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Diagnosing testicular cancer

Page last updated: December 2025

The information on this webpage was adapted from Understanding Testicular Cancer - A guide for people with cancer, their families and friends (2025 edition). This webpage was last updated in December 2025.

Expert content reviewers:

This information was developed with help from a range of health professionals and people affected by thyroid cancer:

A/Prof Peter Grimison, Medical Oncologist, Chris O’Brien Lifehouse and Royal Prince Alfred Hospital, NSW
Marc Diocera, Genitourinary Nurse Consultant, Peter MacCallum Cancer Centre, VIC
A/Prof Peter Heathcote, Urologist, Brisbane Urology Clinic, QLD
Dr Michael Huo, Radiation Oncologist, Princess Alexandra Hospital, QLD
A/Prof Joseph McKendrick, Medical Oncologist, Epworth Eastern Hospital, VIC
Dr Tonia Mezzini, Sexual Health Physician, East Obstetrics and Gynaecology, SA
Dominic Oen, Clinical Psychologist, Bankstown Cancer Centre, NSW
Dr Benjamin Thomas, Urological Surgeon, The Royal Melbourne Hospital and The University of Melbourne, VIC
Paul Zawa, Consumer

To diagnose testicular cancer, you are likely to have some of the following tests:

Physical examination – A doctor will examine your testicles, scrotum and groin for a lump or swelling.
Ultrasound – This is an accurate way to tell the difference between benign fluid-filled cysts and solid tumours that might be cancer. An ultrasound can show if a tumour is present and how large it is. A gel is spread over your scrotum, and a small device called a transducer is moved over the area. An ultrasound scan is painless.
Blood tests – Samples of your blood will be taken and tested for tumour markers, which are proteins made by some cancer cells. If your blood test results show an increase in the levels of certain tumour markers, you may have testicular cancer.
Further tests – If the pathology report on the removed testicle and other test results show that you have cancer, you may have one or more imaging scans. These scans will check whether the cancer has spread to other parts of your body, such as the lymph nodes or other organs. These tests will usually include a CT scan and possibly an MRI or PET-CT scan.

Surgery to remove the testicle

The only way to be sure of the diagnosis is to surgically remove the affected testicle and examine it in a laboratory. This surgery, called an orchidectomy or orchiectomy, is usually done by a specialist called a urologist.

In the laboratory, a specialist doctor called a pathologist looks for cancer cells and works out what type of testicular cancer it is and whether it has spread. This helps doctors plan treatment.

Doctors don’t usually perform a biopsy of the testicle (taking a small amount of tissue to check) because there is a small risk that making a cut through the scrotum can cause cancer cells to spread.

Tumour markers and testicular cancer

Tumour marker levels are often higher in people with testicular cancer. But sometimes, these levels stay normal even when cancer is present.

Other health problems, like liver or blood diseases, can also cause tumour marker levels to go up.

Doctors use tumour marker levels to help plan treatment. The levels will be checked during treatment and as part of follow-up appointments. Tumour marker levels will drop if your treatment is successful.

If the levels go up, it may mean you cancer is still there or has come back, and you may need more treatment.

Having an orchidectomy

An orchidectomy is done under a general anaesthetic to confirm a diagnosis of testicular cancer. It is also the main treatment for testicular cancer.

The urologist will make a small cut (incision) in the groin above the pubic bone.
The whole testicle is pulled up and out of the scrotum through this cut.
The spermatic cord is removed as it contains blood and lymph vessels that could help cancer spread to other areas of the body.
The scrotum is not removed but, after surgery, it will no longer contain a testicle.
The surgery takes about an hour. You can usually go home the same day, but you may need to stay in hospital overnight.
Some people choose to have the removed testicle replaced with a prosthesis. This can be done during the orchidectomy or later.

What to expect after an orchidectomy

Your body needs time to heal after the surgery. The information below is a general overview of what to expect.

If you have any questions about your recovery and how best to look after yourself when you get home, ask the doctors and nurses caring for you.

Pain relief

You will have some pain and discomfort for several days after surgery, but this can be managed with pain medicines.

Let your doctor or nurse know if the pain worsens – don’t wait until it’s severe before asking for more pain relief.

Daily activities

You will need to take care while you recover. Try to do some gentle exercise, such as walking. It will be some weeks before you can lift heavy things, exercise vigorously, drive or resume sexual activity.

You will also be advised to take time off work. Ask your doctor how long you should wait before attempting any of these activities.

Underwear

For the first couple of weeks, it’s best to wear underwear that provides cupping support for the scrotum. This provides comfort and protection as you recover, and can also reduce swelling.

You can buy scrotal support underwear at most pharmacies. Avoid wearing loose-fitting underwear such as boxer shorts.

Fertility

As long as the other testicle is healthy, losing one testicle is unlikely to affect your ability to have children. However, some people may have fertility problems that may or may not be linked with testicular cancer.

Talk to your urologist about whether you should store some sperm at a spermbanking facility before the surgery, in case you have fertility problems in the future.

Stitches and bruising

You will have a few stitches to close the incision. These will usually dissolve after several weeks.

There may be some bruising around the wound and scrotum. The scrotum can become swollen if blood collects inside it (intrascrotal haematoma).

If this occurs, the swelling may make it feel like the testicle hasn’t been removed. Both the bruising and the swelling will disappear over time.

How you might feel

After your testicle is removed, you may feel sad, depressed, embarrassed or anxious.

Usually, these feelings will get better in time, but it may help to talk about how you are feeling with someone you trust, such as a partner, friend or counsellor.

Sex and intimacy

Your ability to get an erection and experience orgasm should not be affected by the removal of a testicle.

Some people find that it takes time to adjust to the changes to their body and this may affect how they feel about sex and intimacy.

Staging

There are several staging systems for testicular cancer, but the most commonly used is the TNM system. Based on the TNM scores and the levels of tumour markers in the blood, the doctor then works out the cancer’s overall stage from stage 1 to stage 3:

stage 1 – cancer is found only in the testicle (early-stage cancer)
stage 2 – cancer has spread outside the testicle to nearby lymph nodes in the abdomen or pelvis
stage 3 – cancer has spread to lymph nodes outside the abdomen or pelvis (e.g. in the chest) or other areas of the body.

TNM system for testicular cancer

Testicular cancer is often staged using the TNM system. In this system, letters and numbers are used to describe the cancer, with higher numbers indicating larger size or spread.

T (tumour) describes whether the cancer is only in the testicle (T1) or has spread into nearby blood vessels or tissue (T2, T3, T4).
N (nodes) describes whether the cancer has spread to nearby lymph nodes in the abdomen – N0 means it has not and N1–3 means it has.
M (metastasis) describes whether the cancer has spread to distant lymph nodes, organs or bones – M0 means it has not and M1 means it has.