Testicular cancer, while relatively uncommon, is the most frequently diagnosed solid tumor in men between the ages of 15 and 35. This type of cancer has a high rate of successful treatment when identified early, making prompt detection an important health goal. Detection relies on a combination of personal awareness and professional medical tools. The best way to detect this cancer involves knowing how to check for changes and understanding the diagnostic steps doctors use.
Performing a Self-Examination
A self-examination is the most direct and accessible method for individuals to monitor their health and notice any abnormalities. The best time to perform this check is during or immediately after a warm shower or bath. The heat relaxes the scrotal skin, allowing the testicles to drop lower and making them easier to feel accurately.
The self-exam should be performed monthly to establish a baseline of what feels normal and to quickly notice any new changes. While standing, gently examine each testicle separately using the thumb and fingers of both hands. Roll the testicle firmly but softly between the fingers, feeling for any hard lumps, nodules, or changes in size, shape, or consistency.
It is normal for one testicle to be slightly larger or to hang lower than the other. A soft, cord-like structure known as the epididymis is typically felt on the back and top of each testicle, which should feel smooth and somewhat firm. If any hard mass, swelling, or irregularity is detected, it warrants a consultation with a healthcare provider.
Recognizing Signs and Symptoms
Beyond the monthly self-exam, a person should be aware of physical signs that could indicate a problem requiring medical attention. The most common finding is a painless lump or swelling on one of the testicles. This mass may be as small as a pea or a marble, representing a change in the normal texture of the testicle.
Other symptoms include a feeling of heaviness or a dull ache in the scrotum or lower abdomen. Some men report discomfort or a change in the way the testicle feels, even without a distinct lump. A sudden collection of fluid in the scrotum is another sign that requires professional evaluation.
These symptoms can also be caused by non-cancerous conditions, such as infection or injury. However, any persistent change in the testicle or scrotum should be immediately assessed by a doctor.
Initial Clinical Assessment
When a patient reports a symptom or abnormality, the healthcare professional begins with a thorough clinical assessment. This evaluation involves taking a complete medical history, including asking about specific symptoms, their duration, and any known risk factors. A history of an undescended testicle (cryptorchidism) or a family history of the cancer can inform the doctor’s suspicion level.
The doctor then performs a physical examination, carefully palpating the scrotum to feel for any lumps, swelling, or hardening. The examination also includes checking the abdomen, groin, and lymph nodes for any signs that the cancer may have spread. This initial assessment determines if the abnormality is an intratesticular mass—a lump within the testicle itself—which is highly suspicious for cancer.
Definitive Diagnostic Testing
Following a suspicious finding during the clinical assessment, the doctor moves to advanced testing to confirm or rule out the presence of cancer. These tests are essential for achieving a definitive diagnosis and determining the extent of the disease. The primary tools used are medical imaging and blood analysis for specific biomarkers.
Imaging Technology
The primary imaging study for evaluating a testicular mass is a high-frequency scrotal ultrasound. This non-invasive procedure uses sound waves to create detailed images of the testicles and surrounding structures. The ultrasound offers high sensitivity when combined with a physical examination for diagnosis.
The imaging study allows the doctor to confirm if the abnormality is a solid mass within the testicle, characteristic of a tumor, or a more benign fluid-filled cyst. A solid mass that appears dark (hypoechoic) and sometimes shows increased blood flow suggests testicular cancer. Ultrasound is also used to examine the other testicle for any concurrent abnormalities.
Blood Markers
Simultaneously with or prior to imaging, a blood test measures levels of specific proteins known as serum tumor markers. The three primary markers associated with this cancer are Alpha-fetoprotein (AFP), Human Chorionic Gonadotropin (HCG), and Lactate Dehydrogenase (LDH). These markers are proteins released into the bloodstream by certain types of cancer cells.
Elevated levels of AFP and HCG are indicative of non-seminoma germ cell tumors, though HCG can also be raised in some seminomas. LDH is a less specific marker but is often elevated in cases of high tumor burden. Measuring these markers before surgical intervention provides a baseline for diagnosis, helps with staging the disease, and is later used to monitor treatment effectiveness and check for recurrence.