What kind of tests can be carried out

The urologist will listen to your complaints, examine your testicles and other organs and prescribe tests. Often, after examining your testicles, the doctor can estimate whether the lesions are similar to those of testicular cancer. An ultrasound examination of the testicles is performed to assess the lesions more accurately. This examination allows a more accurate assessment of whether a nodule in the testicle or an enlargement of the testicle is due to cancer or to another cause.

However, surgery is the only way to fully investigate and confirm the diagnosis of cancer. During surgery, the surgeon removes a small piece of abnormal testicular tissue, which is quickly examined under a microscope by a pathologist. If testicular cancer is detected, an orchofuniculectomy is performed, i.e. the entire testicle is removed. The removed testicle is examined microscopically by a pathologist to clarify the type of tumour.

After this operation, the patient can go home the next day. If the cancer has not spread beyond the testicle, the orchofuniculectomy may be sufficient and no other treatment will be needed. However, regular health checks will be needed for several years. Removal of one testicle does not affect a man's ability to have sex or prevent him from having children. If cancer is detected in the testicular tissue, tests will be carried out to see if the cancer has spread to other organs in other parts of the body.

Some or all of the following tests are carried out:

A blood test to determine the general condition of the body and its response to the illness. A blood test reflects the functioning of the kidneys, liver and other organs and their systems, and their ability to perform basic functions. Blood is taken from a finger and from a vein.

A urine test gives the doctor information about the work of the kidneys, whether there is inflammation, other abnormalities in the urinary organs.

An echoscopy shows the structure of the organs to be examined, its abnormalities and the relationship between the organs. Echocardiography can be used for some therapeutic and diagnostic procedures. The examination sometimes requires additional preparation (e.g. enemas).

Isotopic examination is performed to clarify kidney function and urine leakage from the kidneys. It is a test in which rapidly decaying radioactive substances are injected intravenously and recorded by a clamp.

An intravenous urogram is an X-ray examination that may be prescribed by a doctor to supplement knowledge of the urinary system. It involves the intravenous administration of medicines secreted by the kidneys. These drugs fill the cavities in the urinary system and are visible on the X-ray images, which are taken at intervals. This test requires special preparation of the body.

Cancer markers

Some testicular tumours produce certain substances called cancer markers. The most important are alpha fetoprotein (AFP), beta chorionic gonadotropin (hCG), and lactate dehydrogenase (LDH). The increase in these substances in the blood can also be used to predict the spread of testicular cancer and the effectiveness of treatment. The level of these markers in the blood is continuously monitored throughout the treatment period, during the monitoring of the effectiveness of the treatment, and later on when the patient's health is monitored after the treatment is fully completed.

Chest X-ray

Usually, an X-ray is performed to check for metastases of testicular cancer in the lungs.

Computed tomography (CT)

CT is a sophisticated, modern method of X-ray examination performed with sophisticated machines - computed tomographs. It produces a series of cross-sectional X-ray images of the part of the body under examination. The cross-sectional X-ray images show the organs from a projection as if the part of the body being examined had been 'sliced' across. Only in this case the 'cuts' are made by the X-ray beam. Each X-ray image shows all the organs in that 'cut' and their changes. The examination is painless and is carried out while the patient is lying down, but it takes 30-40 minutes to lie still. After the examination, the patient can go home. In the case of testicular cancer, a CT scan of the pelvis, abdomen and chest is performed to check for metastases in the lymph nodes, abdominal organs and lungs. CT scans of other areas of the body may also be performed if necessary. Sometimes a contrast agent (iodine) is given as an oral or intravenous injection before the CT scan. The contrast medium increases the contrast of the X-ray images, allowing a better assessment of existing lesions. If the patient is allergic to iodine, he/she must inform the radiologist performing the CT scan before the examination.

Magnetic resonance imaging

This test is similar to a CT scan and has a similar purpose, but differs in that the images of the body are obtained by applying a strong magnetic field instead of X-rays. During the test, the patient lies on a special table inside a metal cylinder with both ends open. The test is not painful at all and takes about 30 minutes. This test may be uncomfortable for those individuals who are afraid of confined spaces. MRI is not necessarily used in every case of testicular cancer. The MRI scanner has a powerful magnet, so it is necessary to remove any metal objects (watch, jewellery, etc.) before the procedure. This test cannot be performed on people who have a pacemaker implanted under the skin, or who have metal staples inside the body that were used to sew up tissues during a previous operation. Other tests not described above are also available. The number and order of tests is determined by the attending physician.

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