Testicular Cancer: Blood Tests and Next Steps

Blood tests for testicular cancer?

Hello, Dr.
Hsu: Since I developed epididymitis in November of last year, it initially affected my right side.
After it improved, I soon experienced it on the left side.
Although the pain symptoms on the left side have disappeared, I now feel a hard mass when I touch the testicle.
At the same time, the epididymitis on the right side has recurred, so I continue to take antibiotics, which alleviate the pain.
This makes it difficult to determine if the hard mass on the left side is painful upon touch.
Subsequently, the doctor conducted a blood test to check for testicular cancer, and today I was informed that the results were normal.
However, since the hard mass appeared, the doctor has not performed a physical examination or visual inspection during my visits, which still concerns me.
I would like to ask the doctor: Is it possible that even with normal blood test results, I could still have testicular cancer? Should I request the doctor to perform an ultrasound for further confirmation?

Tian, 20~29 year old female. Ask Date: 2014/05/09

Dr. Xu Weikai reply Urology

Hello, testicular cancer can often be detected through blood tests.
Of course, if an ultrasound examination can be added, it will be more accurate.
Generally speaking, if a mass originates from the epididymis, it is usually benign.
Conversely, if the mass originates from the testis, there is an 80-90% chance that it is malignant.
My recommendation is to undergo a testicular ultrasound examination.
As for whether a physical examination is necessary, you can discuss this with your clinician.
If there are any unclear points, feel free to ask again for further discussion and research.
Responses from the internet should only be used as a reference; if necessary, it is important to seek medical care at a healthcare facility.
This message is from Dr.
Hsu Wei-Kai, Director of the Urology Department at Taitung Hospital, Ministry of Health and Welfare.

Reply Date: 2014/05/09

More Info

Dear Patient,
Thank you for reaching out with your concerns regarding the recent developments in your health, particularly regarding the hard mass you have noticed in your testicle after experiencing epididymitis. I understand that this situation can be quite distressing, especially when it involves potential concerns about testicular cancer.

Firstly, it is important to note that while blood tests can provide valuable information, they are not definitive for diagnosing testicular cancer. The most common blood tests for this purpose measure tumor markers such as alpha-fetoprotein (AFP), human chorionic gonadotropin (hCG), and lactate dehydrogenase (LDH). A normal result in these tests is reassuring, but it does not completely rule out the possibility of cancer, especially if there are physical findings that warrant further investigation.

In your case, the presence of a hard mass in the testicle is a significant finding that should not be overlooked. While the blood tests returned normal results, the fact that you have a palpable mass means that further evaluation is warranted. Testicular cancer can sometimes present with a mass that may not produce elevated tumor markers, particularly in the early stages or in certain types of tumors.

I strongly recommend that you discuss your concerns with your healthcare provider and request an ultrasound of the scrotum. An ultrasound is a non-invasive imaging technique that can provide detailed information about the structure of the testicle and any masses present. It can help differentiate between benign conditions, such as a cyst or a hydrocele, and more serious issues like tumors.

In addition to ultrasound, if the imaging results are inconclusive or if there is still a high suspicion of malignancy, your doctor may suggest further diagnostic procedures, such as a biopsy or surgical exploration. It is crucial to have a thorough evaluation to ensure that any potential issues are addressed promptly.

Moreover, it is essential to communicate openly with your doctor about your symptoms and concerns. If you feel that your doctor has not adequately addressed your worries, seeking a second opinion or asking for a referral to a specialist, such as a urologist, may provide you with additional reassurance and clarity.

In summary, while your blood tests are normal, the presence of a hard mass in your testicle necessitates further investigation. An ultrasound is a logical next step to evaluate the mass more thoroughly. Please do not hesitate to advocate for your health and seek the necessary evaluations to ensure your peace of mind.

Wishing you the best in your health journey, and please feel free to reach out with any further questions or concerns.

Sincerely,
Doctor Q&A Teams

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