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Published: 18/03/2023

Testicular Cancer Screening

Testicular cancer is the most common male cancer and it can be curable if caught early.

If you are at risk, your healthcare provider may recommend performing a testicular self-exam (TSE) on yourself regularly. This is an easy and painless way to detect tumors in the testis.

Testicular self-examination

Testicular self-examination is a quick inspection of your testicles to detect any lumps or swellings that could indicate an issue. It's especially crucial for men who have undescended testicles, which increases their risk for testicular cancer.

The testicles, commonly referred to as testes, are two glands in the scrotum that produce sperm and produce testosterone. They resemble small eggs in size and shape and feature a coiled tube at their rear known as an epididymis which stores sperm.

Men are encouraged to perform a testicular exam once per month in order to reduce the likelihood of missing a tumor. It also helps you become familiar with your testicles' appearance and feel, so that you can become more alert to any changes that may take place.

To perform a testicular self-exam, stand and place your right leg on an elevated surface about chair height. Gently roll each testicle between the thumb and forefinger of both hands to feel for any hard lumps or bumps. Pay particular attention to the soft tube-like structure behind each testicle called the epididymis; check for changes in size, shape or texture there as well.

Repeat on the left side and feel for any differences in texture or consistency. It is normal for one testicle to be slightly larger than the other.

Testicular self-exams are an excellent way to monitor the health of your testicles and identify any issues before they become major problems, so they should be done regularly. They're especially beneficial after taking a bath or shower since the skin in the scrotum is more relaxed.

Blood tests

Blood tests are an effective way to detect testicular cancer. They measure levels of specific proteins and hormones produced by cancers, helping doctors determine the type of tumor it is and whether it has spread outside the testis.

Your urologist may order blood tests for several reasons. These include checking your white blood cell count (WBC), neutrophil lymphocytic ratio (NLR) and tumor marker levels. The results of these tests will help them decide which treatment option is most suitable for you.

Blood tests used for screening include alpha-fetoprotein (AFP), human chorionic gonadotropin (HCG) and lactate dehydrogenase (LDH), all tumor markers that can increase with certain types of cancer.

One common test to diagnose testicular cancer is an ultrasound scan. This imaging technique utilizes sound waves to create images of your testicles and scrotum, helping identify certain benign conditions (like hydrocele or varicocele) as well as solid tumors which could be cancerous.

Most doctors begin with a physical exam and ultrasound before ordering other tests. They also look for any signs of sexually transmitted disease or other conditions that could be the source of the lump.

Your doctor may order additional tests and surgery to check for testicular cancer. They'll use these results to determine how advanced the cancer is and if it has spread elsewhere in your body.

If the testicular cancer is small and hasn't spread, your doctor may treat it without needing further testing or surgery. On the other hand, if it's large and has spread, surgery may be recommended to remove your testicle. After that, tissue samples and biopsies will be taken to identify what kind of cancer it is and its extent of spread.


Ultrasound is a non-invasive test that uses sound waves to create pictures of your body. It can help your doctor detect lumps in the testes that could be cancer or other issues such as fluid-filled sacs (cysts) or irregular blood flow.

A healthcare provider applies gel onto your scrotum and uses a small tool called a transducer against it to take pictures. While this won't hurt, you may feel pressure as the tool moves against your skin. A radiologist will examine the images and send them on to your doctor.

If there's a lump inside your testis, your doctor may order another test to see if it's cancerous. If so, surgery will be performed and the sample taken for analysis in a laboratory.

If your doctor suspects you of having testicular cancer, they may recommend an orchiectomy - the safest way to diagnose the disease.

Your doctor may use ultrasound to check for changes in the shape of your testicles or scrotum, such as hydrocele or varicocele. This information can give them more insights into the lump and help them decide whether other tests should be ordered or if surgery is necessary.

Another crucial part of testicular cancer screening is a chest X-ray and scan of your lungs to look for signs of a tumour. These tests can also help your doctor gauge how far the cancer has spread and measure levels of chemicals linked to cancer in your bloods.

Ultrasound for testicular cancer screening has been called into question. According to a recent study, ultrasound only correctly predicted physical examination findings in 54 % of patients; this disparity can be attributed to the high number of physicians with less experience practicing medicine and the large number of referrals from community doctors.

CT scan

CT scans are x-rays that use radiation to create detailed pictures of parts of your body. It can be used to view areas such as your abdomen, pelvis, chest/lungs and brain in detail.

Your healthcare team may use this scan to detect cancer that is causing your symptoms or assess how well you are healing from surgery. The scan requires special dye, and in order to guarantee its accurate use, a blood test may be required beforehand.

CT scans are typically done in a hospital. A radiographer (the health care professional who does the scan) will explain the procedure and what to expect. They may ask you to remove any jewelry that could interfere with the test, such as earrings or piercings.

Some people experience claustrophobia or have difficulty with small spaces, so let the radiographer know if that applies to you. They will do their best to keep you as comfortable as possible and take extra care if needed.

After your scan, you will meet with your doctor to review the results and decide next steps. They may also inquire about any existing health conditions like a heart condition.

If your doctor suspects you of having testicular cancer, they may order additional tests to rule it out. For instance, they could order blood tests that detect whether there are certain proteins produced by cancer cells in your system and a liver function test to see if the tumor has spread to your liver.

Men with early-stage, low risk testicular cancer often undergo years of monitoring to see if their cancer returns. CT scans, which expose them to radiation, are commonly used during this time; however, recent research suggests MRI (magnetic resonance imaging), which does not involve radiation exposure, may be just as effective at catching relapses of this disease as using CT scans.


Magnetic resonance imaging (MRI) is an essential test for diagnosing testicular cancer and can be used to estimate its size. Furthermore, MRI helps determine if cancer has spread elsewhere in your body.

MRI is a safe, painless procedure that uses magnetic fields and radio waves to create 3-dimensional pictures of the inside of your body. You'll lie flat on a tube-like machine with both ends open, while a technologist monitors you from another room.

If you're anxious about feeling radiation or have claustrophobia, your doctor may administer special drugs to make the scan more comfortable. Some MRI machines produce loud noises which could be uncomfortable; therefore, you might need to wear ear protection.

In addition to your entire testes, an MRI scan can also examine your chest/lungs, abdomen, pelvis and brain. To make these areas easier to see on the images, you may be given a dye before the scan.

Most men who have undergone surgery for low-risk testicular cancer must be rescanned annually for several years to make sure the cancer doesn't recur. CT scans are typically used to check for relapses, but a recent study has demonstrated that MRI is just as reliable at catching them as CT scans at doing so.

Seminomas on ultrasound usually present as hypoechogenic or lobulated structures with occasional calcifications, while non-seminomas tend to be inhomogeneous and often show cystic structures or calcifications [15, 16]. When there are no other testicular masses present, MRI provides a useful differential diagnosis option when the location and vascularity of a lesion cannot be accurately assessed through ultrasound alone - such as mature teratomas).

At present, MRI is not widely used in clinical practice to monitor relapsed seminomas. However, the United Kingdom "Trial of Imaging and Schedule in Seminoma Testis" is testing whether MRI can be used to detect these cases of relapse and will provide guidance on when it may be beneficial to use MRI instead of CT for follow up imaging

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