Symptoms, risk, screening and diagnostic confirmation

Detect Testicular Cancer is about choosing the right test for the right risk.

A testicular cancer detection guide covering painless lump, ultrasound, AFP, beta-hCG, LDH, CT staging and orchiectomy histology.

Screening reality Symptoms not to ignore Immunotherapy

Educational, not personal medical advice. A painless testicular lump, swelling, heaviness, ache or breast tenderness needs prompt examination and ultrasound.

Young men

commonest solid cancer in younger adult men.

Ultrasound

key first imaging test.

Markers

AFP, hCG and LDH help subtype/stage.

Do not biopsy

radical inguinal orchiectomy is diagnostic/therapeutic.

Brief outline

What testicular cancer means.

Testicular cancer is often curable, especially when detected early. A solid testicular mass is cancer until proven otherwise.

Testicular tumor markers — AFP, hCG and LDH support diagnosis and monitoring.

Detection frame

Screening is for people without symptoms. Diagnosis is for symptoms, abnormal examination, family history, imaging findings or abnormal labs. The same test can be sensible in one setting and misleading in another.

Do not ignore

Symptoms and signs not to ignore.

Painless lumpClassic presentation.

Swelling/heavinessMay be subtle.

AcheDull testicular or lower abdominal ache.

Acute painCan occur but torsion is also emergency.

Breast tendernesshCG-producing tumors can cause this.

Back painMay suggest retroperitoneal nodes.

Risk and genetics

Demographics, risks and genetics.

CryptorchidismUndescended testis raises risk.

Prior testicular cancerRaises contralateral risk.

Family historyIncreases risk.

Infertility/testicular dysgenesisAssociated risk.

AgeMost common in young/middle-aged men.

Race/geographyHigher incidence in some populations.

Screening

Who should actually be screened?

No formal population screening program exists, but self-awareness and prompt ultrasound for a lump are sensible.

First line

Scrotal ultrasound

Distinguishes intratesticular mass from cyst/epididymal disease.

Blood

AFP, beta-hCG, LDH

Markers help diagnosis, staging and follow-up.

Staging

CT abdomen/pelvis/chest

Assesses nodal and metastatic disease.

Tissue

Radical inguinal orchiectomy

Provides diagnosis and local treatment.

Pathology

Seminoma vs non-seminoma

Changes treatment and marker interpretation.

Caution

Trans-scrotal biopsy

Generally avoided because it can alter spread pathways.

Images, labs and tissue

Useful tests and what they can miss.

Detection usually needs a chain: suspicion, imaging or lab triage, tissue or cytology when needed, then pathology and molecular testing where it changes management.

Testicular cancer PET-CT example — Cross-sectional imaging helps stage selected disease.

Testicular cancer specialist collage — Ultrasound and orchiectomy pathology define diagnosis.

Pros, cons and controversy

Benefits, harms and the false-positive problem.

The danger is delay from embarrassment or assuming pain is required. Most lumps are not cancer, but solid intratesticular masses need rapid workup.

Testicular Cancer detection trials immunotherapyfortesticularcancer.com DetectCancer.org hub

Sources and trials

Good starting points.

NCI testicular cancerTesticular cancer overview and diagnosis. ClinicalTrials.gov testicular detectionDiagnostic and surveillance trials.