Your doctor may need to get more information about what’s going on with your nuts, so they might order some testicular cancer tests. There are three main types of tests used when looking into (or more ideally ruling out) testicular cancer.
In some cases, a lump or swelling on your nuts could be caused by an infection. Your doctor might take a urine sample or use a swab (small cotton bud) to collect a sample of cells and fluid from your urethra (the tube that carries pee out of your body).
If there’s a chance you have a sexually transmitted infection (STI) you may be referred to a sexual health clinic.
You may be asked to get an ultrasound on your nuts to check for testicular cancer. An ultrasound sends out sound waves, which echo when they encounter something dense like a tumor (in the same way it can detect a baby in a woman’s uterus). The ultrasound images are then projected onto a computer screen so you can create a picture of what’s beneath the skin.
In terms of what to expect, ultrasounds are usually painless and only take about 15 minutes. A gel will be spread over your scrotum and a small device called a transducer is pressed into the area.
Your doctor may also ask you to get a blood test before your next appointment. This checks for something called “tumor markers” in your blood. If tumor markers are increased in your blood, it could be a hint that there’s a testicular tumor.
While these numbers will be pretty meaningless to you, your doctor will be able to use them to get a good indication of what’s going on.
Let’s delve a bit deeper into how a blood test can help diagnose testicular cancer.
Many testicular cancers make high levels of certain proteins called tumor markers. When these tumor markers are in the blood, it suggests that you could have a testicular tumor.
Rises in certain proteins can also help doctors tell which type of testicular cancer it might be:
Non-seminomas often raise AFP and/or HCG levels.
Pure seminomas occasionally raise HCG levels but never AFP levels, so any increase in AFP means that the tumor has a non-seminoma component. (Tumors can be mixed and have areas of seminoma and non-seminoma.)
Sertoli and Leydig cell tumors don't make these substances.
Some cancers are too small to elevate levels of these tumor markers.
All sounds pretty confusing, right? That’s why it's best to talk through the test results with your doctor.
A testicular tumor might also increase the levels of an enzyme called lactate dehydrogenase (LDH). But LDH levels can also be increased in conditions other than cancer, such as other diseases.
Other reasons a tumor marker test could be used include:
To help estimate how much cancer is present.
To follow a patient’s response to treatment.
To look for signs a tumor might have returned.
If tests indicate that you might have testicular cancer, your doctor might tell you this straight up, or they may refer you to a urologist to make a final call.