In short
If a testicular lump might be cancer, a GP refers you for an urgent scrotal ultrasound. Blood tests measure AFP, HCG and LDH — tumour markers that help type the cancer and plan treatment. A chest X-ray or CT looks for spread. Diagnosis is usually confirmed when the testicle is removed, not by cutting into it in the scrotum.
Do not let embarrassment delay ultrasound. It is a standard, private scan and the fastest way to explain a lump.
Why ultrasound first?
Ultrasound distinguishes a cyst, a hydrocele and a solid lump that needs surgery. It does not use radiation.
What do tumour markers mean?
AFP and HCG can be raised in some germ-cell tumours. They are not a screening test for well men. They guide treatment and follow-up after surgery.
Help a patient afford cancer care
Gifts go to the Cancer Emergency Appeal’s wider fund for patients who cannot pay. They do not buy a guaranteed treatment or result.
Donate to cancer careWhy is the testicle removed to diagnose?
Cutting into a testicular cancer through the scrotum can spread cells. An inguinal orchidectomy — removing the testicle through a groin incision — is both diagnosis and first treatment.
Key takeaways
- Urgent ultrasound is the first specialist test.
- Marker blood tests help type the tumour.
- The diagnostic operation is usually through the groin, not the scrotum.
Care like this is out of reach for millions
The diagnosis, screening and treatment described here are routine in the UK. In Pakistan, Indonesia and Malaysia, poverty can put them out of reach. The Cancer Emergency Appeal raises funds towards clinically recommended care for patients who cannot pay; gifts go to the wider fund and do not buy a guaranteed treatment or result.
Frequently asked questions
Will I need both testicles removed?
Almost never for a first cancer. One testicle is enough for hormone production in most men.
Are markers always raised?
No. Some tumours do not produce AFP or HCG. Ultrasound and surgery still go ahead.
Does WAN offer UK ultrasound?
No. We fund overseas hospital bills.
Editorial summary of published sources. A named oncology clinician has not signed off this guide. Use it to prepare questions for your healthcare team, not to diagnose symptoms or choose treatment. Editorial responsibility: Kaiser Khan. Updated 4 October 2026.
What are the sources for this guide?
Follow the original guidance for its evidence, dates and limitations. General background references are not a clinical review of this page.