Some testicular cancers produce chemicals called tumour markers|, which are released into the bloodstream. These can be measured in simple blood tests.

Other blood tests will also be taken to check how well organs, such as your liver and kidneys, are working.

Chest x-ray

You may have a chest x-ray to check that your lungs are healthy before your operation to remove your testicle.

CT (computerised tomography) scan 

This is the most common scan that’s used. A CT scan takes a series of x-rays, which build up a three-dimensional picture of the inside of your body. It’s done to check for any signs that the cancer has spread to the lymph nodes in your abdomen| or to the lungs. Usually you’ll have x-ray pictures taken of the chest, abdomen and pelvis. The pictures are fed into a computer to give a detailed picture.

The scan is painless and takes 10–30 minutes. You may be asked not to eat or drink anything for several hours beforehand.

Most people who have a CT scan are given a drink or injection of dye before the scan. This helps the doctor to see particular areas more clearly.

Most people feel hot and flushed for a few minutes after having the injection. You’ll probably be able to go home as soon as the scan is over.

Magnetic resonance imaging (MRI) scan

This test is similar to a CT scan but uses magnetism instead of x-rays to build up a detailed picture of areas of your body.

Before the scan you may be asked to complete and sign a checklist. This is to make sure that it’s safe for you to have an MRI scan because the scanner is a powerful magnet.

The checklist asks about any metal implants you may have, for example a pacemaker, surgical clips or bone pins. You should also tell your doctor if you have ever worked with metal or in the metal industry as very tiny fragments of metal can sometimes lodge in the body. If you do have any metal in your body it’s likely that you won’t be able to have an MRI scan. In this situation another type of scan can be used.

Before having the scan, you’ll be asked to remove any metal belongings including jewellery. Some people are given an injection of dye into a vein in the arm. This doesn’t usually cause discomfort. The dye is called a contrast medium and can help the images from the scan to show up more clearly.

During the test you will be asked to lie very still on a couch inside a long cylinder (tube) for about 30 minutes. It is painless but can be slightly uncomfortable, and some people feel a bit claustrophobic during the scan. It’s also noisy, but you’ll be given earplugs or headphones. You will be able to hear, and speak to, the person operating the scanner.

PET (positron emission tomography) scan

A PET scan uses low-dose radioactive sugar to measure the activity of cells in the body. A very small amount of a mildly radioactive sugar is injected into a vein in your hand or arm. You then have the scan. Areas of cancer are normally more active than surrounding tissue and absorb more of the sugar, which shows up on the scan.

There are only a few PET scanners in the UK, so you may have to travel to a specialist centre if you need one. But this scan is rarely needed in testicular cancer.