If your healthcare provider thinks you might have testicular cancer, you will need certain exams and tests to be sure. The process starts with your healthcare provider asking you questions. He or she will likely ask you about your:

• Health history

• Symptoms

• Risk factors

• Family history of disease 

Your healthcare provider will also give you a physical exam. During the exam, he or she will feel your testicles for any swelling, sore areas, or lumps. If there is a lump, your healthcare provider will note its size and location. The healthcare provider may also look carefully at your belly (abdomen), groin, and other parts of your body. This is to find signs that any tumors may have spread. 

You may have one or more of these tests:

• Ultrasound. An ultrasound will often be the first test done if you have a lump on or near your testicle. This test uses sound waves to see if the lump is filled with fluid or is a solid mass. Solid lumps are more likely to be cancer.

• Blood tests. Blood levels of some proteins often change if you have testicular cancer. These proteins are called tumor markers. The main tumor markers for testicular cancer are alpha-fetoprotein (AFP) and human chorionic gonadotropin (HCG). Another marker is the enzyme lactate dehydrogenase (LDH). Your healthcare providers may be able to tell what kind of testicular cancer you have based on these marker levels. Your healthcare provider may repeat these blood tests during and after treatment. This is to see how well the treatment is working. 

• Surgery to remove the testicle. If a lump is found and the healthcare provider thinks it is cancer, a surgeon will most likely try to remove all of it. Most often this is done by removing your testicle and spermatic cord. This surgery is called a radical inguinal orchiectomy. The surgeon removes the testicle and cord through a cut (incision) above your pubic area. The surgeon does not do this surgery through the scrotum. This is because if you have cancer, the surgery could spread the cancer cells to your scrotum or your other testicle. The surgeon sends the testicle and spermatic cord to a lab for testing. A pathologist is a doctor who looks at cells under the microscope to tell if they are cancer. He or she will look for cancer cells.

Your healthcare provider will contact you with the results of your tests. You may need other tests. Make sure you understand the results and what follow-up you need.