The most obvious sign of testicular cancer is a lump in the testicle. This lump must be distinguished from lumps in the epididymis behind the testicle or lumps elsewhere in the scrotum but not in the body of the testicle.
All lumps of the body of the testicle need urgent assessment, to rule out the possibility of a testicular cancer.
The most accurate test for testicular cancer is an ultrasound of the scrotum. This will detect the presence of a lump in the body of the testicle and distinguish it from benign causes such as cysts in the epididymis and collections of fluid around the testicle known as hydrocoeles.
Blood tests including Beta HCG, AFP and LDH may be used by your specialist to assist in diagnosis and to monitor for signs of recurrence or spread of the cancer.
CT scans of the chest and abdomen and occasionally PET scans are used to detect spread of the testicular cancer. There are no proven measures to prevent testicular cancer.
The first step to a definitive diagnosis and treatment of testicular cancer is the removal of the testicle, its coverings and its attachments through an incision in the groin in a procedure known as a radical orchidectomy. A testicular prosthesis or silicone replacement may be placed in the scrotum for those patients who request it. However, this procedure is usually performed at a later date after any additional treatments below have been completed.
After removal of the testicle, a pathologist will perform a microscopic examination to determine which subtype of testicular cancer is present. Testicular cancer is broadly subdivided into seminoma and non-seminoma.
Most patients will be referred for consultation with an oncologist specialist soon after surgery. The oncologist will decide if any further treatment such as chemotherapy is required. Occasionally patients may also see a radiotherapy specialist for consultation and advice.
The freezing and storage of sperm known as sperm banking may be organized at any point in the patient journey but will generally be done before chemotherapy or radiotherapy treatments are undertaken.
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