Testicular Cancer

Testicular Cancer Lab Tests and health information

The testicular cancer test screens for testicular tumors that make high levels of specific proteins called tumor markers, such as alpha-fetoprotein (AFP) and human chorionic gonadotropin (HCG). Ulta Lab Tests provides reliable blood work and secure testing, so order today!


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Elevation of serum AFP above values found in healthy individuals occurs in several malignant diseases, most notably nonseminomatous testicular cancer and primary hepatocellular carcinoma. AFP is not recommended as a screening procedure to detect cancer in the general population.

Description: The Alpha-Fetoprotein and AFP-L3 test is a blood test used to detect the protein alpha-fetoprotein which is produced by the liver.

Also Known As: AFP Test, Total AFP Test, AFP-L3 Test, Alpha-Fetoprotein Tumor Markers, Alpha-Fetoprotein Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is an Alpha-Fetoprotein and AFP-L3 test ordered?

An AFP blood test may be ordered by a healthcare provider:

  • When abdominal masses are felt during a medical examination or imaging testing reveal possible malignancies, it is likely that someone has liver cancer or certain malignancies of the testicles or ovaries.
  • When someone has been diagnosed with and treated for cancer of the liver, testicles, or ovaries, the success of treatment is being assessed.
  • When someone is being watched for a recurrence of cancer
  • Patients with persistent hepatitis or liver cirrhosis should be followed up on.
  • When a person has chronic liver illness, an AFP-L3 percent is occasionally ordered to help evaluate the risk of hepatocellular carcinoma, test the efficiency of hepatocellular carcinoma treatment, or monitor for recurrence.

What does an Alpha-Fetoprotein and AFP-L3 blood test check for?

Alpha-fetoprotein is a protein produced predominantly by the liver of a developing baby and the yolk cavity of a developing embryo. When a baby is born, AFP levels are usually high and then rapidly drop. Liver injury and certain malignancies can drastically raise AFP levels. This test determines the amount of AFP in your blood.

When the liver cells regenerate, AFP is generated. AFP can be continuously high in chronic liver illnesses such hepatitis and cirrhosis. Certain cancers can produce extremely high quantities of AFP. Because of this, the AFP test can be used as a tumor marker. Many persons with hepatocellular carcinoma and hepatoblastoma, a kind of liver cancer that affects babies, have elevated levels of AFP. They're also discovered in certain persons who have testicular or ovarian cancer.

There are various different types of AFP. The normal AFP test measures total AFP, which includes all of the AFP variations. In the United States, this is the most common AFP test.

One of the AFP variations is known as L3 because of its propensity to attach to a protein called Lens culinaris agglutinin in the lab. The AFP-L3 percent test compares the quantity of AFP-L3 to the total amount of AFP and is a relatively recent test. Increased L3 levels are linked to a higher likelihood of developing hepatocellular carcinoma in the near future, as well as a worse prognosis, because L3-related malignancies are more aggressive.

AFP-L3 can be higher in people with hepatocellular carcinoma than in those with benign liver disorders who have low total AFP. In Japan, tumor markers such as total AFP and AFP-L3 are utilized in conjunction with ultrasound to monitor hepatocellular carcinoma. This procedure differs from that in the United States and Europe, but healthcare practitioners in the United States occasionally order the two tests.

Lab tests often ordered with an Alpha-Fetoprotein and AFP-L3 test:

  • CEA
  • CA-125
  • hCG Tumor Marker
  • DCP

Conditions where an Alpha-Fetoprotein and AFP-L3 test is recommended:

  • Ovarian Cancer
  • Testicular Cancer

How does my health care provider use an Alpha-Fetoprotein and AFP-L3 test?

The tumor marker alpha-fetoprotein is used to detect and diagnose malignancies of the liver, testicles, and ovaries. Despite the fact that the test is frequently done to monitor persons with chronic liver illnesses including cirrhosis, chronic hepatitis B, or hepatitis C who have an elevated lifetime risk of developing liver cancer, most current guidelines do not advocate it. An AFP test, together with imaging studies, may be ordered by a healthcare provider to try to diagnose liver cancer in its earliest and most treatable stages.

If a person has been diagnosed with hepatocellular carcinoma or another type of AFP-producing cancer, an AFP test may be done on a regular basis to assess treatment response and disease recurrence.

When comparing the amount of the AFP variation AFP-L3 to the total amount of AFP, an AFP-L3 percent is occasionally ordered. The AFP-L3 percent test is not extensively used in the United States, but it is becoming more popular in other nations, such as Japan. The test is used to assess the risk of developing hepatocellular carcinoma, particularly in people with chronic liver disease, as well as the response of the cancer to treatment.

What do my Alpha-fetoprotein test results mean?

Increased AFP levels can suggest the presence of cancer, such as liver cancer, ovarian cancer, or testicular germ cell tumors. However, not all cancers of the liver, ovary, or testicles produce substantial amounts of AFP.

Other malignancies, such as stomach, colon, lung, breast, and lymphoma, might sometimes have elevated levels, but it is rarely ordered to check these illnesses. Cirrhosis and hepatitis are two disorders that can generate elevated levels.

When using AFP as a monitoring tool, lower levels suggest a therapeutic response. If concentrations do not considerably drop after cancer therapy, usually to normal or near-normal levels, some tumor tissue may still be present.

If AFP levels start to rise, the cancer is most likely to return. However, because AFP levels can be deceiving in hepatitis or cirrhosis, AFP levels can be misleading. If AFP levels are not raised prior to therapy, the test will not be useful in monitoring treatment effectiveness or detecting recurrence.

People with chronic liver disease have a higher chance of getting liver cancer when their AFP levels rise from normal to moderately raised to significantly elevated. When total AFP and AFP-L3 percent are highly higher, the person is more likely to develop or have hepatocellular carcinoma in the next year or two. In persons with chronic hepatitis and cirrhosis, however, both AFP and AFP-L3 percent concentrations might be increased and fluctuate. In these circumstances, a significant increase in AFP is more essential than the test result's numerical value.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.


This test is specific for hCG beta subunit and offers sensitivity necessary to detect pregnancy as early as ten days post conception.

Description: The hCG test is a blood test that measures the amount of hCG in the blood. It is used to confirm pregnancy or to help identify an ectopic pregnancy. It can also be used to confirm that there is not a pregnancy before a medical treatment.

Also Known As: Beta hCG Test, Chorionic Gonadotropin Test, hCG Total Qualitative Test, Human Chorionic Gonadotropin (Hcg), Qualitative Human Chorionic Gonadotropin Total, Qualitative, Pregnancy Test. hCG Blood Test

Collection Method: Blood draw

Specimen Type: Serum

Test Preparation: No preparation required

When is an hCG Total Qualitative test ordered?

The timing of pregnancy testing is determined by a woman's accuracy in predicting the day of her menstrual period, as well as the technique of testing employed. Blood tests are more sensitive than urine tests and can be performed two days before a woman's period is expected to begin. By 10 days after a missed menstrual cycle, a urine or blood hCG test can be done with confidence. A woman may be able to ascertain whether she is pregnant the day she misses her period with a urine test, but the result may be mistakenly negative. If the first test is negative but pregnancy is suspected, the test may be repeated at a later date.

When a doctor wants to diagnose or rule out an ectopic pregnancy or monitor a woman after a loss, he or she may perform quantitative blood hCG testing over several days. A woman may first have the standard signs and symptoms of pregnancy, but subsequently develop others that signal the pregnancy is not proceeding as planned.

The following are some of the indications and symptoms of an ectopic pregnancy:

  • Abnormal vaginal bleeding
  • Lower abdominal pain or cramps on one side of the pelvis

If left untreated, the following signs and symptoms may worsen:

  • Weakness, dizziness
  • Fainting or feeling faint
  • Blood pressure that is too low
  • Suffering from shoulder pain
  • In the pelvic area, there is a sudden, severe ache.
  • Flu-like symptoms and a fever
  • Vomiting

If left untreated, the region around an ectopic pregnancy might burst and hemorrhage, resulting in cardiac arrest and death.

Prior to a medical operation or therapy that could be detrimental during pregnancy, an hCG test may be recommended.

What does an hCG Total Qualitative blood test check for?

Human chorionic gonadotropin is a hormone produced by a pregnant woman's placenta. The level of hCG in the blood rises early in pregnancy and is excreted in the urine. A pregnancy test detects human chorionic gonadotropin in the blood or urine and confirms or disproves pregnancy.

During the first few weeks of pregnancy, hCG is crucial for sustaining the corpus luteum's function. During the first trimester of a typical pregnancy, hCG production rises steadily, culminating around the 10th week after the last menstrual cycle. During the duration of the pregnancy, levels gradually decrease. Within a few weeks of birth, hCG is no longer detectable.

The level of hCG in the blood increases at a slower rate when a pregnancy develops outside of the uterus. When an ectopic pregnancy is suspected, monitoring the level of hCG in the blood over time may be helpful in confirming the diagnosis.

Similarly, when a developing baby has a chromosomal problem such as Down syndrome, the hCG blood level may be abnormal. As part of the usual screening for fetal anomalies, an hCG test is utilized in conjunction with a few additional assays.

Lab tests often ordered with an hCG Total Qualitative test:

  • Progesterone
  • First Trimester Screening
  • Second Trimester Screening

Conditions where an hCG Total Qualitative test is recommended:

  • Pregnancy

How does my health care provider use an hCG Total Qualitative test?

The presence of hCG is detected by qualitative hCG testing, which is commonly used to screen for pregnancy. A test strip is dipped into a collected cup of urine or exposed to a woman's urine stream, depending on the method. Within the time provided by the instructions, generally approximately 5 minutes, a colored line appears. It is critical to properly follow the test recommendations in order to obtain reliable test results. If the test comes out negative, it's usually repeated a few days later. Because hCG levels grow quickly, a previously negative test can become positive in a short period of time.

Quantitative hCG testing, also known as beta hCG testing, determines the amount of hCG in the blood. It's possible that it'll be utilized to confirm a pregnancy. It can also be used in conjunction with a progesterone test to help diagnosis an ectopic pregnancy, diagnose and monitor a failing pregnancy, and/or monitor a woman following a miscarriage.

hCG blood levels, along with a few other tests, can also be used to screen for fetal abnormalities. See First Trimester Down Syndrome Screen or Second Trimester Maternal Serum Screening for further information on this application.

If a woman is about to undergo medical treatment, be put on certain drugs, or have other testing, such as x-rays, that could harm the developing baby, an hCG test may be done to check for pregnancy. This is normally done to make sure the woman isn't expecting. Before any medical intervention, such as an operation, that could potentially harm a fetus, most institutions now screen all female patients for pregnancy using a urine or blood hCG test.

What do my hCG test results mean?

A negative hCG result indicates that a woman is unlikely to be pregnant. However, tests conducted too early in a pregnancy, before a sufficient hCG level has been reached, may result in false-negative results. If there is a strong likelihood of pregnancy, the test may be repeated a few days later.

A positive hCG test indicates that a lady is pregnant.

The level of hcG in a woman's blood rises at a slower rate than normal in an ectopic pregnancy. For the first four weeks of a typical pregnancy, hCG levels double about every two days, then slow to every 3 1/2 and half days by six weeks. Those who had failed pregnancies often have a lengthier doubling time early on, and their hCG concentrations may even fall during the doubling stage. Following a miscarriage, hCG levels will drop rapidly. If hCG levels do not drop to undetectable levels, it could mean that there is still hCG-producing tissue that needs to be removed.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.


Description: The hCG test is a blood test that measures the amount of hCG in the blood. It is used to confirm pregnancy or to help identify an ectopic pregnancy. It can also be used to confirm that there is not a pregnancy before a medical treatment.

Also Known As: Beta hCG Test, Chorionic Gonadotropin Test, hCG Total Quantitative Test, Human Chorionic Gonadotropin (Hcg), Quantitative Human Chorionic Gonadotropin Total, Quantitative, Pregnancy Test, hCG Blood Test

Collection Method: Blood draw

Specimen Type: Serum

Test Preparation: No preparation required

When is an hCG Total Quantitative test ordered?

The timing of pregnancy testing is determined by a woman's accuracy in predicting the day of her menstrual period, as well as the technique of testing employed. Blood tests are more sensitive than urine tests and can be performed two days before a woman's period is expected to begin. By 10 days after a missed menstrual cycle, a urine or blood hCG test can be done with confidence. A woman may be able to ascertain whether she is pregnant the day she misses her period with a urine test, but the result may be mistakenly negative. If the first test is negative but pregnancy is suspected, the test may be repeated at a later date.

When a doctor wants to diagnose or rule out an ectopic pregnancy or monitor a woman after a loss, he or she may perform quantitative blood hCG testing over several days. A woman may first have the standard signs and symptoms of pregnancy, but subsequently develop others that signal the pregnancy is not proceeding as planned.

The following are some of the indications and symptoms of an ectopic pregnancy:

  • Abnormal vaginal bleeding
  • Lower abdominal pain or cramps on one side of the pelvis

If left untreated, the following signs and symptoms may worsen:

  • Weakness, dizziness
  • Fainting or feeling faint
  • Blood pressure that is too low
  • Suffering from shoulder pain
  • In the pelvic area, there is a sudden, severe ache.
  • Flu-like symptoms and a fever
  • Vomiting

If left untreated, the region around an ectopic pregnancy might burst and hemorrhage, resulting in cardiac arrest and death.

Prior to a medical operation or therapy that could be detrimental during pregnancy, an hCG test may be recommended.

What does an hCG Total Quantitative blood test check for?

Human chorionic gonadotropin is a hormone produced by a pregnant woman's placenta. The level of hCG in the blood rises early in pregnancy and is excreted in the urine. A pregnancy test detects human chorionic gonadotropin in the blood or urine and confirms or disproves pregnancy.

During the first few weeks of pregnancy, hCG is crucial for sustaining the corpus luteum's function. During the first trimester of a typical pregnancy, hCG production rises steadily, culminating around the 10th week after the last menstrual cycle. During the duration of the pregnancy, levels gradually decrease. Within a few weeks of birth, hCG is no longer detectable.

The level of hCG in the blood increases at a slower rate when a pregnancy develops outside of the uterus. When an ectopic pregnancy is suspected, monitoring the level of hCG in the blood over time may be helpful in confirming the diagnosis.

Similarly, when a developing baby has a chromosomal problem such as Down syndrome, the hCG blood level may be abnormal. As part of the usual screening for fetal anomalies, an hCG test is utilized in conjunction with a few additional assays.

Lab tests often ordered with an hCG Total Quantitative test:

  • Progesterone
  • First Trimester Screening
  • Second Trimester Screening

Conditions where an hCG Total Quantitative test is recommended:

  • Pregnancy
  • Cancer

How does my health care provider use an hCG Total Quantitative test?

The presence of hCG is detected by qualitative hCG testing, which is commonly used to screen for pregnancy. A test strip is dipped into a collected cup of urine or exposed to a woman's urine stream, depending on the method. Within the time provided by the instructions, generally approximately 5 minutes, a colored line appears. It is critical to properly follow the test recommendations in order to obtain reliable test results. If the test comes out negative, it's usually repeated a few days later. Because hCG levels grow quickly, a previously negative test can become positive in a short period of time.

Quantitative hCG testing, also known as beta hCG testing, determines the amount of hCG in the blood. It's possible that it'll be utilized to confirm a pregnancy. It can also be used in conjunction with a progesterone test to help diagnosis an ectopic pregnancy, diagnose and monitor a failing pregnancy, and/or monitor a woman following a miscarriage.

hCG blood levels, along with a few other tests, can also be used to screen for fetal abnormalities. See First Trimester Down Syndrome Screen or Second Trimester Maternal Serum Screening for further information on this application.

If a woman is about to undergo medical treatment, be put on certain drugs, or have other testing, such as x-rays, that could harm the developing baby, an hCG test may be done to check for pregnancy. This is normally done to make sure the woman isn't expecting. Before any medical intervention, such as an operation, that could potentially harm a fetus, most institutions now screen all female patients for pregnancy using a urine or blood hCG test.

What do my hCG test results mean?

A negative hCG result indicates that a woman is unlikely to be pregnant. However, tests conducted too early in a pregnancy, before a sufficient hCG level has been reached, may result in false-negative results. If there is a strong likelihood of pregnancy, the test may be repeated a few days later.

A positive hCG test indicates that a lady is pregnant.

The level of hcG in a woman's blood rises at a slower rate than normal in an ectopic pregnancy. For the first four weeks of a typical pregnancy, hCG levels double about every two days, then slow to every 3 1/2 and half days by six weeks. Those who had failed pregnancies often have a lengthier doubling time early on, and their hCG concentrations may even fall during the doubling stage. Following a miscarriage, hCG levels will drop rapidly. If hCG levels do not drop to undetectable levels, it could mean that there is still hCG-producing tissue that needs to be removed.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.


Clinical Significance

Limbic encephalitis (LE) is a paraneoplastic neurological syndrome often associated with small cell lung carcinoma and more rarely with testicular, breast, and other tumors. Clinical hallmarks of paraneoplastic limbic encephalitis are changing mental status, short-term memory impairment, seizures, confusion, and behavioral changes. Hu antibody-negative LE patients usually do not develop symptoms beyond the limbic system and appear to improve more often after treatment of the cancer than those who have Hu antibodies, suggesting that the pathogenesis of the LE in both groups could be different. Recent studies have detected antibodies to voltage-gated potassium channels (VGKC) in patients with LE, with and without associated tumors. Neurological symptoms were found to improve with a reduction of VGKC antibody levels.

Alternative Name(s) 

VGKC



Testicular cancer is a rare form of cancer (the abnormal, uncontrolled growth of cells) that occurs in the testicles. Typically, males have two testicles, which are part of the reproductive system. Also referred to as gonads, these egg-shaped glands are held in a sac known as scrotum just below the penis. They have a slightly spongy feel, with uniform firmness and similar size. Testicles are responsible for sperm production and ideally make hormones like testosterone, which controls sex drive and starts the growth of muscles and body hair in males.

Testicular cancer can affect any boy or man of any age, but it usually affects those between the age of 20 and 35, and the average diagnosis age is 33. According to the American Cancer Society, around 9,000 men are diagnosed with the condition in the US each year, and about 4% of the patients die of it.

Fortunately, testicular cancer is treatable, and it’s one of the most curable forms of cancer. It has a five-year relative survival rate of 99% if it hasn’t spread beyond the testicles. However, if left unattended, it can spread to nearby organs, affecting the lymph nodes and even making its way to vital organs like lungs. The survival rate for regional cancer (one that has spread to nearby tissues or lymph nodes) is 96%, and that of distant cancer (spread to other organs) is 73%. When it comes to curing testicular cancer, early detection and treatment are vital.

Testicular Cancer Risk Factors Include:

  • Gonadal dysgenesis- the abnormal development of testicles
  • Prior cancer in one gonad
  • Cryptorchidism or undescended testicles.
  • History of a father or brother with testicular cancer
  • Abnormal cells in the testicles known as germ cell neoplasia in situ.
  • HIV infection
  • Stature- According to some studies, tall men have a higher risk of getting testicular cancer, but this hasn’t been proven.
  • Race- Caucasian men are at a higher risk for this type of cancer compared to Hispanic, African, and Asian males. However, the cause of this risk hasn’t been discovered.

Types of Testicular Tumors

  • Stromal Tumors: These types of tumors account for 5% of testicular tumors in adults and 20% in children. They form in the tissues that make hormones and support the testicles. They are usually non-cancerous, and the primary types include:
  • Leydig Cell Tumor: This type of tumor forms in the cells responsible for producing male sex hormones like testosterone. The tumor itself can produce male sex hormones and, sometimes, estrogen (a female sex hormone), which leads to breast enlargement.
  • Sertoli Cell Tumor: This one affects cells that support germ cells, which are responsible for sperm production.
  • Germ Cell Tumor: This one affects the cells that produce sperm. It accounts for over 90% of testicular cancers. These can be separated into two categories, seminomas, and nonseminomas. Some of these tumors have both seminoma and nonseminomas tissues. The former type is less aggressive, meaning they develop slowly are less likely to metastasize or spread to other tissues or organs. They come two types, typical or classical (which make up around 95% of seminomas) and spermatocytic, which are rare and tend to affect older males. Nonseminomas or non-seminomatous germ cell tumors come in four types. These include teratomas, yolk sac tumors, choriocarcinomas, and embryonal carcinomas. These tend to spread faster than seminomas and usually affect younger men.

Some other forms of cancer, like lymphoma, can spread from other tissues and organs to the testicles, but they are not considered true testicular cancers as they are treated differently.

Signs & Symptoms

Often, testicular cancer is initially detected as a painless swelling or lump in the testicle. Affected individuals usually discover these tumors by accident or when examining themselves. However, they can ideally be discovered during a routine physical evaluation or a medical test that’s being conducted for other reasons like infertility evaluation.

Testicular cancer usually doesn’t give warning signs, but it may cause subtle symptoms like:

  • Dull pain in the groin or abdomen
  • Breast growth
  • Pain in the testicles
  • Early puberty with signs like body or facial growth and deepening of the voice

Keep in mind that these symptoms can be a result of other conditions like inflammation or injury and so, you should not be quick to conclude its cancer.

Early Testicular Cancer Detection

Currently, there are no means to screen for testicular cancer. Also, there are no studies that show if self-exams, regular evaluations by a practitioner, or other screening tests in males with no testicular cancer symptoms would reduce the risk of death from the condition.

Some doctors recommend individuals between 15 and 55 years to do a monthly self-evaluation to identify any changes in their gonads. Most, if not all, doctors agree that a testicular exam should be included in every general physical evaluation. The American Cancer Society (ACS) recommends the exam as part of cancer-related checkups, but it doesn’t have recommendations for testicular self-exams. Those who are at a higher risk for the condition may want to do a self-exam once per month.

Testicular Cancer Lab Tests

Various tests can be done to check for testicular cancer. These are primarily blood tests that look for elevated amounts of the proteins discussed below:

Alpha-fetoprotein (AFP)

Nonseminoma germ cells usually produce AFP. Seminoma germ cell tumors, on the other hand, don’t. So, if an individual’s AFP levels are high, the doctor will know that their tumor is composed of nonseminoma cells, and the cancer should be treated as such.

Human Chorionic Gonadotropin (hCG)

Both seminomas and nonseminomas (non-seminomatous germ cell tumors) can lead to the elevation of hCG levels in the blood.

Keep in mind that Sertoli and Leydig cell tumors (going under the umbrella term Stromal tumors) don’t produce hCG or AFP, and so, they won’t lead to the increase in blood levels of each.

Lactate dehydrogenase (LDH)

The levels of this protein can go up in the presence of most testicular cancer types. LDH is a type of enzyme present in many body tissues and makes its way into the bloodstream when a cell is damaged. However, it’s not specific for this type of cancer, as many conditions can cause LDH levels to rise. If an individual has testicular cancer, high LDH levels can be a sign that it is widespread.

Testicular ultrasound can also be conducted to check for suspicious lumps. X-rays can also be done to check whether the cancer has spread to lymph nodes and other vital organs.