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Testicular Cancer: Tests After Diagnosis

After a diagnosis of testicular cancer, you will likely need more tests. These tests help your healthcare providers learn more about the cancer. They can help show if it has grown into nearby tissues or spread to other parts of the body. The test results help your healthcare providers work with you to decide the best ways to treat the cancer. If you have any questions about these or other tests, talk with your healthcare team.

Some of the tests used after diagnosis include:

  • Chest X-ray

  • CT scan

  • MRI

  • Positron emission tomography (PET) scan

  • Biopsy

Imaging tests

Chest X-ray 

A chest X-ray can help find out if the cancer has spread to your lungs or lymph nodes in the middle of your chest.

For the test, you stand in front of a rectangular target area where the X-ray film is held. You may be asked to hold your arms to the side or over your head. You take a breath and stay still for a few seconds. An X-ray will be done from the front and from the side.

CT scan 

In this test, a series of X-rays is used to get pictures of the inside of your body from many angles. A computer then combines these images to make a detailed 3-D picture of your insides. CT scans can be used to see if the cancer has spread to other parts of your body, such as the lungs, liver, or lymph nodes in the back of your belly (abdomen).

During the test, you lie still on a table as it slides through the center of the ring-shaped CT scanner. Then the scanner sends X-ray beams at your body. A computer uses the X-rays to create many pictures of the inside of your body. These are put together to create a 3-D picture. You may be asked to hold your breath once or more during the scan. You may be asked to drink a contrast dye after the first set of pictures is taken. This dye can help get clearer images. It will pass out of your body over the next day or so through your bowel movements. If the dye is put into your blood through an IV (intravenous) line in your arm, it may cause a feeling of warmth in your body for a few minutes. In rare cases, it can also cause hives or other allergic reactions. Tell the technician if you don’t feel well during the test.

MRI 

This test uses radio waves and magnets to make detailed pictures of the inside of your body. It's a lot like a CT scan, but it doesn't use X-rays. An MRI can be more uncomfortable than a CT scan because you are in a fairly confined space and need to stay still. It may also take longer. But there should be no pain from an MRI. MRI is especially useful in looking at the spinal cord and brain. It might be used if your healthcare provider thinks the cancer may have spread to these areas. 

To do this test, you lie still on a table as it moves into a narrow, tube-like scanner. The scanner sends beams of radio waves at the part of your body being scanned. A computer uses the radio waves to create a 3-D picture of your insides. You may need more than one set of images. Each one may take 2 to 15 minutes, so that the whole scan may take an hour or more. A contrast dye might be put into a vein in your hand or arm before this scan. It helps get even clearer images of the inside of your body. You might be given earplugs because there's loud thumping and buzzing noises during the scan. If you're claustrophobic, tell your healthcare provider before the test. You may need to be given a sedative before having this test.

PET scan

A PET scan looks at your entire body. A sugar solution that contains a mildly radioactive material is put into your blood through a vein in your hand or arm. Cancer cells use the sugar faster than other cells, so the radioactive material collects in them. Then a machine takes pictures of your whole body. The places where the solution collects show up as "hot spots" on the scan.

A PET scan is often combined with a CT scan (PET-CT scan). This allows areas that show up on the PET scan to be compared to the more detailed images of the CT scan. This test is most often used with certain types of testicular cancer to see how well the treatment has worked.

Biopsy

A biopsy is a tiny piece of tissue that's removed from a changed area that might be cancer. A healthcare provider called a pathologist examines this tissue sample to see if it contains cancer cells.

Your healthcare provider might want to do a biopsy if they think cancer might have spread (metastasized) to other parts of your body, such as the lymph nodes or lungs. The biopsy is done to find out if the changes seen on imaging tests are cancer. Biopsies can be done in different ways, depending on where the tumor is.

CT scans are sometimes used to help guide a needle biopsy. This is called a CT-guided needle biopsy. The CT scan helps your provider make sure the needle is in the right place. 

Working with your healthcare provider

Talk with your healthcare provider about which tests you'll have. Get ready for the tests as instructed. Be sure you know what the test will be like and why it's being done. Ask questions and talk about any concerns you have. 

Medical Reviewers:

  • Jessica Gotwals RN BSN MPH
  • Ronald Karlin MD
  • Todd Gersten MD