Diagnosis Of Testicular Cancer

  • Your GP will examine you and arrange for any necessary tests, which may include a blood test and ultrasound of the testicles.
  • Your doctor may then refer you to a hospital specialist for further tests and treatment at the hospital.
  • Where you’re referred to will depend on the results of the tests. You may go straight to a doctor or hospital specialising in testicular cancer, or you  may see doctors with more general experience first. If you’re diagnosed with testicular cancer and not already seeing a specialist, you will be  referred to one.You’ll probably see a lot of doctors. The hospital doctor will also examine you and arrange for more detailed tests, which may include:
  • An ultrasound test of the scrotum and testicles if you haven’t already had one. An ultrasound can often tell the difference between a cancerous and  benign (harmless) lump.
  • Blood tests – they will check for levels of certain proteins in the blood – ones called AFP and HCG (short for alpha-fetoprotein and human chorionic  gonadtrophin). The cancer triggers higher than usual levels of these proteins, which are called tumour markers. Ongoing blood tests are usually  taken, as they show whether the tumour markers are rising or falling in response to treatment. You’ll continue to have blood tests at check-ups after  treatment, to check if the cancer has returned or spread.
  • Alpha-fetoprotein – AFP is a protein found in the bloodstream of some men with nonseminomatous testicular cancer (It is NEVER present in seminoma patients). The level rises when the cancer is growing and falls when the cancer is shrinking or has been surgically removed, so a blood test can possibly measure the progress of the disease and success of treatment. Because of this behavior, it is referred to as a tumor marker. Elevated levels of AFP occur in 75 per cent of patients with teratocarcinoma, embryonal cell carcinoma, and yolk sac carcinoma. (However, increased levels of AFP are also found in patients with liver diseases, such as cirrhosis, acute and chronic hepatitis and hepatic necrosis.) The serum half life of AFP is 5 to 7 days, which implies that elevated levels of AFP should fall by one half of the initial level per week and should probably return to normal within 25 to 35 days after surgery if all of the tumor has been removed. The higher the level, though, the longer it will take to return to normal. Please note that AFP is normally less than about 5 ng/ml, but cancer cannot be assumed until it is over 25 ng/ml. Also note that a very small number of people have a naturally high level of this protein in their blood (though less than 25) even though they do not have cancer.
  • Further tests may also be done to check the size of the tumour and whether it has spread, such as chest x-rays or  scans – these may include CT,  MRI, or PET scans.
  • You won’t necessarily need all of these – and further tests will often depend on the results of your first ones.
  • Waiting for test results can be a scary time, but understanding a little about them – what will happen, how you’ll feel and when you’ll get the results   – can help you cope.
  • If it is cancer, you might need a few more tests to check how your body is working in general. The hospital doctor will also examine you and arrange for more detailed tests, which may include:
  • These could be blood tests, or tests looking at your heart (an echo-cardiogram or electrocardiogram – ECG), or a test to check your kidneys. This  may seem like a lot of tests, but they are necessary to help the doctors provide the right treatment for you.

 

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