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Testicular Cancer Diagnosis & Staging

Testing for Testicular Cancer

  • Scrotal ultrasound is used to confirm solid mass.
  • Blood tests for tumor markers: alpha-fetoprotein (AFP), human chorionic gonadotrophin (HCG), and lactic dehydrogenase (LDH). Approximately 85% of non-seminomas will have elevations of either AFP or beta HCG. These tests can also be used to monitor the response to treatment.
  • A chest X-ray is done to look for potential metastasis (spreading of cancer) to the lungs.
  • An abdominal CT scan may be done to look for potential metastasis.
  • Physical exam by a urologist

Stages of Testicular Cancer

Once cancer of the testicle has been found, more tests will be done to find out if the cancer has spread from the testicle to other parts of the body (staging). A doctor needs to know the stage of the disease to plan treatment. The following stages are used for cancer of the testicle:

Stage I

Cancer is found only in the testicle.

Stage II

Cancer has spread to the lymph nodes in the abdomen (lymph nodes are small, bean-shaped structures that are found throughout the body; they produce and store infection-fighting cells).

Stage III

Cancer has spread beyond the lymph nodes in the abdomen. There may be cancer in parts of the body far away from the testicles, such as the lungs and liver.


Recurrent disease means that the cancer has come back (recurred) after it has been treated. It may come back in the same place or in another part of the body. A patient should regularly examine the opposite testicle for possible recurrence for many years after treatment. Patients will probably have check-ups once per month during the first year after surgery, every other month during the next year, and less frequently after that.