A lump or hardening in the testicle could be a symptom of testicular cancer and any such abnormality should be checked by a professional. It is important to seek medical attention as soon as possible because the treatment for testicular cancer is more effective the earlier it is started.

Steps in diagnosis

Some of the steps taken to diagnose testicular cancer are described below:

• Physical examination – A torchlight beam is held against the abnormality to see if light passes through it. Compared to a fluid-filled cyst for example, cancerous lumps tend to be solid and light does not pass through them.
• If the physician suspects the abnormality is cancerous, the patient is referred for an ultrasound scan which uses high-frequency sound waves to generate an image of the inside of the testicle. This is the primary method of determining whether the tumor is benign or malignant. The position and size of the lump is also established.
• Blood tests may be carried out to check the levels of certain hormones that can be indicators of testicular cancer. These markers include alpha feta protein (AFP), human chorionic gonadotrophin (HCG) and lactate dehydrogenase (LDH). These markers are not produced in all types of testicular cancer, so cancer may still be diagnosed even if the blood levels of these hormones are normal.
• The only way to confirm a diagnosis of testicular cancer is through tissue biopsy. A sample of the tumor is taken and checked for the presence of cancer cells. In most cases, the only safe way to perform a biopsy is to completely remove the affected testicle, so a physician will only recommend a biopsy if they are almost certain the lump is cancerous. This course of action would need to be taken if the lump was cancerous in any case. The removal of a testicle is known as an orchidectomy.
• If a physician suspects the cancer has spread, other tests that may also be performed include imaging studies such as X-ray, computed tomography (CT) scan, and magnetic resonance imaging (MRI).