Cancer of the Testes; Testicular Carcinoma; Testis Tumor; Testicular Tumor; Testicular Neoplasm
Testicular cancer mainly affects young men between the ages of 20 and 39. Symptoms include pain, swelling, or lumps in the testicles or groin area. Fortunately, most cases can be treated, especially if found early. Learn more about the symptoms, diagnosis, and treatment options for testicular cancer.
Testicular Cancer
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Testicular Cancer
Seminoma of the Testis
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Seminoma of the Testis
Image by Ed Uthman, MD.
Testicular Cancer
Testicles, or testes, make male hormones and sperm. They are two egg-shaped organs inside the scrotum, the loose sac of skin behind the penis. You can get cancer in one or both testicles.
Testicular cancer mainly affects young men between the ages of 20 and 39. It is also more common in men who:
Have had abnormal testicle development
Have had an undescended testicle
Have a family history of the cancer
Symptoms include pain, swelling, or lumps in your testicles or groin area. Doctors use a physical exam, lab tests, imaging tests, and a biopsy to diagnose testicular cancer. Most cases can be treated, especially if found early. Treatment options include surgery, radiation, and/or chemotherapy. Regular exams after treatment are important.
Treatments may also cause infertility. If you may want children later on, you should consider sperm banking before treatment.
Source: NIH: National Cancer Institute
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Testicular Cancer
Lump or swelling in the testes.
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human male reproductive system - Testicle
Male Reproductive System: The prostate sits behind the base of the penis, underneath the bladder, and in front of the rectum. The urethra, which carries both semen and urine, runs through the prostate and is joined by the two seminal ducts at about the center of the gland. The seminal vesicles are located at the top rear part of the prostate. The gland is composed of five lobes: the anterior (front) lobe, the median (middle) lobe, the two lateral (side) lobes, and the posterior (rear) lobe.
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Male Reproductive Organ
Three-dimensional visualization reconstructed from scanned human data. Lateral view of the male reproductive system, with a cross-sectional wedge removed from the testicle. The interior of the testicle is comprised of multiple lobules with a system of septa that channel sperm to the Rete testis, an anastomosis of tubules at the posterior of the testicle. From here sperm enter into the efferent ductules, the epididymis, and finally the vas deferens; they then travel through the ejaculatory ducts that pass through the prostate to the urethra, and exit the body as component of semen upon ejaculation.
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Male Reproductive, System Glans Penis, Testicle, Prostate, Urethra, Epididymus and Vas deferens
Male Reproductive, System Glans Penis, Testicle, Prostate, Urethra, Epididymus and Vas deferens
Demonstration of a 20-year-old healthy male performing a testicular self-exam. The subject's genitals are in a non-aroused flaccid state. In the exam, the subject first balances both testicles to compare their weights. He then gently rolls each individual testicle between thumb and fingers to locate any soreness, lumps, hardness, swelling, or other abnormalities. He then checks the epididymis attached to each testicle for swelling, soreness, or other abnormalities. This process should be performed at least once a month on all pubescent and post-pubescent males, ideally during or after a warm shower when the scrotum is loose and the testicles are low. PLEASE NOTE: I am not a licensed medical professional, and this photo and description should only be considered an amateur example of this procedure. The Wikipedia page for TSEs contains links to professional descriptions and demonstrations.
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A Teenager Overcomes Testicular Cancer
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Testicular Cancer | Did You Know?
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Testicular Cancer
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human male reproductive system - Testicle
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Male Reproductive, System Glans Penis, Testicle, Prostate, Urethra, Epididymus and Vas deferens
Testicular Cancer: Facts and Fictions | Mark S. Litwin, MD | UCLAMDChat
UCLA Health/YouTube
4:20
Testicular Cancer - Bradley Leibovich, M.D. - Mayo Clinic
Mayo Clinic/YouTube
2:19
How To Check For Testicular Cancer | Lorraine
Lorraine/YouTube
1:56
Testicular cancer | Healthy Male
Healthy Male/YouTube
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Testicular Cancer: What You Really Need to Know | Mark Litwin, MD, MPH | UCLAMDChat
UCLA Health/YouTube
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Testicular cancer | NHS
NHS/YouTube
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Howcast/YouTube
3:57
Chemotherapy | Testicular Cancer
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27:20
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mdconversation/YouTube
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Medical Centric/YouTube
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Dana-Farber Cancer Institute/YouTube
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How is Testicular Cancer Diagnosed? | Dana-Farber Cancer Institute
Dana-Farber Cancer Institute/YouTube
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Introduction
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Testicle Self Exam for Cancer
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Testicle Self Exam for Cancer
Testicular self-exams help men learn the normal feel and appearance of their testicles. That may make it more likely that they'll notice subtle changes, should they occur. Changes in their testicles could be a sign of a common benign condition, such as an infection or a cyst, or a less common condition, such as testicular cancer. While medical organizations differ on their recommendations for testicular exams, the American Cancer Society recommends that men discuss testicular self-exams with their doctor during routine checkups.
Image by TheVisualMD
Introduction to Testicular Cancer
Although cancer of the testes is rare, accounting for only about 1 percent of all cancers in men of all ages and about 5 percent of all male genitourinary system cancers, it is the most common cancer in men between the ages of 15 and 35, and the second most common malignancy in men ages 35 to 39.
Fortunately, testicular cancer is often curable. The treatment success is due to effective diagnostic methods, including identification of tumor markers; effective combinations of chemotherapy drugs; and improved surgical techniques.
Testicular cancers almost always occur in just one testis rather than both; however, about two to three percent occur in both testes either at the same time or successively. The cancer cells grow rapidly but are very susceptible to chemotherapy and radiation therapy.
Because the incidence of testicular cancer has risen markedly in the past 20 years, numerous studies are being conducted to explore possible environmental causes, including the mother's diet during her pregnancy as well as her use of diethylstilbestrol (DES) to prevent miscarriage. Researchers are also looking at the increasing presence of estrogen-mimicking pollutants in the environment. The most consistent occupational association has been the elevated rate among men in professional and white-collar occupation, which may be linked to an increased risk observed with lower levels of exercise.
Other possible causes include hereditary factors, genetic anomalies, congenital defects involving the reproductive tract, testicular injury, and atrophy of the testes. Viral infections such as mumps, which cause inflammation of the testes, have not been proven to cause cancer.
Source: National Cancer Institute (NCI) / SEER Training
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Effects of exposure to per- and polyfluoroalkyl substances (PFASs) on human health
Effects of exposure to per- and polyfluoroalkyl substances (PFASs) on human health
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This 21-year-old male was aware of this 10-cm testicular mass for several months before he sought attention. His serum beta-HCG and alpha-fetoprotein were elevated. CT scan showed enlarged retroperitoneal and mesenteric lymph nodes, suspicious for malignancy. The urologist performed an orchiectomy.
The cut surface of the tumor was soft and hemorrhagic. I intially put in 20 sections, but the tumor was almost entirely necrotic. There were a few microscopic foci of what appeared to be syncytiotrophoblast. I put in 30 more sections and am awaitng those slides.
Image by Ed Uthman, MD.
Effects of exposure to per- and polyfluoroalkyl substances (PFASs) on human health
European Environment Agency (original image) Mrmw (vectorization)
Testicular Cancer Mainly Affects Young Men Between the Ages of 20-39
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Testicular Cancer Mainly Affects Young Men Between the Ages of 20-39
While the conversation about our bits and bobs has gone mainstream, the mental health aspect remains a sticking point. Despite the high cure rate, many men continue to quietly suffer from issues related to complications after treatment.
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What Is Testicular Cancer?
KEY POINTS
Testicular cancer is a disease in which malignant (cancer) cells form in the tissues of one or both testicles.
Health history can affect the risk of testicular cancer.
Signs and symptoms of testicular cancer include swelling or discomfort in the scrotum.
Tests that examine the testicles and blood are used to diagnose testicular cancer.
Certain factors affect prognosis (chance of recovery) and treatment options.
Treatment for testicular cancer can cause infertility.
Testicular cancer is a disease in which malignant (cancer) cells form in the tissues of one or both testicles.
The testicles are 2 egg-shaped glands located inside the scrotum (a sac of loose skin that lies directly below the penis). The testicles are held within the scrotum by the spermatic cord, which also contains the vas deferens and vessels and nerves of the testicles.
Anatomy of the male reproductive and urinary systems, showing the testicles, prostate, bladder, and other organs.
The testicles are the male sex glands and produce testosterone and sperm. Germ cells within the testicles produce immature sperm that travel through a network of tubules (tiny tubes) and larger tubes into the epididymis (a long coiled tube next to the testicles) where the sperm mature and are stored.
Almost all testicular cancers start in the germ cells. The two main types of testicular germ cell tumors are seminomas and nonseminomas. These 2 types grow and spread differently and are treated differently. Nonseminomas tend to grow and spread more quickly than seminomas. Seminomas are more sensitive to radiation. A testicular tumor that contains both seminoma and nonseminoma cells is treated as a nonseminoma.
Testicular cancer is the most common cancer in men 20 to 35 years old.
Health history can affect the risk of testicular cancer.
Anything that increases the chance of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesn’t mean that you will not get cancer. Talk with your doctor if you think you may be at risk. Risk factors for testicular cancer include:
Having had an undescended testicle.
Having had abnormal development of the testicles.
Having a personal history of testicular cancer.
Having a family history of testicular cancer (especially in a father or brother).
Being White.
Certain factors affect prognosis (chance of recovery) and treatment options.
The prognosis and treatment options depend on the following:
Stage of the cancer (whether it is in or near the testicle or has spread to other places in the body, and blood levels of AFP, beta-hCG, and LDH).
Type of cancer.
Size of the tumor.
Number and size of retroperitoneal lymph nodes.
Testicular cancer can usually be cured in patients who receive adjuvant chemotherapy or radiation therapy after their primary treatment.
Treatment for testicular cancer can cause infertility.
Certain treatments for testicular cancer can cause infertility that may be permanent. Patients who may wish to have children should consider sperm banking before having treatment. Sperm banking is the process of freezing sperm and storing it for later use.
Source: National Cancer Institute (NCI)
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Microscopic image of testicular cancer
Microscopic image of testicular cancer
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Testicular Cancer, Causes, Signs and Symptoms, Diagnosis and Treatment.
Video by Medical Centric/YouTube
Microscopic image of testicular cancer
Małgorzata Figura/Wikimedia
4:56
Testicular Cancer, Causes, Signs and Symptoms, Diagnosis and Treatment.
Medical Centric/YouTube
Review
Left Ovarian Cancer, Right Testicular Cancer
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Left Ovarian Cancer, Right Testicular Cancer
Left Ovarian Cancer, Right Testicular Cancer
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Review: Introduction to Testicular Cancer
Testicular cancer is the most common cancer in males between the ages of 15 and 35.
Testicular cancer is the second most common malignancy in men ages 35 to 39.
Testicular cancer is often curable.
Cancer cells of testicular cancer grow rapidly, but are usually very susceptible to chemotherapy and radiation therapy.
Lower levels of exercise are believed to be linked to increased risk of testicular cancer.
Other possible risk factors include heredity, genetic abnormalities, congenial defects in the reproductive tract, testicular injury, and atrophy of the testes.
Ninety-five percent of testicular cancers arise from sperm-forming, or germ, cells and are called germinal tumors; the remaining 5 percent are nongerminal tumors.
Germ cells become malignant at a very early stage in their development, and they may be anaplastic, classic (or typical), or spermatocytic, depending on their origin.
Cells more mature and specialized than the germ cells give rise to nonseminomas.
Testicular cancers tend to spread through the spermatic cord and associated blood and lymph vessels into local lymph glands called the retroperitoneal lymph nodes.
Signs and symptoms of testicular cancer include testicular pain, acute epididymitis, night sweats and fever, weight loss, abdominal pain.
Source: National Cancer Institute (NCI) / SEER Training
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Fatal testicular cancer in a 66-year old man with secondarie
Fatal testicular cancer in a 66-year old man with secondaries in adrenals and kidney: swollen right testicle section showing tumour and surrounding growth in complete replacement. Watercolour by Barbara E. Nicholson, 1958.
Iconographic Collections
Keywords: Tumour; Testicular cancer; Cancer; Tumor; Norman Murdoch Matheson; Barbara E. Nicholson
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Testicular Cancer: Signs, Symptoms and Self-Exams
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Fatal testicular cancer in a 66-year old man with secondarie
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Testicular Cancer: Signs, Symptoms and Self-Exams
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Types
Histology of main types of testicular germ cell tumors.
Histology of main types of testicular germ cell tumors.
The large images show a general histology pattern of a seminoma (upper panel) and two most often seen types of non-seminoma: undifferentiated embryonal carcinoma (middle panel) and teratoma, a tumor displaying differentiation into various somatic tissues (bottom panel). Small square pictures on the right show cellular characteristics in a greater magnification. All sections are stained with hematoxyllin-eosin (HE).
Ninety-five percent of testicular cancers arise from sperm-forming, or germ cells, and are called germinal tumors. The remaining 5 percent are nongerminal tumors. About 40 percent of germinal tumors are categorized as seminomas. Several other types of germinal tumors are referred to collectively as non-seminomas.
These distinctions are important because each type grows and spreads differently, which influences treatment.
Seminomas
Germ cells become malignant at a very early stage in their development. They may be anaplastic, classic (or typical), or spermatocytic, depending on their origin. Eighty-five percent of seminomas are of the classic type. They occur most often in men in their 40s. Anaplastic seminomas are more aggressive and are more likely to metastasize to other parts of the body. Spermatocytic seminomas usually occur in men over 50. The rate of metastasis for this type of cancer is low.
Non-seminomas
Cells, which are more mature and specialized than the germ cells, give rise to non-seminomas. This type of testicular cancer affects men in their mid-30s; the aggressiveness of the disease varies. Twenty to 25 percent of the tumors are embryonal carcinomas, which are aggressive tumors; 25 to 30 percent are teratoma carcinomas, which are also aggressive; yolk-sac tumors, or choriocarcinomas, are extremely rare (about 1 percent of testicular cancers); and some tumors include more than one cell type.
Testicular cancers tend to spread via the spermatic cord and associated blood and lymph vessels into local lymph glands called the retroperitoneal the lymph nodes. Metastases of the right testis are more likely to affect the lymph nodes near the aorta, the major blood vessel leading away from the heart, called the para-aortic lymph nodes. When metastases beyond the lymph nodes occur, they are most likely to arise in the lungs, liver, bone, or brain.
Source: National Cancer Institute (NCI) / SEER Training
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Testis with prostate carcinoma - 2 -- intermed mag
Micrograph showing testis with metastatic prostate carcinoma. H&E stain.
Related images
Testis with PCa - very low mag.
Testis with PCa - low mag.
Testis with PCa - intermed. mag.
Testis with PCa - intermed. mag.
Testis with PCa - high mag.
Testis with PCa - low mag.
Testis with PCa - intermed. mag.
Testis with PCa - high mag.
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Testicular seminoma (1) nodal metastasis
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Ovarian Germ Cell Tumors - Treatment
Micrograph of a seminoma. H&E stain.Features:
Image by Nephron
Seminoma
Micrograph of a testicular seminoma. H&E stain.
Histologic characteristics of seminoma: fried egg-like cells (clear cytoplasm with a central nucleus), nuclei have a squared-off nuclear contour/are polygonal (normal = ovoid or circular), a lymphocytic infiltration is common.
Image by Nephron/Wikimedia
Seminoma in ultrasound
Seminoma in ultrasound
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Seminomas vs. Nonseminomas | Testicular Cancer
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Testis with prostate carcinoma - 2 -- intermed mag
Nephron/Wikimedia
Testicular seminoma (1) nodal metastasis
/Wikimedia
Ovarian Germ Cell Tumors - Treatment
Nephron
Seminoma
Nephron/Wikimedia
Seminoma in ultrasound
Mme Mim
2:45
Seminomas vs. Nonseminomas | Testicular Cancer
Howcast/YouTube
Risk Factors
White males between the ages of 20-40 years old are at higher risk
Image by Ian Robertson from East Lothian, Scotland/Wikimedia
White males between the ages of 20-40 years old are at higher risk
Testicular cancer awareness week
Image by Ian Robertson from East Lothian, Scotland/Wikimedia
What Are the Risk Factors for Testicular Cancer?
Orchiopexy: surgical placement of an undescended testis. The risk factor here is the scrotal surgery, not the procedure itself.
Age: most common in young adults 20-40 years
Race: whites are 6 times more likely to develop testicular cancer than blacks
Vasectomy: surgical separation of the seminal vesicles for contraception. The risk factor here is the scrotal surgery, not the vasectomy.
Testicular trauma: crushing injury, blunt trauma (such as getting kneed in the groin) and other accidental injuries; risk of cancer is not known but is under investigation.
Other: Orchitis (inflammation of the testicle); irradiation
Men with a history of hernia
Men with extra nipples
Men with a history of infertility problems
Men with cryptorchidism or undescended testes—the failure of one or both testicles to descend from the pelvis (about 10 percent of men with testicular cancer have a history of cryptorchidism)
Source: National Cancer Institute (NCI) / SEER Training
Additional Materials (11)
White males between the ages of 20-40 years old are at higher risk
Image by StockSnap/Pixabay
Phil Morris MBE - Founder of testicular cancer UK
Image by Youplonka/Wikimedia
Cancer survivor Lt. Dennis Wischmeier was diagnosed with an advanced stage of testicular cancer
PEARL HARBOR (Feb. 11, 2009) Cancer survivor Lt. Dennis Wischmeier and his son share a moment outside their home on Ford Island. In 2005, Wischmeier was diagnosed with an advanced stage of testicular cancer, resulting in an 11-centimeter tumor in his lower abdomen. (U.S. Navy photo by Blair Martin/Released)
Image by U.S. Navy photo by Blair Martin/Wikimedia
Ultrasonography of cryptorchidism - annotated
Scrotal ultrasonography of a 28 year old male with pain upon palpation in the right inguinal region. It shows right-sided cryptorchidism, with the testicle being located under subcutaneous fat, approximately 7 cm rostral to the public bone.
Image by Mikael Häggström, M.D. - Author info - Reusing imagesConsent note: Written informed consent was obtained from the individual, including online publication./Wikimedia
CryptorchidismForms
Different forms of cryptorchidism
Image by Lamiot/Wikimedia
The Scrotum and Testes
This anterior view shows the structures of the scrotum and testes.
Image by CNX Openstax
Brinster Male germline stem cell transplantation
Diagram depicting male germline stem cell transplantation. The proposed clinical application of human spermatogonial stem cells (SSCs). Before treatment for cancer by chemotherapy or irradiation, a prepubertal boy could undergo a testicular biopsy to recover SSCs. The SSCs would be cryopreserved and/or cultured to expand their number in vitro. After treatment, the SSCs would be transplanted to the patient’s testes to produce spermatozoa. A step for genetic correction to rescue a genetic disorder is possible prior to transplantation.
Image by Credd7398/Wikimedia
Descending of testis (old and present theory)
Descending of testis (old and present theory)
Image by Kwanjin Park and Hwang Choi
Testicular Cancer Risk Factors | Testicular Cancer
Video by Howcast/YouTube
What Causes Testicular Cancer | Testicular Cancer
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How to Prevent Testicular Cancer | Testicular Cancer
Video by Howcast/YouTube
White males between the ages of 20-40 years old are at higher risk
StockSnap/Pixabay
Phil Morris MBE - Founder of testicular cancer UK
Youplonka/Wikimedia
Cancer survivor Lt. Dennis Wischmeier was diagnosed with an advanced stage of testicular cancer
U.S. Navy photo by Blair Martin/Wikimedia
Ultrasonography of cryptorchidism - annotated
Mikael Häggström, M.D. - Author info - Reusing imagesConsent note: Written informed consent was obtained from the individual, including online publication./Wikimedia
CryptorchidismForms
Lamiot/Wikimedia
The Scrotum and Testes
CNX Openstax
Brinster Male germline stem cell transplantation
Credd7398/Wikimedia
Descending of testis (old and present theory)
Kwanjin Park and Hwang Choi
1:01
Testicular Cancer Risk Factors | Testicular Cancer
Howcast/YouTube
2:22
What Causes Testicular Cancer | Testicular Cancer
Howcast/YouTube
2:25
How to Prevent Testicular Cancer | Testicular Cancer
Howcast/YouTube
Screening
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testicular self examination
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testicular self examination
A medical illustration depicting a testicular self examination.
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Can Testicular Cancer Be Cured?
Testicular cancer can usually be cured.
Although the number of new cases of testicular cancer has doubled in the last 40 years, the number of deaths caused by testicular cancer has decreased greatly because of better treatments. Testicular cancer can usually be cured, even in late stages of the disease.
Source: PDQ® Screening and Prevention Editorial Board. PDQ Testicular Cancer Screening. Bethesda, MD: National Cancer Institute.
Additional Materials (6)
Relative incidences of testicular tumors
Relative incidences of testicular tumors. Reference:
Gill MS, Shah SH, Soomro IN, Kayani N, Hasan SH (2000). "Morphological pattern of testicular tumors.". J Pak Med Assoc 50 (4): 110-3. PMID 10851829.
Image by
Mikael Häggström, M.D. - Author info - Reusing images- Conflicts of interest: None
Mikael Häggström, M.D./Wikimedia
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Testicular Cancer
Lump or swelling in the testes.
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testicular self examination
A medical illustration depicting a testicular self examination.
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Movember cancer and well-being infographic (15950106606)
Facts about prostate and testicular cancer, and male-well-being
Image by Office for National Statistics/Wikimedia
How to Perform a Testicular Cancer Self Exam
Video by LIVESTRONG.COM/YouTube
How to Do a Testicular Cancer Self-Exam | Testicular Cancer
Video by Howcast/YouTube
Relative incidences of testicular tumors
Mikael Häggström, M.D. - Author info - Reusing images- Conflicts of interest: None
Mikael Häggström, M.D./Wikimedia
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Testicular Cancer
Scientific Animations, Inc.
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testicular self examination
BruceBlaus
Movember cancer and well-being infographic (15950106606)
Office for National Statistics/Wikimedia
1:04
How to Perform a Testicular Cancer Self Exam
LIVESTRONG.COM/YouTube
2:30
How to Do a Testicular Cancer Self-Exam | Testicular Cancer
Howcast/YouTube
Symptoms
Male Reproductive Organ
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Male Reproductive Organ
Male Reproductive Organ Revealing Urethra
Image by TheVisualMD
What Are Signs and Symptoms of Testicular Cancer?
These and other signs and symptoms may be caused by testicular cancer or by other conditions. Check with your doctor if you have any of the following:
A painless lump or swelling in either testicle.
A change in how the testicle feels.
A dull ache in the lower abdomen or the groin.
A sudden build-up of fluid in the scrotum.
Pain or discomfort in a testicle or in the scrotum.
Source: National Cancer Institute (NCI)
Additional Materials (4)
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Male Reproductive System
Male Reproductive System
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Testicular Cancer’s Hidden Costs in a Nutshell: Infertility, Sexual Dysfunction, Poor Self-Esteem
While the conversation about our bits and bobs has gone mainstream, the mental health aspect remains a sticking point. Despite the high cure rate, many men continue to quietly suffer from issues related to complications after treatment.
Image by StoryMD
Acute epididymitis, low mag
Acute epididymitis with abundant fibrinopurulent exudate in the tubules, H&E Stain.
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Testicular Cancer Signs & Symptoms | Testicular Cancer
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Male Reproductive System
TheVisualMD
Testicular Cancer’s Hidden Costs in a Nutshell: Infertility, Sexual Dysfunction, Poor Self-Esteem
StoryMD
Acute epididymitis, low mag
CoRus13/Wikimedia
1:44
Testicular Cancer Signs & Symptoms | Testicular Cancer
Howcast/YouTube
Diagnosis
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Testicle Self Exam Checking Spermatic Cord
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Testicle Self Exam Checking Spermatic Cord
Medical visualization of an anteriolateral view of a testicular self exam: palpitation of spermatic cord. Testicular self-exam is the best method for early detection of testicular cancer, and it can also help men discover other benign growths that may or may not benefit from treatment. From approximately the age of 15, men need to regularly examine their testicles for any change in size, pain on manipulation, or the presence of abnormal lumps. 1 of 2.
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What Tests Are Used to Detect and Diagnose Testicular Cancer?
The following tests and procedures may be used:
Physical exam and health history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. The testicles will be examined to check for lumps, swelling, or pain. A history of the patient's health habits and past illnesses and treatments will also be taken.
Ultrasound exam of the testes: A procedure in which high-energy sound waves (ultrasound) are bounced off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram.
Serum tumor marker test: A procedure in which a sample of blood is examined to measure the amounts of certain substances released into the blood by organs, tissues, or tumor cells in the body. Certain substances are linked to specific types of cancer when found in increased levels in the blood. These are called tumor markers. The following tumor markers are used to detect testicular cancer:
Alpha-fetoprotein (AFP).
Beta-human chorionic gonadotropin (beta-hCG).
Tumor marker levels are measured before inguinal orchiectomy and biopsy, to help diagnose testicular cancer.
Inguinal orchiectomy: A procedure to remove the entire testicle through an incision in the groin. A tissue sample from the testicle is then viewed under a microscope to check for cancer cells. (The surgeon does not cut through the scrotum into the testicle to remove a sample of tissue for biopsy, because if cancer is present, this procedure could cause it to spread into the scrotum and lymph nodes. It's important to choose a surgeon who has experience with this kind of surgery.) If cancer is found, the cell type (seminoma or nonseminoma) is determined in order to help plan treatment.
Source: National Cancer Institute (NCI)
Additional Materials (4)
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Testicular self-examination
Demonstration of a 27-year-old healthy Caucasian male performing a testicular self-exam. The subject's genitals are in a non-aroused flaccid state. In the exam, the subject first balances both testicles to compare their weights. He then gently rolls each individual testicle between thumb and fingers to locate any soreness, lumps, hardness, swelling, or other abnormalities. He then checks the epididymis attached to each testicle for swelling, soreness, or other abnormalities.
Image by Calscot84
Human Chorionic Gonadotropin (hCG) Rotation
Gonadotropins are hormones that stimulate gonad functions, including hormonal functions of the ovaries. In the very earliest stages of pregnancy, a developing placenta begins to secrete human chorionic gonadotropin (hCG). The hormone enters maternal circulation once an embryo is implanted in the endometrium. Levels of hCG rise sharply and peak during the first trimester but remain high throughout gestation.
hCG testing is used widely to detect pregnancy. Because hCG levels begin to rise immediately after conception, the test enables accurate, early detection. Measuring the amount of hCG in circulation is furthermore useful in determining the specific stage of pregnancy, as hCG volumes are associated with the number of weeks an embryo has been implanted. hCG is also a component of the multiple-marker first-semester screen and the "quad" screen used in the second trimester; in conjunction with other markers, abnormal levels of hCG may indicate chromosomal abnormality.
hCG testing for pregnancy is available to women of child-bearing age. The "quad" screen, of which hCG is a component, is especially recommended for women with higher-risk pregnancies as indicated by factors such as maternal age, family history, and disease history. hCG tests are used to diagnosis testicular cancer in men presenting with enlarged breasts (gynecomastia). Prepubescent boys may also be tested for testicular malignancies when exhibiting secondary sexual characteristics before the age of 8 (isosexual precocious puberty).
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How is Testicular Cancer Diagnosed? | Dana-Farber Cancer Institute
Video by Dana-Farber Cancer Institute/YouTube
Recognizing a Testicular Cancer Lump | Testicular Cancer
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Testicular self-examination
Calscot84
Human Chorionic Gonadotropin (hCG) Rotation
TheVisualMD
2:48
How is Testicular Cancer Diagnosed? | Dana-Farber Cancer Institute
Dana-Farber Cancer Institute/YouTube
1:59
Recognizing a Testicular Cancer Lump | Testicular Cancer
Howcast/YouTube
Testicular Biopsy
Testicular Biopsy
Also called: Biopsy of the Testicle
A testicular biopsy is a procedure in which a small tissue sample from one or both testicles is taken and then sent to a specialist for its evaluation. This test can be used to help find the cause of male infertility or to diagnose testicular cancer.
Testicular Biopsy
Also called: Biopsy of the Testicle
A testicular biopsy is a procedure in which a small tissue sample from one or both testicles is taken and then sent to a specialist for its evaluation. This test can be used to help find the cause of male infertility or to diagnose testicular cancer.
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Your result is Normal.
A normal biopsy result means that no cancer or abnormal cells were found and sperm development appears to be normal.
Related conditions
A testicular biopsy is a test in which a small piece of tissue from one or both testicles is taken and then sent to a pathologist for evaluation.
Your doctor may want to order this test to help find the cause of male infertility in the following situations:
When a semen analysis shows abnormalities in the sperm and other tests (such as blood and hormone tests) have not found the cause
To distinguish between obstructive and nonobstructive causes of azoospermia (absence of sperm)
To retrieve sperm for in vitro fertilization (IVF)
A testicular biopsy may also be done if an abnormal mass has been found during testicular examination. In this case, the biopsy is more frequently performed intraoperatively (during the surgery) to determine whether the mass is cancerous or noncancerous. If cancer is found, the entire testicle is removed (orchidectomy).
There are several approaches to take the testicular tissue sample, which are by performing an open biopsy (doing a small incision in the testicle) or a percutaneous biopsy (inserting a thin biopsy needle through the scrotum).
The kind of biopsy you have depends on the reason for the test.
Open Biopsy
For the open biopsy you will be put under local or general anesthesia, then the scrotum is cleaned with a germ-killing (antiseptic) solution, and your doctor makes a small cut in the skin and testicle. Then a small sample of the testicle tissue is removed, and stitches are used to close both cuts.
Percutaneous Biopsy
For the percutaneous biopsy you will be put under local anesthesia, then the scrotum is cleaned with a germ-killing (antiseptic) solution, and your doctor will insert a thin biopsy needle into the testicle. Then a small sample of the testicle tissue is aspirated. This procedure does not require an incision or stitches.
No special preparations are usually necessary. Inform your healthcare practitioner if you are taking any over-the-counter or prescription medications.
Biopsies are considered to be low-risk procedures; however, as with most procedures, a biopsy also carries the risk of pain on the site, bleeding, hematomas, and infection. You may also present a bad reaction to the anesthesia.
After the biopsy is common for the area to be sore, this usually goes away within two or three days.
You may also be required to avoid any sexual activity for one or two weeks after the test.
A testicular biopsy is normal when no cancerous cells are found, and sperm development appears to be normal.
Results are considered abnormal when any of the following findings are present:
Spermatocele (a lump filled with fluid and dead sperm cells)
Orchitis (inflammation of the testicles, usually caused by an infection)
Testicular cancer
If your testicular biopsy result is normal, but your semen analysis shows azoospermia (absence of sperm) or oligozoospermia (low sperm count), this may indicate a blockage of the vans deferens (the tube through which the sperm passes from the testes to the urethra). Blockages can usually be repaired with surgery.
DIAGNOSTIC PROCEDURES | Stony Brook Medicine [accessed on Dec 27, 2018]
Testicular biopsy Information | Mount Sinai - New York [accessed on Dec 27, 2018]
Testicular biopsy and vasography in the evaluation of male infertility. - PubMed - NCBI [accessed on Dec 27, 2018]
https://www.researchgate.net/publication/265934322_Diagnostic_Surgery_Vasography_Seminal_Vesicle_Aspiration_and_Testis_Biopsy [accessed on Dec 27, 2018]
Testicle Biopsy: Purpose, Procedure & Recovery [accessed on Dec 27, 2018]
Testicular biopsy: clinical practice and interpretation [accessed on Dec 27, 2018]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Human Chorionic Gonadotropin Test
Human Chorionic Gonadotropin (HCG) Tumor Marker Test
Also called: hCG Tumor Marker, Beta-human chorionic gonadotropin, Beta-hCG
An hCG (human chorionic gonadotropin) tumor marker test measures the level of hCG in your blood. High levels of hCG can be a sign of gestational trophoblastic disease and germ cell tumors.
Human Chorionic Gonadotropin (HCG) Tumor Marker Test
Also called: hCG Tumor Marker, Beta-human chorionic gonadotropin, Beta-hCG
An hCG (human chorionic gonadotropin) tumor marker test measures the level of hCG in your blood. High levels of hCG can be a sign of gestational trophoblastic disease and germ cell tumors.
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(mi.U.)/mL
3
Your result is Normal.
Normal results vary based on the laboratory and the method used.
Related conditions
Human chorionic gonadotropin (hCG) is a hormone found normally in a woman's blood and urine during pregnancy. However, outside pregnancy, it can be secreted by certain types of tumor and abnormal tissues.
The human chorionic gonadotropin (hCG) blood test is used to determine the levels of this hormone in your blood. Some tests may only test for intact hCG and some others will also measure free beta-hCG. The tests that detect both are more sensitive in detecting hCG-producing tumors.
Human chorionic gonadotropin is useful as a tumor marker, which means that if a tumor or cancer is producing hCG, then this test can be used to help detect the tumor and monitor its activity.
This hormone isn’t normally present in men or non-pregnant women; therefore, finding hCG in these populations can be related to gestational trophoblastic disease (GTD), gestational trophoblastic neoplasm, choriocarcinoma, and placental site tumors, as well as in testicular, ovarian, stomach, liver, and lung cancers.
Gestational trophoblastic disease (GTD) is a group of tumors that develops in the uterus. GTD occurs at the beginning of pregnancy. After an egg has been fertilized, the cells start piling up, growing a tissue mass instead of supporting the growth of the fetus. Generally, these are benign tumors, and only a small percentage is malignant.
A quantitative hCG may be ordered if a doctor suspects gestational trophoblastic disease or germ cells tumor, or in the following situations:
For women:
Abnormal vaginal bleeding, along with nausea, vomits and lower back pain
Abdominal discomfort
To monitor a pregnancy
To screen for fetal abnormalities
If you have a family history of ovarian cancer
To monitor cancer treatment
For men:
Abdominal discomfort
Pelvic pain
Pain in the testicles
Breast growth (gynecomastia)
Collection of fluid in the scrotum
Enlarged scrotum
History of testicular cancer in the family
HIV infection
To monitor cancer treatment
A healthcare professional takes a blood sample from a vein, generally in your arm, using a needle. A small amount of blood is collected into a test tube. You may feel a little sting when the needle goes in or out.
No fasting or other preparations are needed.
You may feel a little sting when the needle is inserted and extracted but otherwise is a quick procedure. You may also experience bruising and a little bleeding, as well as mild soreness for a short amount of time after the extraction.
If your hCG levels are higher than normal, this means you may be pregnant, or worst-case scenario, have a tumor. Your doctor will take into consideration this test results, along with the results of other tests, your clinical findings, and your family medical history to make an accurate diagnosis.
If you have an hCG-secreting tumor and your hCG levels are getting lower, this means that the treatment is going well.
https://labtestsonline.org/tests/hcg-tumor-marker [accessed on Aug 17, 2018]
AAFP/Serum Tumor Markers; Am Fam Physician. 2003 Sep 15;68(6):1075-1082. [accessed on Aug 17, 2018]
LabCorp: Human Chorionic Gonadotropin (hCG), β-Subunit, Quantitative [accessed on Aug 17, 2018]
Selecting an appropriate hCG test for managing gestational trophoblastic disease and cancer. - PubMed - NCBI [accessed on Nov 07, 2018]
BHCG - Clinical: Beta-Human Chorionic Gonadotropin, Quantitative, Serum [accessed on Nov 07, 2018]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
17-Ketosteroids Test
17-Ketosteroids Test
Also called: 17-KS, 17-Ketosteroids, Urine
17-ketosteroids are substances that form when the body breaks down male steroid sex hormones called androgens and other hormones released by the adrenal glands in males and females, by the testes in males, and by the ovaries in females. This test detects the presence of some of these steroids in a sample of your urine.
17-Ketosteroids Test
Also called: 17-KS, 17-Ketosteroids, Urine
17-ketosteroids are substances that form when the body breaks down male steroid sex hormones called androgens and other hormones released by the adrenal glands in males and females, by the testes in males, and by the ovaries in females. This test detects the presence of some of these steroids in a sample of your urine.
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mg/h
7
20
Your result is Normal.
Normal results vary based on the laboratory and the method used.
Related conditions
17-ketosteroids are a group of substances that are formed when your body breaks down male steroid sex hormones, known as androgens, and other hormones that are released by the testes in males, by the ovaries in females, and by the adrenal glands (which are small organs located at the top of each kidney) in males and females.
17-ketosteroids include steroids such as dehydroepiandrosterone (DHEA), estrone, androstenedione, and androsterone, which are the compounds that are measured with this test.
Your doctor may order this test to assess how well your adrenal glands are producing androgens when you have signs or symptoms of a disorder related to abnormal androgens levels.
You will be asked to provide a urine sample, or a small amount of blood will be drawn from a vein in your arm using a needle.
No fasting or other preparations are needed. For the urine test, you will be required to use a container to store your urine during a 24-hour period.
Inform your healthcare practitioner if you are taking any over-the-counter or prescription medications since you might be asked to temporarily stop taking certain drugs that may affect your test results.
There are no known risks associated with a urine 17-ketosteroids test.
In a blood 17-ketosteroids test you may feel discomfort when the needle is inserted and extracted, but, otherwise, it is a quick procedure. You may also experience bruising and a little bleeding, as well as mild soreness for a short amount of time after the blood extraction.
Normal reference ranges vary widely depending on the person's age, sex, and method used for testing by the laboratory.
High
Increased levels of 17-ketosteroids may the result of:
Stress
Obesity
Pregnancy
Overactive thyroid (hyperthyroidism)
Tumor in the adrenal glands
Polycystic ovary syndrome
Ovarian cancer
Testicular cancer
Low
Decreased levels of 17-ketosteroids may be the result of:
Kidney damage
Addison disease, which is the result of damage to the adrenal glands
Hypopituitarism, which is a dysfunction of the pituitary gland
Removal of the testicles (castration)
Certain drugs can affect your test results, including aspirin, birth control pills, estrogen, and some antibiotics, among others. Do not stop taking any prescribed drugs before the test without first consulting your doctor.
https://medlineplus.gov/ency/article/003460.htm [accessed on Mar 07, 2019]
https://www.labcorp.com/test-menu/23881/dehydroepiandrosterone-dhea [accessed on Mar 07, 2019]
https://emedicine.medscape.com/article/2089246-overview#showall [accessed on Mar 07, 2019]
http://ltd.aruplab.com/tests/pub/0080650 [accessed on Mar 07, 2019]
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1520349/ [accessed on Mar 07, 2019]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (3)
Male Endocrine System
3D visualization reconstructed from scanned human data. The endocrine system is the regulator of the human body as it responsible for maintaining homeostasis by producing and directing chemical messengers called hormones. Hormones act on just about every cell to carry out a variety of functions related to the following: metabolism, water and mineral balance, sexual development, growth, and stress reactions. Most hormones travel throughout the body via the bloodstream to affect their target organs and tissues. Other hormones act locally and arrive at their site of action via microcirculation.
Image by TheVisualMD
Man Sitting on the Floor Showing Endocrine System
3D visualization reconstructed from scanned human data. The endocrine system is the regulator of the human body as it responsible for maintaining homeostasis by producing and directing chemical messengers called hormones. Hormones act on just about every cell to carry out a variety of functions related to the following: metabolism, water and mineral balance, sexual development, growth, and stress reactions. Most hormones travel throughout the body via the bloodstream to affect their target organs and tissues. Other hormones act locally and arrive at their site of action via microcirculation.
Image by TheVisualMD
Endocrine System of a Male
The endocrine system comprises several small organs that involve the release of extracellular signaling molecules known as hormones. The endocrine system is responsible for regulating metabolism, growth and development and puberty, tissue function, and plays a part also in mood.
Image by TheVisualMD
Male Endocrine System
TheVisualMD
Man Sitting on the Floor Showing Endocrine System
TheVisualMD
Endocrine System of a Male
TheVisualMD
Tumor Marker Tests
Tumor Marker Tests
Tumor markers are substances made by cancer cells or normal cells in response to cancer in the body. These tests can help find out if your cancer has spread, if treatment is working, or if cancer has returned after you've finished treatment.
Tumor Marker Tests
Tumor markers are substances made by cancer cells or normal cells in response to cancer in the body. These tests can help find out if your cancer has spread, if treatment is working, or if cancer has returned after you've finished treatment.
These tests look for tumor markers, sometimes called cancer markers, in the blood, urine, or body tissues. Tumor markers are substances made by cancer cells or by normal cells in response to cancer in the body. Some tumor markers are specific to one type of cancer. Others can be found in several types of cancers.
Because tumor markers can also show up in certain noncancerous conditions, tumor marker tests are not usually used to diagnose cancer or screen people at low risk of the disease. These tests are most often done on people already diagnosed with cancer. Tumor markers can help find out if your cancer has spread, whether your treatment is working, or if your cancer has come back after you've finished treatment.
Tumor marker tests are most often used to:
Plan your treatment. If tumor marker levels go down, it usually means the treatment is working.
Help find out if a cancer has spread to other tissues
Help predict the likely outcome or course of your disease
Check to see if your cancer has come back after successful treatment
Screen people at high risk for cancer. Risk factors can include family history and previous diagnosis of another type of cancer
You may need a tumor marker test if you are currently being treated for cancer, have finished cancer treatment, or have a high risk of getting cancer because of family history or other reasons.
The type of test you get will depend on your health, health history, and symptoms you may have. Below are some of the most common types of tumor markers and what they are used for.
CA 125 (cancer antigen 125)
Tumor marker for:
ovarian cancer
Used to:
See if cancer treatment is working
See if cancer has come back after you've finished treatment
CA 15-3 and CA 27-29 (cancer antigens 15-3 and 27-29)
Tumor markers for:
breast cancer
Used to:
Monitor treatment in women with advanced breast cancer
PSA (prostate-specific antigen)
Tumor marker for:
prostate cancer
Used to:
Screen for prostate cancer
Help diagnose prostate cancer
Monitor treatment
Check to see if cancer has come back after you've finished treatment
CEA (carcinoembryonic antigen)
Tumor marker for:
colorectal cancer, and also for cancers of the lung, stomach, thyroid, pancreas, breast, and ovary
Used to:
See if cancer treatment is working
See if cancer has come back after you've finished treatment
AFP (Alpha-fetoprotein)
Tumor marker for:
liver cancer, and cancers of the ovary or testicles
Used to:
Help diagnose liver cancer
Find out if cancer has spread (the stage of cancer)
See if cancer treatment is working
Predict chances for recovery
B2M (Beta 2-microglobulin)
Tumor marker for:
multiple myeloma, some lymphomas, and leukemias
Used to:
See if cancer treatment is working
Predict chances for recovery
There are different ways to test for tumor markers. Blood tests are the most common type of tumor marker tests. Urine tests or biopsies may also be used to check for tumor markers. A biopsy is a minor procedure that involves removing a small piece of tissue for testing.
If you are getting a blood test, a health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.
If you are getting a urine test, ask your health care provider for instructions on how to provide your sample.
If you are getting a biopsy, a health care provider will take out a small piece of tissue by cutting or scraping the skin. If your provider needs to test tissue from inside your body, he or she may use a special needle to withdraw the sample.
You usually don't need any special preparations for a blood or urine test. If you are getting a biopsy, you may need to fast (not eat or drink) for several hours before the procedure. Talk to your health care provider if you have any questions about preparing for your test.
There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.
There is no risk to a urine test.
If you have had a biopsy, you may have a little bruising or bleeding at biopsy site. You may also have a little discomfort at the site for a day or two.
Depending in what type of test you had and how it was used, your results may:
Help diagnose the type or stage of your cancer.
Show whether your cancer treatment is working.
Help plan future treatment.
Show if your cancer has returned after you've finished treatment.
If you have questions about your results, talk to your health care provider.
Tumor markers can be very useful, but the information they provide can be limited because:
Some noncancerous conditions can cause tumor markers.
Some people with cancer don't have tumor markers.
Not all types of cancer have tumor markers.
So, tumor markers are almost always used with other tests to help diagnose and monitor cancer.
Tumor Markers - National Cancer Institute [accessed on Oct 04, 2018]
Tumor Markers [accessed on Oct 04, 2018]
Additional Materials (7)
What to Know About Germ Cell Tumor Markers, with Timothy Gilligan, MD
Video by Cancer.Net/YouTube
Why Don't We Have Cancer-Sniffing Dogs?
Video by SciShow/YouTube
Tumor Markers in Cancer Detection, Diagnosis and Management
Video by USMLEVideoLectures/YouTube
Tumor Markers in Cancer diagnosis and Monitoring
Video by Pathology Simplified/YouTube
Clinical Chemistry - Tumor Markers as Diagnostic Tests for Cancer
Video by قناة لابوتيوب LaboTube Channel/YouTube
Understanding CA-125 Screening for Ovarian Cancer
Video by Roswell Park Comprehensive Cancer Center/YouTube
Tracking cancer with a blood test
Video by Cancer Research UK/YouTube
3:07
What to Know About Germ Cell Tumor Markers, with Timothy Gilligan, MD
Cancer.Net/YouTube
6:33
Why Don't We Have Cancer-Sniffing Dogs?
SciShow/YouTube
9:15
Tumor Markers in Cancer Detection, Diagnosis and Management
USMLEVideoLectures/YouTube
9:47
Tumor Markers in Cancer diagnosis and Monitoring
Pathology Simplified/YouTube
4:49
Clinical Chemistry - Tumor Markers as Diagnostic Tests for Cancer
قناة لابوتيوب LaboTube Channel/YouTube
2:25
Understanding CA-125 Screening for Ovarian Cancer
Roswell Park Comprehensive Cancer Center/YouTube
1:49
Tracking cancer with a blood test
Cancer Research UK/YouTube
Alpha Fetoprotein (AFP) Tumor Marker Test
Alpha Fetoprotein (AFP) Tumor Marker Test
Also called: AFP Tumor Marker, Alpha-Fetoprotein Tumor Marker, Alpha-Fetoprotein-L3 Percent
An AFP (alpha-fetoprotein) tumor marker test measures the level of AFP in your blood. High levels of AFP can be a sign of liver cancer, cancer of the ovaries or testicles, and noncancerous liver disorders.
Alpha Fetoprotein (AFP) Tumor Marker Test
Also called: AFP Tumor Marker, Alpha-Fetoprotein Tumor Marker, Alpha-Fetoprotein-L3 Percent
An AFP (alpha-fetoprotein) tumor marker test measures the level of AFP in your blood. High levels of AFP can be a sign of liver cancer, cancer of the ovaries or testicles, and noncancerous liver disorders.
{"label":"AFP tumor marker reference range","scale":"lin","step":0.1,"hideunits":false,"items":[{"flag":"normal","label":{"short":"Normal","long":"Normal","orientation":"horizontal"},"values":{"min":0,"max":8.3},"text":"AFP is normally elevated in pregnant women since it is produced by the fetus. However, AFP is not usually found in the blood of adults.","conditions":[]},{"flag":"abnormal","label":{"short":"High","long":"High","orientation":"horizontal"},"values":{"min":8.3,"max":500},"text":"In men, and in women who are not pregnant, an elevated level of AFP may indicate liver cancer or cancer of the ovary or testicle. Noncancerous conditions may also cause elevated AFP levels, such as cirrhosis and hepatitis.","conditions":["Liver disease","Chronic hepatitis","Cirrhosis","Liver cancer","Ovarian cancer","Testicular cancer","Hodgkin disease"]}],"units":[{"printSymbol":"ng\/mL","code":"ng\/mL","name":"nanogram per milliliter"}],"value":4.2}[{"normal":0},{"abnormal":0}]
Use the slider below to see how your results affect your
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ng/mL
8.3
Your result is Normal.
AFP is normally elevated in pregnant women since it is produced by the fetus. However, AFP is not usually found in the blood of adults.
Related conditions
{"label":"AFP-L3% reference range","scale":"lin","step":0.1,"hideunits":false,"items":[{"flag":"negative","label":{"short":"Negative","long":"Negative","orientation":"horizontal"},"values":{"min":0,"max":10},"text":"Normal results can vary depending on the method used for testing by the laboratory.","conditions":[]},{"flag":"positive","label":{"short":"Positive","long":"Positive","orientation":"horizontal"},"values":{"min":10,"max":100},"text":"Elevated AFP-L3% levels have been associated with an increased risk of developing hepatocellular carcinoma (liver cancer) and with a poorer prognosis for people with this type of cancer. <br \/>\n","conditions":["Hepatocellular carcinoma"]}],"units":[{"printSymbol":"%","code":"%","name":"percent"}],"value":5}[{"negative":0},{"positive":0}]
Use the slider below to see how your results affect your
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%
10
Your result is Negative.
Normal results can vary depending on the method used for testing by the laboratory.
Related conditions
An AFP tumor marker test is a blood test that measures the level of AFP (alpha-fetoprotein) in a sample of your blood. It's usually used to help diagnose certain types of cancer and to check how well treatment is working.
AFP is a protein that the liver makes when its cells are growing and dividing to make new cells. AFP is normally high in unborn babies. After birth, AFP levels drop very low. Healthy children and adults who aren't pregnant have very little AFP in their blood.
AFP in non-pregnant people is mainly measured as a tumor marker. Tumor markers are substances that are often made by cancer cells or by normal cells in response to cancer. High levels of AFP can be a sign of cancer of the liver, ovaries or testicles.
An AFP tumor marker test cannot be used by itself to screen for or diagnose cancer. That's because other conditions can increase AFP levels, including liver diseases that aren't cancer. And some people who do have liver, ovarian, or testicular cancer will have normal AFP levels. So, an AFP tumor marker test can't rule out cancer for sure. But when used with other tests and exams, AFP tumor marker testing can help diagnose and monitor cancers that cause high AFP levels.
Other names: total AFP, alpha-fetoprotein-L3 Percent
An AFP tumor marker test may be used during the diagnosis and/or treatment of cancer of the liver, ovaries, or testicles that make high levels of AFP. It is used to:
Help confirm or rule out a cancer diagnosis when used with other exams and tests.
Predict how cancer may behave over time.
Monitor cancer treatment. AFP levels often go up if cancer is growing and go down when treatment is working.
Check whether cancer has returned after treatment.
In certain cases, results from an AFP tumor marker test may be used to guide treatment choices for specific types of cancer. The test may also be used to monitor your health if you have chronic (long lasting) hepatitis or cirrhosis of the liver. These conditions aren't cancer, but they increase your risk of developing liver cancer.
You may need an AFP tumor marker test if:
A physical exam and/or other tests suggest that you may have cancer of the liver, ovaries, or testicles.
You are currently being treated for a cancer that causes high AFP levels. Measuring your AFP test can show how well your treatment is working.
You have completed treatment for a cancer that increased your AFP level. You may need an AFP tumor marker test from time to time to check whether your cancer is coming back.
If you have chronic hepatitis or cirrhosis, you have a higher risk of developing liver cancer. A very high level of AFP or a sudden increase can be an early sign of liver cancer. Most medical experts don't recommend measuring AFP levels to screen for cancer in these diseases. But, some health care providers may still use an AFP tumor marker test with other tests to watch for liver cancer.
A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.
You don't need any special preparations for an AFP tumor marker test.
There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.
If you haven't been diagnosed with cancer, test results that show:
High levels of AFP may be a sign of cancer of the liver, ovaries, or testicles. But having a high AFP level doesn't mean you have cancer or that you will get cancer. Liver injury and liver diseases that aren't cancer can also cause high AFP levels. Less often, high levels of AFP may be a sign of other cancers, including lymphoma or lung cancer. Your provider will use your medical history and other test results to make a diagnosis.
Normal levels of AFP mean you're less likely to have a cancer that causes high AFP levels. But a normal test result doesn't rule out cancer because some people with these cancers have normal AFP levels.
If you're being treated for a cancer that increased your AFP levels, you may be tested several times during treatment. Your provider will look at all your AFP test results to see how your levels have changed over time. If your results show:
Your AFP levels are increasing, it may mean that your treatment isn't working.
Your AFP levels are decreasing, it may mean your treatment is working.
Your AFP levels have stayed the same, it may mean your disease is stable and hasn't gotten better or worse.
If you've finished treatment for cancer that caused high AFP levels and your test results are:
Not normal, it may mean that you still have some cancer in your body.
Higher now than they were shortly after treatment, it may mean your cancer is growing again.
If you have a long-lasting liver disease that's not cancer, you may need other tests to check for liver cancer if your test results show a sudden increase in AFP or your level is very high.
Ask your provider to explain what your test results mean for your health.
In the U.S., the most common AFP tumor marker test measures all forms of AFP in your blood. A less common AFP test may be used to check the risk of liver cancer in people who have chronic liver disease. It measures a form of AFP called L3.
An AFP-L3 percent test (AFP-L3%) compares the amount of L3 to the amount of total AFP in your blood. If the portion of L3 increases, it may mean you have a high risk of developing a serious form of the most common liver cancer called hepatocellular carcinoma.
You may have heard of another type of AFP test that's used during pregnancy. This test measures total AFP levels in the blood, but it's not a tumor marker test for cancer. It's used to check for the risk of certain birth defects in an unborn baby.
Alpha Fetoprotein (AFP) Tumor Marker Test: MedlinePlus Medical Test [accessed on Feb 12, 2024]
Lab Tests Online: Alpha-fetoprotein (AFP) Tumor Marker [accessed on Aug 24, 2018]
URMC / Encyclopedia / Alpha-Fetoprotein Tumor Marker (Blood) [accessed on Aug 24, 2018]
Arrieta, Oscar et al. “The Progressive Elevation of Alpha Fetoprotein for the Diagnosis of Hepatocellular Carcinoma in Patients with Liver Cirrhosis.” BMC Cancer 7 (2007): 28. PMC. Web. 24 Aug. 2018. [accessed on Aug 24, 2018]
AAFP: Serum Tumor Markers; Am Fam Physician. 2003 Sep 15;68(6):1075-1082. [accessed on Aug 24, 2018]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (6)
Genes and Genetic Defects
Genetic testing isn't new. In the 1960s, doctors were able to test newborn babies for certain rare single-gene disorders, such as phenylketonuria (PKU), a rare metabolic disease that causes mental retardation. (PKU can be prevented with a special diet if it's detected early, which was why it was critical to test newborns.)
Image by TheVisualMD
This browser does not support the video element.
Prenatal Diagnostic Testing
If a pregnant woman has an abnormal genetic screening test result, a doctor may suggest a prenatal diagnostic test be done to determine with more certainly whether or not a fetus has a particular disorder. There are two main diagnostic testing procedures, chorionic villus sampling (CVS) and amniocentesis. Both of these tests involve collecting a sample from inside the womb, which is then examined to detect diseases such as Down Syndrome, Edwards Syndrome, neural tube defects, cystic fibrosis, fragile-x, and spinal muscular atrophy. Prenatal diagnostic tests provide valuable information on the health of the fetus and can help alleviate the stress of expectant parents.
Video by TheVisualMD
Mapping Your Future: Screening for Disease Risk
Image by TheVisualMD
Amniocentesis
Amniocentesis is a prenatal test that gathers information about a fetus` health from a sample of amniotic fluid. Amniotic fluid is the fluid that surrounds the fetus in the uterus. It contains cells from the fetus that naturally slough off during development. If a woman is at high risk for a genetic disease, a doctor may recommend an "amnio" to determine whether a fetus has certain genetic disorders, such as cystic fibrosis, among other diseases.
Image by TheVisualMD
Megacystis
Megacystis in fetus : Ultrasound revealing megacystis in a fetus with Down syndrome.
Image by X.Compagnion
Maternal Serum Screening (MSS)
Video by Washington State Department of Health/YouTube
Genes and Genetic Defects
TheVisualMD
4:34
Prenatal Diagnostic Testing
TheVisualMD
Mapping Your Future: Screening for Disease Risk
TheVisualMD
Amniocentesis
TheVisualMD
Megacystis
X.Compagnion
3:57
Maternal Serum Screening (MSS)
Washington State Department of Health/YouTube
Beta 2 Microglobulin (B2M) Tumor Marker Test
Beta 2 Microglobulin (B2M) Tumor Marker Test
Also called: Beta-2 Microglobulin, β2-Microglobulin, B2M, B2MG, Thymotaxin
The test measures the amount of beta-2 microglobulin (B2M) in your body fluids, usually in the blood. B2M is found on most of the cells in your body in small amounts. High levels of B2M in body fluids may be indicative of certain cancers. The B2M tumor marker is used to determine prognosis and follow response to treatment.
Beta 2 Microglobulin (B2M) Tumor Marker Test
Also called: Beta-2 Microglobulin, β2-Microglobulin, B2M, B2MG, Thymotaxin
The test measures the amount of beta-2 microglobulin (B2M) in your body fluids, usually in the blood. B2M is found on most of the cells in your body in small amounts. High levels of B2M in body fluids may be indicative of certain cancers. The B2M tumor marker is used to determine prognosis and follow response to treatment.
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Use the slider below to see how your results affect your
health.
μg/mL
2.7
Your result is Normal.
Healthy people have small amounts of B2M in their blood. Normal results vary based on the laboratory and the method used.
Related conditions
{"label":"B2M (cerebrospinal fluid) reference range","scale":"lin","step":0.1,"hideunits":false,"items":[{"flag":"normal","label":{"short":"Normal","long":"Normal","orientation":"horizontal"},"values":{"min":0.7,"max":1.8},"text":"Normal results vary based on the laboratory and the method used.","conditions":[]},{"flag":"abnormal","label":{"short":"High","long":"High","orientation":"horizontal"},"values":{"min":1.8,"max":5},"text":"Increased levels of B2M means that a disease is likely to be present, and further testing needs to be done. Usually, higher levels correspond with higher stages of the disease; hence, worse prognosis.","conditions":["Non-Hodgkin lymphoma","Acute lymphocytic leukemia","HIV progression","Chronic inflammation","Multiple sclerosis","Acute viral infection","Neurologic processes"]}],"units":[{"printSymbol":"\u03bcg\/mL","code":"ug\/mL","name":"microgram per milliliter"}],"value":1.3}[{"normal":0},{"abnormal":0}]
Use the slider below to see how your results affect your
health.
μg/mL
1.8
Your result is Normal.
Normal results vary based on the laboratory and the method used.
Related conditions
{"label":"B2M (urine) reference range","scale":"lin","step":0.1,"hideunits":false,"items":[{"flag":"normal","label":{"short":"Normal","long":"Normal","orientation":"horizontal"},"values":{"min":0,"max":300},"text":"Healthy people have small amounts of B2M in their blood. Normal results vary based on the laboratory and the method used.","conditions":[]},{"flag":"abnormal","label":{"short":"High","long":"High","orientation":"horizontal"},"values":{"min":300,"max":500},"text":"Increased urine B2M levels indicate kidney damage, and further testing needs to be done. Usually, higher levels correspond with higher stages of the disease; hence, worse prognosis.","conditions":["Renal tubular damage","Pyelonephritis","Balkan nephropathy","Exposure to cadmium","Exposure to mercury","Exposure to lithium","Aminoglycoside toxicity"]}],"units":[{"printSymbol":"\u03bcg\/L","code":"ug\/L","name":"microgram per liter"}],"value":150}[{"normal":0},{"abnormal":0}]
Use the slider below to see how your results affect your
health.
μg/L
300
Your result is Normal.
Healthy people have small amounts of B2M in their blood. Normal results vary based on the laboratory and the method used.
Related conditions
A beta-2 microglobulin tumor marker test measures the amount of a protein called beta-2 microglobulin (B2M) in your body fluids. The test usually uses a sample of your blood. It may also be done using urine (pee) or in rare cases cerebrospinal fluid (CSF).
B2M is a type of tumor marker. Tumor markers are substances that are often made by cancer cells or by normal cells in response to cancer in the body. B2M is found on most of the cells in your body. Normally, you have only small amounts of B2M in your blood and urine. High levels of B2M in body fluids are often caused by these blood and bone marrow cancers:
Multiple myeloma
Chronic lymphocytic leukemia (CLL)
Certain types of lymphoma
A beta-2 microglobulin tumor marker test can't diagnose cancer or any other condition. That's because there are so many conditions that can cause high levels of B2M. But if you've already been diagnosed with one of these blood and bone marrow cancers, a B2M test can provide important information about your cancer including:
How much cancer you have in your body and how fast it's growing
How your cancer may behave in the future
How much your treatment is helping
This information can help you and your health care provider plan your care.
Other names: total beta-2 microglobulin, β2-microglobulin, B2M, B2MG, thymotaxin
A beta-2 microglobulin tumor marker test is most often used if you have been diagnosed with certain cancers of the bone marrow or blood. Testing your B2M levels can help:
Find out how much cancer is in your body
Predict how your cancer will develop
Pick your treatment and check whether it's working
Check whether cancer has spread to your brain and/or spinal cord (This is done only if you have symptoms.)
If you have been diagnosed with multiple myeloma, chronic lymphocytic leukemia, or certain types of lymphoma, you may need a B2M test to find out how serious your disease is. B2M testing can help monitor your cancer and check whether your treatment is working.
If you have multiple myeloma, you may need a B2M test to see whether your cancer is spreading. A test of a urine sample may also be needed to check whether your disease is affecting your kidneys.
A beta-2 microglobulin test usually uses a sample of your blood. In certain cases, you may need to provide a 24-hour urine sample, which means collecting all your urine for a full day. If your provider suspects that cancer has spread to your brain or spine, you may have a cerebrospinal fluid (CSF) analysis.
For a blood test, a health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.
For a 24-hour urine sample, you will be given a special container to collect your urine and instructions on how to collect and store your samples. Your provider will tell you what time to start. The test generally includes the following steps:
To begin, urinate (pee) in the toilet as usual. Do not collect this urine. Write down the time you urinated.
For the next 24 hours, collect all your urine in the container.
During the collection period, store the urine container in the refrigerator or in a cooler with ice.
24 hours after starting the test, try to urinate if you can. This is the last urine collection for the test.
Return the container with your urine to your provider's office or the laboratory as instructed.
For a cerebrospinal fluid (CSF) analysis, a provider will do a procedure called a spinal tap (also known as a lumbar puncture). A spinal tap is usually done in a hospital. A provider numbs your skin with medicine and uses a thin, hollow needle to remove some fluid from between the bones in your lower spine. You usually go home the same day.
For blood and urine tests, there are no special preparations.
For a CSF analysis (spinal tap), you may be asked to empty your bladder (pee) and bowels (poop) before the test.
With a blood test, there is very little risk. After the test, you may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.
With a urine test, there is no known risk.
With a CSF analysis, there is very little risk from a spinal tap. You may feel a little pinch or pressure when the needle is inserted. After the test, you may feel some pain or tenderness in your back or have some bleeding where the needle was inserted. You may also get a headache. The headache may last for several hours or up to a week or more. Your provider may suggest treatment to relieve the pain.
If your B2M levels were measured to learn about your cancer:
The higher your B2M levels, the more cancer you have in your body. Higher levels are linked to cancers that tend to grow faster.
If you have multiple myeloma, higher levels of B2M are linked with kidney problems.
If your B2M levels were measured to check how well your treatment is working, your provider may look at several test results over time to look for a trend:
Increasing B2M levels may mean your treatment is not working.
Decreasing B2M levels may mean your treatment is working.
B2M levels that don't change may mean that your disease is stable and hasn't gotten better or worse.
If you have questions about your test results, talk with your provider.
B2M levels may be higher than normal in many conditions that aren't cancer. The amount of B2M in body fluids may be measured in conditions such as:
Kidney disease
HIV/AIDS
Multiple sclerosis
Beta 2 Microglobulin (B2M) Tumor Marker Test: MedlinePlus Medical Test [accessed on Jan 20, 2024]
Tumor Marker Tests in Common Use - NCI. National Cancer Institute. Dec 7, 2023 [accessed on Jan 20, 2024]
Beta 2 Microglobulin (B2M) Test. City of Hope. [accessed on Jan 20, 2024]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (1)
Electrophoresis - concentration - b-Globulin
Beta globulins are a group of globular proteins in plasma that are more mobile in alkaline or electrically charged solutions than gamma globulins, but less mobile than alpha globulins. Examples of beta globulins include beta-2 microglobulin, plasminogen, angiostatins, properdin, sex hormone-binding globulin, & transferrin.
Image by TheVisualMD
Electrophoresis - concentration - b-Globulin
TheVisualMD
CA-125 Blood Test
CA-125 Blood Test
Also called: CA-125 Tumor Marker, Glycoprotein Antigen, Ovarian Cancer Antigen
This test measures the amount of a protein called CA-125 in the blood. CA-125 levels are high in many women with ovarian cancer. It is not a screening test, but it can help find out if cancer treatment is working.
CA-125 Blood Test
Also called: CA-125 Tumor Marker, Glycoprotein Antigen, Ovarian Cancer Antigen
This test measures the amount of a protein called CA-125 in the blood. CA-125 levels are high in many women with ovarian cancer. It is not a screening test, but it can help find out if cancer treatment is working.
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Use the slider below to see how your results affect your
health.
(i.U.)/mL
35
Your result is Normal.
Having a normal CA-125 result doesn't mean you don't have ovarian cancer. Some women with early ovarian cancer have a normal CA-125 level.
Related conditions
This test measures the amount of a protein called CA-125 (cancer antigen 125) in a sample of your blood. CA-125 is a type of tumor marker. High levels of certain tumor markers in your blood may be a sign of cancer. If you have cancer, measuring certain tumor markers may help provide important information about how to treat your disease.
High levels of CA-125 are often found in people who have ovarian cancer. The ovaries are a pair of female reproductive glands that store ova (eggs) and make female hormones. Ovarian cancer happens when the cells in an ovary begin to grow out of control.
If you have ovarian cancer, CA-125 blood tests can help show whether your treatment is working.
Other names: cancer antigen 125, glycoprotein antigen, ovarian cancer antigen, CA-125 tumor marker
A CA-125 blood test may be used:
To see if ovarian cancer treatment is working and to check for ovarian cancer that has come back. This is the most common use of CA-125 blood testing.
To learn more about a growth or lump in your pelvis (the area below your belly). If a suspicious lump shows up on imaging, such as an ultrasound, your health care provider may check your CA-125 levels along with other tests to find out whether the lump could be ovarian cancer. But a CA-125 blood test alone can't diagnose cancer.
To screen for ovarian cancer if you're risk is very high. If your family health history includes ovarian cancer, your provider may suggest a CA-125 blood test and other tests to look for signs of cancer. But a CA-125 test is not used as a routine screening test for people who don't have a high risk for ovarian cancer. That's because many common conditions that aren't cancer can also cause high CA-125 levels, such as endometriosis or even a menstrual period.
If you've been diagnosed with ovarian cancer, you may have several CA-125 blood tests:
During your treatment to see if your cancer is going away. If CA-125 levels go down, it usually means your treatment is working
After your treatment, to check whether your cancer has returned
If you have a lump in your pelvis that could be ovarian cancer, you may need a CA-125 test to help find out if it could be ovarian cancer. But only a biopsy can diagnose ovarian cancer.
If you have a very high risk of getting ovarian cancer, your health care provider may suggest checking your CA-125 levels. If they're high, you'll probably need more tests to find out if you have cancer. You're more likely to get ovarian cancer if you:
Have a mother or sister, or two or more other relatives who had ovarian cancer
Have family members who have had breast cancer or colorectal cancer (colon cancer)
Have inherited certain gene changes or conditions that increase your risk of ovarian cancer, such as:
Changes in your genes, including BRCA 1 or BRCA 2 genes
Lynch syndrome (also called hereditary non-polyposis colorectal cancer), an inherited disorder that increases the risk for many types of cancer
Have had breast, uterine (uterus), or colorectal cancer
If you're concerned about getting ovarian cancer, talk with your provider about your risk.
A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.
You don't need any special preparations for a CA-125 blood test.
There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.
Your provider will review your CA-125 test results along with other information about your condition. Together, you can discuss how your results affect your diagnosis, treatment, and need for more testing.
In general:
If you are being treated for ovarian cancer, and the results of several tests show that your CA-125 levels are going down, it usually means that the treatment is helping. If your levels go up or stay the same over time, it may mean that the treatment isn't working.
If you have finished your treatment for ovarian cancer and your CA-125 levels begin to increase over time, your cancer may be coming back.
If you have a high risk for ovarian cancer or have a suspicious pelvic lump, a high CA-125 levels could be a sign of cancer. Your provider will usually order more tests to make a diagnosis.
A high CA-125 level doesn't always mean cancer. Other conditions may increase CA-125, including:
Endometriosis
Pelvic inflammatory disease (PID)
Uterine fibroids
Liver disease
Pregnancy
Your menstrual period, at certain times during your cycle
A normal CA-125 test result doesn't rule out ovarian cancer. That's because CA-125 levels may be low in the early stages of cancer. And not everyone with ovarian cancer makes high levels of CA-125.
Talk with your provider if you have questions about your results.
The most common type of ovarian cancer is epithelial ovarian cancer. If you have been treated for this type of cancer, you may be tested for a tumor marker called HE4 along with CA-125. Some studies show that measuring both tumor markers provides more accurate information to check whether treatment is working and to look for the return of this type of cancer.
CA 125 Blood Test (Ovarian Cancer): MedlinePlus Lab Test Information [accessed on Nov 05, 2018]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (8)
Ovarian Cancer
Ovarian cancer is the deadliest of gynecologic cancers. More than 21,000 new cases of ovarian cancer are diagnosed each year, with more than 15,000 deaths. A particular blood protein called cancer antigen 125 (CA-125) is often elevated in women with ovarian cancer, though small amounts of CA-125 are produced by normal tissues throughout the body and levels of CA-125 can be elevated by other conditions. The CA-125 test is used primarily to monitor the effectiveness of treatment for ovarian cancer. There are three different kinds of ovarian cancer: the most common type is epithelial ovarian cancer (90%) which originates from the surface epithelium of the ovary and is more likely to affect older women; germ cell ovarian cancer (5%), which originates from the cells that produce eggs and is more likely to affect younger women; and stromal ovarian cancer (5%), which originates from the connective tissue within the ovary. After age, the most important risk factor for ovarian cancer is family history. Ovarian cancer is relatively uncommon, but is the fifth leading cause of cancer death in women, partly due to diagnosis difficulty; its symptoms are vague, and ovarian cancer can shed cells that can invade other internal organs long before the presence of disease is even suspected.
Image by TheVisualMD
CA-125: Ovaries and Uterus
The cancer antigen 125 test (CA-125) is used to monitor treatment for ovarian cancer. If blood levels of CA-125 fall during treatment, it usually means the cancer is responding; if levels rise after treatment is complete, it may indicate that the cancer has returned.
Image by TheVisualMD
CA-125: Uterus and Ovaries in Ultrasound
When ovarian cancer is suspected, a doctor will typically perform a pelvic exam to check for masses or growths on the ovaries. Other diagnostic tests include a transvaginal ultrasound, which produce detailed images of the ovaries and other reproductive organs.
Image by TheVisualMD
CA-125: Female Reproductive System - A carbohydrate antigen that occurs in tumors of the ovary as well as in breast, kidney, and gastrointestinal tract tumors and normal tissue. While it is tumor-associated, it is not tumor-specific and may have a protective function against particles and infectious agents at mucosal surfaces. (NCBI/NIH)
As our understanding of cancer has deepened and treatment options expanded, the emphasis has shifted to early detection and aggressive treatment. The hope is that earlier and more accurate diagnoses will push survival rates for ovarian cancer higher.
Image by TheVisualMD
Ovarian Cancer Fact Sheet
Ovarian cancer is cancer that begins in the ovaries.
The ovaries make female hormones and produce a
woman’s eggs. Ovarian cancer is a serious cancer that
is more common in older women. Treatment is most
effective when the cancer is found early.
Document by Office on Women's Health, U.S. Department of Health and Human Services
Ovarian Cancer: Symptoms and Treatment
Video by MainMD/YouTube
Premature Ovarian Aging and Early Menopause
Video by Center for Human Reproduction/YouTube
Ovarian cancer: beyond resistance
Video by nature video/YouTube
Ovarian Cancer
TheVisualMD
CA-125: Ovaries and Uterus
TheVisualMD
CA-125: Uterus and Ovaries in Ultrasound
TheVisualMD
CA-125: Female Reproductive System - A carbohydrate antigen that occurs in tumors of the ovary as well as in breast, kidney, and gastrointestinal tract tumors and normal tissue. While it is tumor-associated, it is not tumor-specific and may have a protective function against particles and infectious agents at mucosal surfaces. (NCBI/NIH)
TheVisualMD
Ovarian Cancer Fact Sheet
Office on Women's Health, U.S. Department of Health and Human Services
3:04
Ovarian Cancer: Symptoms and Treatment
MainMD/YouTube
5:09
Premature Ovarian Aging and Early Menopause
Center for Human Reproduction/YouTube
2:22
Ovarian cancer: beyond resistance
nature video/YouTube
CA 15-3 Test
CA 15-3 Test
Also called: CA 15-3 Tumor Marker, Cancer Antigen 15-3, Cancer Antigen-Breast
CA 15-3 testing is mostly used in women who have been diagnosed with invasive breast cancer to monitor the response to treatment and to help watch for recurrence of the disease.
CA 15-3 Test
Also called: CA 15-3 Tumor Marker, Cancer Antigen 15-3, Cancer Antigen-Breast
CA 15-3 testing is mostly used in women who have been diagnosed with invasive breast cancer to monitor the response to treatment and to help watch for recurrence of the disease.
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Use the slider below to see how your results affect your
health.
(i.U.)/mL
30
Your result is Normal.
Normal results vary based on the laboratory and the method used.
Related conditions
Suggests limited tumor burden (less cancer is present)
Suggests breast-cancer patient is responding well to treatment
Cancer antigen 15-3 (CA 15-3) is a protein that is produced by normal breast cells, and its production increases when cancerous breast tumors are present. Therefore, this antigen can be used as a tumor marker (meaning that if you have high levels of it, there is a good chance that you have cancer).
This test measures CA 15-3 levels in a sample of your blood.
Since not all women with breast cancer will have an increased CA 15-3 level, this test is not useful in all cases and should not be used as a screening tool to detect breast cancer in healthy women.
Hence, your doctor might want to test your CA 15-3 levels to monitor your response to treatment after the diagnosis of advanced breast cancer has already been made and to control whether the disease has recurred.
A small amount of blood will be drawn from a vein in your arm by using a needle.
No fasting is needed. Your doctor may recommend you not to take multivitamins or dietary supplements containing biotin (vitamin B7) for 12 hours prior to the test.
Only the risks related to blood extraction, which are temporary discomfort, bruising, little bleeding, and risk of infection in the place where the needle was inserted.
Normal values of CA 15-3 are less than 30 units/mL. However, reference ranges can slightly vary from laboratory to laboratory.
Usually, the more advanced the breast cancer is, the higher the CA 15-3 level will be. The highest levels of CA 15-3 often are seen when the disease has already spread to other tissues (metastasized).
Nevertheless, besides breast cancer, CA 15-3 levels can be mild to moderately increased in other conditions, including:
Colon cancer
Lung cancer
Pancreatic cancer
Ovarian cancer
Prostate cancer
Liver cancer
Liver disease (hepatitis, cirrhosis)
Benign breast disease
Having normal or elevated CA 15-3 levels does not discard or confirm the presence of cancer as this antigen should not be interpreted alone, but rather taking into consideration other tests and procedures.
Some women with breast cancer can have normal CA 15-3 levels because it may be too early in the disease process for this antigen to be detected, or the woman may fall in the category of individuals with advanced breast cancer whose tumor do not shed CA 15-3.
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (5)
Cancer
Cancer is a group of diseases characterized by uncontrolled cell growth.
Image by National Human Genome Research Institute (NHGRI)
CA 15-3: Breast Tumor Size When Found by Imaging or Touch
The foods in the image represent the average size of breast cancer tumors when discovered by mammogram, by regular breast self-exam, or by accident. Breast calcifications too small to be felt can be seen as white spots on a mammogram, as shown by the sesame seeds (far left). The blueberry represents the average size of a lump detected by routine mammogram (.43 inches/1.1 cm). The hazelnut shows average tumor size when discovered in a first mammogram (.59 inches/1.5 cm). The grape represents average tumor size when detected by regular breast self-exam (.83 inches/2.1 cm), and the strawberry shows average tumor size when found accidentally (1.42 inches/3.6 cm).
Image by TheVisualMD
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CA 15-3: Breast Tissue and Lymph Node Network
Breast tissue isn't found only in the breast itself: It extends from the breastbone to the armpit, and from below the collarbone to the level of the sixth or seventh rib. The breast contains lymphatic vessels that drain into a network of lymph nodes. These nodes are located around the edges of the breast, in the underarm area, and near the collarbone. Breast cancer often spreads first to the underarm lymph nodes. That's why breast self-examination should include feeling and checking the appearance of the underarm area, with arm only slightly raised.
Image by TheVisualMD
What Are Tumor Markers for Breast Cancer?
Video by Breast Cancer Answers®/YouTube
Biomarker Testing
Video by Merck/YouTube
Cancer
National Human Genome Research Institute (NHGRI)
CA 15-3: Breast Tumor Size When Found by Imaging or Touch
TheVisualMD
Sensitive content
This media may include sensitive content
CA 15-3: Breast Tissue and Lymph Node Network
TheVisualMD
2:42
What Are Tumor Markers for Breast Cancer?
Breast Cancer Answers®/YouTube
1:36
Biomarker Testing
Merck/YouTube
CA 19-9 Blood Test
CA 19-9 Blood Test
Also called: CA 19-9 Tumor Marker, Carbohydrate Antigen 19-9, Pancreatic Cancer Antigen
CA 19-9 testing is mostly used to monitor the effectiveness of treatment in individuals who have been diagnosed with pancreatic cancer. However, this antigen can also be elevated in other conditions, diseases, or types of cancer.
CA 19-9 Blood Test
Also called: CA 19-9 Tumor Marker, Carbohydrate Antigen 19-9, Pancreatic Cancer Antigen
CA 19-9 testing is mostly used to monitor the effectiveness of treatment in individuals who have been diagnosed with pancreatic cancer. However, this antigen can also be elevated in other conditions, diseases, or types of cancer.
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Use the slider below to see how your results affect your
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U/mL
35
75
Your result is Low.
Low amounts of CA 19.9 may be detected in healthy people. Low or stable counts may also indicate positive response to treatment or stabilized tumor growth.
Related conditions
A CA 19-9 test measures the amount of a protein called CA 19-9 (cancer antigen 19-9) in a sample of your blood. CA 19-9 is a type of tumor marker. Tumor markers are substances made by cancer cells or by normal cells in response to cancer in your body.
Healthy people can have small amounts of CA 19-9 in their blood. High levels of CA 19-9 are often a sign of pancreatic cancer. But high levels can also be a sign of other types of cancer or certain conditions that aren't cancer. For example, gallstones and cirrhosis of the liver can cause high CA 19-9 levels.
Because high levels of CA 19-9 can mean different things, the test is not used by itself to screen for or diagnose cancer or other diseases. But it can help monitor your cancer and check how well your treatment is working.
Other names: cancer antigen 19-9, carbohydrate antigen 19-9, CA 199 measurement, CA 19-9 radioimmunoassay (RIA)
CA 19-9 blood tests may be used to:
Monitor certain types of cancer and cancer treatment. CA 19-9 levels often go up as cancer grows and go down as tumors shrink.
Help predict how cancer may behave over time.
Check whether cancer has returned after treatment.
Help diagnose certain cancers and other diseases when used with other tests.
Some people do not make CA 19-9 even when they have a cancer that usually produces high levels of CA 19-9. For these people, a CA 19-9 tumor marker test is not useful.
You may need a CA 19-9 blood test if you've been diagnosed with pancreatic cancer or another type of cancer that causes high CA 19-9. These include cancers of the:
Bile duct
Colon and rectum
Stomach
Ovaries
Bladder
During cancer treatment, your health care provider may test you on a regular basis to see if your treatment is working.
After your treatment is complete, you may need to have CA 19-9 tests to check whether the cancer has come back. High levels of CA 19-9 may be one of the first signs that cancer cells are growing again.
A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.
Usually, you don't need any special preparations for a CA 19-9 blood test. But ask your provider to be sure. If you take certain vitamins, you may need to stop them before the test.
There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.
If you're being treated for cancer, you may be tested several times during your treatment. Your provider will look at all your test results to see how your CA 19-9 levels have changed. Your results may show:
Your levels of CA 19-9 are increasing. This may mean your tumor is growing, and/or your treatment is not working. More tests are usually needed to find out for sure.
Your levels of CA 19-9 are decreasing. This may mean your tumor is shrinking and your treatment is working.
Your levels of CA 19-9 have stayed the same. This may mean your disease is stable and hasn't gotten better or worse.
Your CA 19-9 levels decreased after treatment, but increased later. This may mean your cancer has come back or grown. You'll need more tests to check whether cancer is really causing the higher level of CA 19-9.
If you don't have cancer but your test results show a high level of CA 19-9, you may not a health problem that needs treatment. Healthy people can have high CA 19-9 levels. But high levels may be a sign of a condition, such as:
Pancreatitis, inflammation of the pancreas
Gallstones
Bile duct disease, including a blockage or infection
Liver disease
Cystic fibrosis
Talk with your provider about what your results may mean.
If your provider thinks you may have one of these conditions, you will probably need other tests to find out for sure.
Labs use different methods to measure the amount of CA 19-9 in your blood sample. The test method can affect your results. If you're having regular tests to monitor cancer, it's important to have your tests done the same way, and usually in the same lab. This allows your provider to compare your results over time. Your test report usually says what method was used to measure your CA 19-9 levels. If you have any questions about how your tests are done, talk with your provider.
CA 19-9 Blood Test (Pancreatic Cancer): MedlinePlus Lab Test Information [accessed on Nov 05, 2018]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (7)
Pancreatic Cancer
Pancreatic Cancer: In Situ : The summary staging system categorizes cancer (shown here in the pancreas) according to its spread. In situ cancer is present only in cells in which it began.
Image by TheVisualMD
Amylase, Pancreatic Cancer
Amylase is one of several enzymes produced by the pancreas and secreted into the digestive tract to help break down nutrients (amylase is also produced by the salivary glands). The enzyme is usually present in the blood and urine only in small quantities, but when pancreatic tissue is injured, inflamed (pancreatitis) or when the pancreatic duct is blocked or a tumor is present, amylase can leak into the blood and urine. As cancerous tissue overwhelms the pancreas, its function is compromised and enzyme levels fall.
Image by TheVisualMD
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Pancreas joined to the small bowel after pylorus preserving surgery for pancreatic cancer
Diagram showing the pancreas joined to the small bowel after pylorus preserving surgery for pancreatic cancer
Image by Cancer Research UK / Wikimedia Commons
Pancreatic Cancer
Cancer Types _ Pancreatic Cancer Cells or Tissue _ Abnormal Cells or Tissue
Image by Dr. Lance Liotta Laboratory _ NCI
Doctor explains Ca 19-9 blood test used in PANCREATIC CANCER | LAB TESTS explained
Video by Doctor O'Donovan/YouTube
Diagnosing Pancreatic Tumors and Cysts - Mayo Clinic
Video by Mayo Clinic/YouTube
T1 stage - the tumor is inside the pancreas and is 2cm or less in any direction.
T2 stage - the cancer is more than 2cm but no more than 4cm in size in any direction.
T3 stage - the cancer is more than 4cm in size.
T4 stage - the cancer has grown outside the pancreas, into the nearby large blood vessels.
Node (N) describes whether the cancer has spread to the lymph nodes. It is further divided into N0 and N1 stages.
Metastasis (M) describes whether the cancer has spread to a different part of the body. It is further divided into M0 and M1 stages.
1
2
3
4
5
6
TNM Staging for Pancreatic Cancer
TNM stands for Tumour, Node, Metastasis. This system describes the size of a primary tumour (T), whether there are lymph nodes with cancer cells in them (N) and whether the cancer has spread to a different part of the body (M).
Interactive by Cancer Research UK
Pancreatic Cancer
TheVisualMD
Amylase, Pancreatic Cancer
TheVisualMD
Sensitive content
This media may include sensitive content
Pancreas joined to the small bowel after pylorus preserving surgery for pancreatic cancer
Cancer Research UK / Wikimedia Commons
Pancreatic Cancer
Dr. Lance Liotta Laboratory _ NCI
5:17
Doctor explains Ca 19-9 blood test used in PANCREATIC CANCER | LAB TESTS explained
Doctor O'Donovan/YouTube
5:55
Diagnosing Pancreatic Tumors and Cysts - Mayo Clinic
Mayo Clinic/YouTube
TNM Staging for Pancreatic Cancer
Cancer Research UK
CEA Test
CEA Test
Also called: Carcinoembryonic Antigen, CEA Assay, CEA Tumor Marker
A CEA (carcinoembryonic antigen) test measures CEA in a sample of blood or other body fluid. It helps check if treatment for certain cancers is working. The test is most commonly used in colorectal cancer.
CEA Test
Also called: Carcinoembryonic Antigen, CEA Assay, CEA Tumor Marker
A CEA (carcinoembryonic antigen) test measures CEA in a sample of blood or other body fluid. It helps check if treatment for certain cancers is working. The test is most commonly used in colorectal cancer.
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Use the slider below to see how your results affect your
health.
ng/mL
3
5
20
Your result is Normal.
Related conditions
CEA stands for carcinoembryonic antigen. CEA is a protein that is a type of "tumor marker." Tumor markers are substances that are often made by cancer cells or by normal cells in response to cancer.
High levels of CEA are normal in healthy, unborn babies. After birth, CEA levels become very low or disappear completely. So, healthy adults should have little or no CEA in their bodies.
Cancers that may cause high levels of CEA include cancers of the:
Colon and rectum (colorectal or bowel cancer)
Prostate
Ovary
Lung
Thyroid
Liver
Pancreas
Breast
If you've been diagnosed with a cancer that can cause high CEA levels, CEA testing may help your health care provider learn more about your cancer and chance of recovery. The test is often used with other tests to check if cancer treatment is working.
CEA tests are not used to screen for or diagnose cancer. That's because:
Cancers that often cause high CEA levels don't always cause high levels. You can have normal CEA test results even though you have one of these cancers.
Many other health problems that aren't cancer can make CEA levels rise, including certain conditions that affect your liver, digestion, or breathing.
Most CEA tests use a sample of your blood to measure your CEA level. Sometimes the test uses a sample of fluid from your spine, chest, or abdomen (belly), but this is less common.
A CEA test is mostly used in people who have been diagnosed with cancers that often increase CEA levels. It's most commonly used in colorectal cancer. A provider may order a CEA test along with other tests to:
Learn more about a cancer soon after it has been diagnosed. CEA levels can help predict the likelihood of recovery and/or the chance that cancer will come back after treatment.
Check how well cancer treatment is working.
See if cancer has returned after treatment.
If you've been diagnosed with a type of cancer that can cause high CEA levels, you may need CEA testing:
Before treatment to:
Help understand how serious your cancer is.
Help guide treatment decisions.
Get a measurement of your CEA level before treatment to compare with CEA levels after treatment.
During cancer treatment to see if the treatment working.
After treatment to check whether cancer has come back. You may need to have tests on a regular schedule.
CEA is usually measured with a blood sample. During a CEA blood test, a health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.
Sometimes, CEA is tested in other body fluids. For these tests, your provider will remove a small sample of fluid using a thin needle.
For a CEA blood test, you usually don't need to prepare. If you smoke, you may need to stop for a while before your test. That's because smoking increases CEA levels.
A CEA blood test has very little risk. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.
To understand your CEA test results, your provider will consider the results of other tests and exams. Ask your provider to explain what your test results mean for your health and treatment.
If you had a test before starting cancer treatment, in general:
A low level of CEAmay mean your tumor is small and the cancer has not spread to other parts of your body. But some cancers don't make much CEA, so your provider may use other tests to learn more about how much cancer you have and if it's spread.
A high level of CEAmay mean you have a larger tumor and/or your cancer has spread. You'll need other tests to confirm how serious your cancer is.
If you had a test to monitor your cancer during or after treatment, your provider will compare your current CEA test results with your past test results. In general:
Decreases in CEA over time often mean that treatment is working.
Increases in CEA or high levels that stay highmay mean that treatment isn't working. For example, if you had surgery for colorectal cancer, these levels may mean that the entire tumor wasn't removed or the cancer is growing back.
Decreases in CEA after treatment followed by increasesmay mean cancer has come back.
CEA levels that remain high or increase after treatment don't always mean that treatment isn't working, or cancer is growing. So, if your CEA levels don't come down, your provider will likely order other tests to find out why.
If you have questions about your results, talk with your provider.
Labs use different methods to measure CEA. The test method can affect your results. So, its best to have your tests done the same way, and usually in the same lab. This allows your provider to compare your results over time. If you have questions about how your tests are done, ask your provider.
CEA Test: MedlinePlus Medical Test [accessed on Mar 09, 2023]
https://www.cancer.gov/about-cancer/diagnosis-staging/diagnosis/tumor-markers-fact-sheet [accessed on Mar 13, 2019]
https://www.labcorp.com/test-menu/21906/carcinoembryonic-antigen-cea [accessed on Oct 03, 2019]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (20)
Carcinoembryonic Antigen (CEA): CEA in Colorectal Cancer Staging and Treatment
CEA tests are not used to screen for colorectal cancer, but they're frequently performed after the cancer has been diagnosed. CEA is useful in staging--performing tests to determine if the cancer has spread within the intestine or to distant parts of the body. CEA may also be used for treatment planning, as elevated levels may indicate a poorer prognosis. After surgery, CEA levels may be measured periodically to see if the cancer has spread. It is important to note that CEA is not a perfect predictor of how a patient will respond to treatment, nor is it conclusive in determining if cancer has spread. The American Society of Clinical Oncologists (ASCO) states that CEA should not be used as the sole basis for decision-making in colorectal cancer.
Image by TheVisualMD
Carcinoembryonic Antigen (CEA): CEA Testing During Chemotherapy
Whether CEA is tested during systemic treatment for colorectal cancer depends on the stage of the cancer. After surgery, the American Society of Clinical Oncologists (ASCO) recommends that patients with stage II or stage III cancer have a CEA test every 3 months, for a minimum of 3 years. However, if the patient is receiving chemotherapy, CEA testing should be delayed until after chemotherapy is completed. On the other hand, CEA is the marker of choice for monitoring stage IV (metastatic) colorectal cancer during systemic treatment. Patients with metastatic cancer, in which the cancer has spread to distant parts of the body, should have a CEA test every 1-3 months during chemotherapy to see if the treatment is working and whether the cancer is still spreading. ASCO recommends other tests be done in conjunction with the CEA tests.
Image by TheVisualMD
The Importance of Good Bowel Preparation During Colonoscopy
Video by Johns Hopkins Medicine/YouTube
Colon cancer: Essential facts
Video by Institute for Cancer Genetics and Informatics/YouTube
The Colon and Colon Cancer
Video by Armando Hasudungan/YouTube
Colon Cancer: Don't Ignore Your Symptoms
Video by American Cancer Society/YouTube
Colorectal Cancer Screening
Video by Mechanisms in Medicine/YouTube
This browser does not support the video element.
Treating Colon Cancer
This animation explains how colon cancer forms and how it can be treated through chemotherapy and surgery.
Video by TheVisualMD
This browser does not support the video element.
Colorectal Cancer Screening
Colorectal cancer is one of the few preventable forms of cancer thanks to effective screening. For many people, screening for colorectal cancer is an unpleasant thought, but knowing your options and taking a pro-active approach especially if you're over 50 can save your life. In this video, you can learn the "ins and outs" of colonoscopy, as well as learn about a new technique called virtual colonoscopy, which uses high-tech CT scans to screen the colon.
Video by TheVisualMD
This browser does not support the video element.
Colorectal Cancer Clip 6
Colorectal Cancer Clip 6
Video by TheVisualMD
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Dr. O'Kieffe and patient on preparing for a colonoscopy
A recent colonoscopy patient and gastroenterologist Dr. Donald O'Kieffe of Metro Gastroenterology, Chevy Chase, MD, explain what's involved in the preparation for your screening.
Video by TheVisualMD
This browser does not support the video element.
Dr. Klein on who should be screened
Dr. Mark Klein, a radiologist and colorectal cancer screening specialist at Washington Radiology Associates in Washington, DC, discusses who should be screened for colorectal cancer, and when.
Video by TheVisualMD
Colon cancer staging
Colon cancer staging : After colon cancer has been diagnosed, the next step is to perform tests to determine if the cancer has spread within the intestine or to distant parts of the body. This is called staging. Staging helps the doctor to decide the most appropriate treatment for the cancer at its current stage.
Image by TheVisualMD
Colorectal Cancer Types of Surgery
Surgery is the main treatment for colorectal cancer. Polyps and very early stage cancers (Stage 0 and some early Stage I tumors) can be removed during a colonoscopy, using a variety of techniques. In late Stage I and in Stage II and III cancer, the cancerous part of the colon is removed surgically. The surgeon may perform a resection, consisting of a partial colectomy (removing the cancer and a small amount of healthy tissue around it) and an anastomosis (sewing the parts of the colon back together). Nearby lymph nodes may also be removed and biopsied. If it isn't possible to perform a resection (for instance, if the cancer is at the outlet of the rectum), a colostomy may be performed. In a colostomy, a portion of the large intestine is brought through the abdominal wall to carry stool out of the body, where it empties into a special bag. The colostomy may be temporary in order to allow the colon or rectum time to heal after surgery, or it may be permanent.
Image by TheVisualMD
Colon Anatomy & Function
Image by TheVisualMD
Colostomy
Colostomy Illustration
Image by Blausen.com staff. \"Blausen gallery 2014\". Wikiversity Journal of Medicine. DOI:10.15347/wjm/2014.010. ISSN 20018762
Colorectal Cancer
Colorectal cancer refers to cancer of the colon and cancer of the rectum. The colon is the longest part of the large intestine, and the rectum is the last several inches of the large intestine, closest to the anus.
Image by TheVisualMD
What Is Colorectal Cancer?
The process of cell growth in the body is normally an orderly one. Cells grow and divide as necessary to produce more cells as they are needed. Cells that are old or damaged die, and are replaced with new cells.
Image by TheVisualMD
Treating Colorectal Cancer
There are three main treatment options for colorectal cancer:
Image by TheVisualMD
Colorectal Cancer Spread to Body Stage 4
Cancer spreads in three ways: by invading surrounding tissue, by invading the lymph system and traveling through lymph vessels to other places in the body, and by invading veins and capillaries and traveling through the bloodstream to other places in the body. Stage IV: Cancer may have spread to nearby lymph nodes and has spread to other parts of the body, such as the liver or lungs. Stage IV colorectal cancer is not considered curable. Image 5 of 5.
Image by TheVisualMD
Carcinoembryonic Antigen (CEA): CEA in Colorectal Cancer Staging and Treatment
TheVisualMD
Carcinoembryonic Antigen (CEA): CEA Testing During Chemotherapy
TheVisualMD
1:23
The Importance of Good Bowel Preparation During Colonoscopy
Johns Hopkins Medicine/YouTube
2:49
Colon cancer: Essential facts
Institute for Cancer Genetics and Informatics/YouTube
10:05
The Colon and Colon Cancer
Armando Hasudungan/YouTube
6:06
Colon Cancer: Don't Ignore Your Symptoms
American Cancer Society/YouTube
2:42
Colorectal Cancer Screening
Mechanisms in Medicine/YouTube
3:45
Treating Colon Cancer
TheVisualMD
4:13
Colorectal Cancer Screening
TheVisualMD
0:05
Colorectal Cancer Clip 6
TheVisualMD
0:48
Dr. O'Kieffe and patient on preparing for a colonoscopy
Also called: PSA, Prostate-Specific Antigen, Total PSA
Prostate-specific antigen (PSA) test is a blood test that checks the level of PSA in the blood. PSA is a protein made by the prostate gland. The amount of PSA may be higher in men who have prostate cancer, benign prostatic hyperplasia (BPH), or infection or inflammation of the prostate.
Prostate-Specific Antigen (PSA) Test
Also called: PSA, Prostate-Specific Antigen, Total PSA
Prostate-specific antigen (PSA) test is a blood test that checks the level of PSA in the blood. PSA is a protein made by the prostate gland. The amount of PSA may be higher in men who have prostate cancer, benign prostatic hyperplasia (BPH), or infection or inflammation of the prostate.
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Use the slider below to see how your results affect your
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ng/mL
4
10
Your result is Normal.
PSA is always present in low concentrations in the blood of adult males. However, there is no specific normal or abnormal level of PSA in the blood, and levels may vary over time in the same man. Various factors can cause a man’s PSA level to fluctuate, such as inflammation, infections and medications among other factors.
Related conditions
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Use the slider below to see how your results affect your
health.
%
10
25
Your result is Lower risk.
When total PSA is in the range of 4.0-10.0 ng/mL and free PSA is above 25% it indicates a 9% to 16% risk of prostate cancer, depending on age. Studies have shown that men with a total PSA in this "gray area" and a free PSA greater than 25% are more likely to have a benign condition than to have cancer, making a biopsy unnecessary.
Related conditions
A prostate-specific antigen (PSA) test is a blood test that measures the level of PSA in a sample of your blood. PSA is a protein made by your prostate. The prostate is a gland in the male reproductive system. It lies just below the bladder. It makes the fluid part of semen.
It's normal to have a low level of PSA in your blood. A high PSA level may be caused by:
Prostate cancer
An enlarged prostate (BPH) (benign prostatic hyperplasia)
Other common prostate problems
Taking certain medicines
A PSA test can't show what is causing abnormal PSA levels. So, if your level is high, you may need other tests.
Other names: total PSA free PSA
A PSA test is used to screen for prostate cancer. Cancer screening means looking for signs of cancer before it causes symptoms. But screening tests can't diagnose cancer. If a screening test finds signs of cancer, you'll need other tests to find out if you have cancer and how serious it may be.
Most types of prostate cancer grow very slowly. They don't spread beyond the prostate and may never cause health problems. In fact, you can live a long life with prostate cancer and never know you have it. The goal of prostate cancer screening is to help find cancers that may be more likely to spread so they can be treated early. But there are challenges and possible harms from using a PSA test to screen for prostate cancer:
A PSA test can't tell the different between abnormal PSA levels from prostate cancer and noncancerous conditions. If your PSA level is high, a prostate biopsy is the only way to find out if the cause is cancer. And prostate biopsies have possible harms.
A PSA test may lead to finding and treating prostate cancer that would never have affected your health. If prostate cancer is found:
It can be difficult to tell the difference between slow-growing cancers and those that are likely to grow faster and spread in your body.
You could have prostate cancer treatment that you never really needed. And cancer treatment may cause serious harms, such as:
Erectile dysfunction
Urinary incontinence
Problems controlling your bowels (poop)
To decide whether a PSA test to screen for prostate cancer is right for you, talk with your health care provider about:
Your risk for developing a serious type of prostate cancer. If your risk is high, the possible benefits of finding cancer early may outweigh the possible harms.
Your general health. Are you well enough to have treatment for prostate cancer if it's found?
Your preferences. How do you feel about the possible benefits and harms of screening, diagnosis, and treatment?
PSA testing may also be used to:
Help diagnose the cause of prostate conditions that aren't cancer
Monitor treatment for a prostate condition, including cancer
It's your choice whether to have a PSA test to screen for cancer. You and your prover may consider your risk for developing a serious cancer that could spread if you don't catch it early. Your risk for serious prostate cancer may be higher depending on your:
Age. The risk of prostate cancer increases after age 50.
Your family health history. If members of your family have had prostate cancer, your risk may be higher.
Your race. Prostate cancer is more common in African Americans. They also have a higher risk of developing prostate cancer at a younger age and having more serious disease.
You may also have a PSA test if:
You have symptoms of a prostate condition, such as:
Painful or frequent urination (peeing)
Blood in urine or semen
Pelvic and/or back pain
You have prostate cancer. Your provider may use PSA testing to monitor your condition or to see how well treatment is working.
A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.
You will need to avoid having sex or masturbating for 24 hours before your PSA test. That's because releasing semen can increase your PSA levels, which may make your results less accurate. Also, certain medicines may affect your test results, so tell your provider about any medicines you take.
There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.
There is no specific normal or abnormal level for PSA in blood. In general, the higher your PSA level, the more likely it is that you have cancer. But it's possible to have a high PSA without prostate cancer, or a low PSA with prostate cancer.
If you had a PSA test for a prostate cancer screening or because you have prostate symptoms:
High PSA levels can mean you have prostate cancer or a prostate condition that's not cancer, such as an infection (prostatitis) or an enlarged prostate. If your PSA levels are higher than normal, your provider may talk with you about having more tests to diagnose the cause. These tests may include:
Another PSA test, more commonly if you don't have any symptoms. PSA levels can go up and down, so it helpful to see if your PSA levels change over time.
A digital rectal exam (DRE). For this test, your provider inserts a gloved, lubricated finger into your rectum to feel your prostate for lumps or anything unusual.
A urine test. A sample of your urine is tested for infection.
A prostate biopsy. A biopsy is minor surgery. A doctor removes samples of tissue from your prostate so it can be studied under a microscope to look for cancer cells. A biopsy is the only way to diagnose cancer. It may be recommended if your provider thinks you may have prostate cancer.
If you had a PSA test to monitor prostate cancer or treatment, ask your provider what a high PSA level means. Your provider will usually look at several tests results over time to get a fuller understanding of your condition.
If you have questions about your results, talk with your provider.
Prostate-Specific Antigen (PSA) Test: MedlinePlus Lab Test Information [accessed on Feb 29, 2024]
Prostate-specific antigen (PSA) blood test: MedlinePlus Medical Encyclopedia [accessed on Oct 03, 2018]
Prostate-Specific Antigen (PSA) Test - National Cancer Institute [accessed on Oct 03, 2018]
PSA - Clinical: Prostate-Specific Antigen (PSA) Diagnostic, Serum [accessed on Oct 03, 2018]
PSA. Lab Tests Online. [accessed on Oct 03, 2018]
010322: Prostate-specific Antigen (PSA) | LabCorp [accessed on Oct 03, 2018]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (29)
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Prostate Gland
Prostate Description Line drawing showing lateral view of the prostate gland, rectum, bladder, penis and testis.
Image by National Cancer Institute
Normal vs enlarged prostate
BPH - Prostate enlargement problems
Image by Akcmdu9
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What Is Prostate Cancer?
Delve into the prostate, understand this complex disease found in men that is challenging to diagnose and witness a cutting edge procedure that may change how prostate cancer is diagnosed in the future.
Video by TheVisualMD
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Prostate Cancer Treatment
Once someone is diagnosed with prostate cancer, the patient and his doctors decide a course of action, and create a treatment plan. Very often with prostate cancer, that means simply keeping an eye on the progression of the disease. Here, top doctors lay out the most common prostate cancer treatment options, explain the tools and methods used as well as the risk factors involved.
Video by TheVisualMD
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Standard Biopsy for Prostate Cancer
National Cancer Institute urologist and surgeon Dr. Peter Pinto explains the process of the standard multi-core or "blind" biopsy of the prostate.
Video by TheVisualMD
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Visualizing the Prostate
Unlike for many other cancers, there are no standardized imaging protocols, apart from the use of transrectal ultrasound (TRUS), for the early detection and diagnosis of prostate cancer. This is a critical need. Prostate cancer is a disease for which it is crucial to detect and diagnose cancers early and accurately, both because early prostate cancer is usually without symptoms and because treatment side effects can be severe. Fortunately, new technologies are currently being developed, and even being used in some medical facilities, with promising results. By providing more specific and accurate detection and diagnosis results, these more sophisticated forms of prostate imaging and analysis will help in detecting early cancers, and in making the decision of whether to treat for prostate cancer when abnormalities are detected.
Video by TheVisualMD
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Moving Forward with Prostate Imaging
Unlike for many other cancers, there are no standardized imaging protocols, apart from the use of transrectal ultrasound (TRUS), for the early detection and diagnosis of prostate cancer. This is a critical need. Prostate cancer is a disease for which it is crucial to detect and diagnose cancers early and accurately, both because early prostate cancer is usually without symptoms and because treatment side effects can be severe. Fortunately, new technologies are currently being developed, and even being used in some medical facilities, with promising results. By providing more specific and accurate detection and diagnosis results, these more sophisticated forms of prostate imaging and analysis will help in detecting early cancers, and in making the decision of whether to treat for prostate cancer when abnormalities are detected.
Video by TheVisualMD
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Prostate Cancer Prognosis
A cancer's stage (how far it has progressed) is a very important factor in deciding on treatment and estimating the patient's prognosis. After biopsy confirms the presence of cancer in the prostate, the cancer is staged, meaning that more tests are done to find out how far the cancer has spread in the prostate and if it has spread outside the gland to adjacent tissues or to other sites in the body.
Video by TheVisualMD
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Risks of Overdiagnosis of Prostate Cancer
University of Chicago Hospital radiologist Dr. Aytekin Oto talks about the challenge that doctors face in treating less aggressive forms of prostate cancer.
Video by TheVisualMD
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Risks of Treatment for Prostate Cancer
Prostate cancer patients are likely to have a number of treatment options to choose from. If you have prostate cancer, you may feel pressured to make a decision quickly. But take the time to learn as much as you can about prostate cancer, your prognosis, and the treatments that are appropriate for your case. Talk to your doctor and, preferably, get a second opinion as well. Bear in mind that a surgeon may tend to recommend surgery and a radiation oncologist to recommend radiation therapy. Consider your own feelings about these treatments and their possible side effects.
Video by TheVisualMD
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Treatment Options for Prostate Cancer
Prostate cancer patients are likely to have a number of treatment options to choose from. If you have prostate cancer, you may feel pressured to make a decision quickly. But take the time to learn as much as you can about prostate cancer, your prognosis, and the treatments that are appropriate for your case. Talk to your doctor and, preferably, get a second opinion as well. Bear in mind that a surgeon may tend to recommend surgery and a radiation oncologist to recommend radiation therapy. Consider your own feelings about these treatments and their possible side effects.
Video by TheVisualMD
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MRI for Prostate Cancer
A cancer's stage (how far it has progressed) is a very important factor in deciding on treatment and estimating the patient's prognosis. After biopsy confirms the presence of cancer in the prostate, the cancer is staged, meaning that more tests are done to find out how far the cancer has spread in the prostate and if it has spread outside the gland to adjacent tissues or to other sites in the body.
Video by TheVisualMD
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PET/CT for Prostate Cancer
A cancer's stage (how far it has progressed) is a very important factor in deciding on treatment and estimating the patient's prognosis. After biopsy confirms the presence of cancer in the prostate, the cancer is staged, meaning that more tests are done to find out how far the cancer has spread in the prostate and if it has spread outside the gland to adjacent tissues or to other sites in the body.
Video by TheVisualMD
Prostate Anatomy by Zones with insets
Prostate cancer usually starts in certain zones of the prostate. Knowledge of these different zones helps the doctor to decide where to biopsy tissue and where to look for cancer spread. In this image, the central zone is shown as orange, the transition zone is shown as green, and the peripheral zone is shown as yellow.
Image by TheVisualMD
Prostate Gland Zones
The prostate gland is a small gland that sits below the bladder (the gland lies close to the wall of the rectum, which allows it to be felt in a digital rectal exam). The prostate gland can be divided up in two different ways, by lobes or zones; there are four lobes and five zones. The zone system of classification is used mostly for pathology; the largest zone, the peripheral zone, comprises about three-quarters of the prostate and is where most cancer occurs.
Image by TheVisualMD
Prostate Gland and Seminal Vesicle
Visualization reconstructed from scanned human data of a posterior view of the prostate gland, seminal vesicles, ductus deferens and Cowper's glands. The ductus deferens joins with the seminal vesicles to form the ejaculatory duct. The seminal vesicles act to secrete a thick alkaline fluid that mixes with the sperm as it passes into the ejaculatory ducts and the urethra. The prostate gland secretes a lubricant that helps to prevent infection in the urethra and protects and energizes sperm. The Cowper's gland produces a lubricating fluid which is secreted into the urethra.
Image by TheVisualMD
Male Reproductive System Showing Prostate Cancer
Three-dimensional visualization reconstructed from scanned human data. Lateral cross-section of an enlarged cancerous prostate, as well as bladder, penis, and testicles. Prostate cancer is the leading cause of cancer death in men over the age of 75 and the third leading cause of cancer death in men of all ages. Prostate enlargement in older men is usually benign but can be monitored for malignancy through the use of a blood test for prostate specific antigen (PSA) as well as through more invasive exams such as transrectal ultrasound and tranperineal biospy. Early cancers are sometimes treated with removal of the prostate while late-stage cancers are often treated with hormone and/or radiation therapy in combination with removal of the testicles (orchidectomy) to lower the level of testosterone and decrease cell growth. 2 of 2.
Image by TheVisualMD
Prostate Gland
Visualization of the prostate gland. The prostate gland is the largest accessory gland of the male reproductive system. Two thirds of the prostate is glandular while the remaining third is fibromuscular. Prostatic secretions help to prevent infection in the urethra, energizes sperm and keep the urethral lining moist.
Image by TheVisualMD
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Male Reproductive System
Three-dimensional visualization reconstructed from scanned human data. Lateral cross-section of a healthy, normal prostate, as well as bladder, penis, and testicles. Prostate cancer is the leading cause of cancer death in men over the age of 75 and the third leading cause of cancer death in men of all ages. Prostate enlargement in older men is usually benign (noncancerous) but can be monitored for malignancy through the use of a blood test for prostate specific antigen (PSA) as well as through more invasive exams such as transrectal ultrasound and tranperineal biospy. Early cancers are sometimes treated with removal of the prostate while late-stage cancers are often treated by hormone and/or radiation therapy in combination with removal of the testicles (orchidectomy) to lower the level of testosterone and decrease cell growth. 1 of 2.
Image by TheVisualMD
What Is Prostate Cancer?
Image by TheVisualMD
Prostate Cancer Symptoms
Image by TheVisualMD
Prostate Function
Image by TheVisualMD
Prostate Cancer Grading with Gleason Scale
After biopsy, cancer cells are graded
Image by TheVisualMD
Risk Factors for Prostate Cancer
Some risk factors for prostate cancer are controllable, some aren't. Knowing what the risk factors are can help you to lower your chances of getting prostate cancer and to make decisions about beginning screening. Every man should talk with his general practitioner or urologist and discuss the benefits and shortcomings of PSA screening and whether to have it. Risk factors for prostate cancer include: AGE Risk increases dramatically after age 50. RACE Men of African descent are at higher risk. LIFESTYLE Men in North America and northwestern Europe have an increased risk. FAMILY HISTORY Having a brother or father who has the disease raises risk. GENETICS Some genes have been linked to prostate cancer. DIET High-fat diet increases the chances of getting prostate cancer. HORMONES High levels of testosterone can cause or accelerate the disease.
Image by TheVisualMD
Prostate Cancer Symptoms
Prostate cancer usually causes no symptoms in its early stages. Often there are no symptoms until the disease has spread beyond the prostate gland. Symptoms of advanced prostate cancer can include: 1) blood in the urine or semen, 2) difficulty, pain, or frequency in urinating, 3) pain in the lower back, pelvis, hips, or thigh bones, 4) compression of the spine, 5) pain with ejaculation, and 6) anemia and fatigue.
Image by TheVisualMD
Prostate Gland
Prostate and Seminal Vesicles sagittal and axial slices : Derived from magnetic resonance imaging (MRI) data, the axial and sagittal slices (cross sections) through the prostate reveal the glandular tissue of the prostate as well as the ejaculatory ducts and the urethra. The inner coils of the seminal vesicles are also visible within the slices. Seminal fluid from the seminal vesicles mixes with sperm from the testes, via the ductus deferens, within the ejaculatory duct. The contents of the ejaculatory duct are then deposited into the urethra. There prostatic fluid is added to the mix along with contributions from the bulbourethral glands, forming semen. The prostatic urethra most often carries urine from the bladder and through the prostate.
Image by TheVisualMD
Side Effects of Treatment for Prostate Cancer
The side effects of prostate cancer treatment can be severe and sometimes permanent. They include impotence, incontinence, bleeding, and nerve damage.
Image by TheVisualMD
Prostate Gland
MRI Slices of the Prostate : Radiologists view different cross-sectional slices of the prostate, including the sagittal and axial slices, in order to detect any abnormalities.
Image by TheVisualMD
Decipher Test for Prostate Cancer Recurrence
Range of scores for the Decipher test showing low, intermediate, and high risk of prostate cancer metastasis. By estimating the future risk of prostate cancer spread and death, the Decipher test could help patients and their doctors make treatment decisions.
Image by National Cancer Institute (NCI)
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Prostate Gland
National Cancer Institute
Normal vs enlarged prostate
Akcmdu9
4:26
What Is Prostate Cancer?
TheVisualMD
2:35
Prostate Cancer Treatment
TheVisualMD
0:51
Standard Biopsy for Prostate Cancer
TheVisualMD
1:00
Visualizing the Prostate
TheVisualMD
0:34
Moving Forward with Prostate Imaging
TheVisualMD
0:39
Prostate Cancer Prognosis
TheVisualMD
0:40
Risks of Overdiagnosis of Prostate Cancer
TheVisualMD
0:42
Risks of Treatment for Prostate Cancer
TheVisualMD
0:33
Treatment Options for Prostate Cancer
TheVisualMD
0:27
MRI for Prostate Cancer
TheVisualMD
0:33
PET/CT for Prostate Cancer
TheVisualMD
Prostate Anatomy by Zones with insets
TheVisualMD
Prostate Gland Zones
TheVisualMD
Prostate Gland and Seminal Vesicle
TheVisualMD
Male Reproductive System Showing Prostate Cancer
TheVisualMD
Prostate Gland
TheVisualMD
Sensitive content
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Male Reproductive System
TheVisualMD
What Is Prostate Cancer?
TheVisualMD
Prostate Cancer Symptoms
TheVisualMD
Prostate Function
TheVisualMD
Prostate Cancer Grading with Gleason Scale
TheVisualMD
Risk Factors for Prostate Cancer
TheVisualMD
Prostate Cancer Symptoms
TheVisualMD
Prostate Gland
TheVisualMD
Side Effects of Treatment for Prostate Cancer
TheVisualMD
Prostate Gland
TheVisualMD
Decipher Test for Prostate Cancer Recurrence
National Cancer Institute (NCI)
Staging
Tumor Sizing
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Tumor Sizing
Cancer staging, that is, determining the extent and spread of cancer in the body, is used by doctors to plan treatment and to arrive at a prognosis (estimate of future course and outcome) for the disease. For most cancers, staging is done using the TNM (Tumor, Node, Metastasis) system, developed by the American Joint Committee on Cancer (AJCC) and the International Union Against Cancer (UICC). A T1 tumor may be the size of a pea (less than 2cm); a T3 tumor could be the size of a lime (up to 5 cm).
Image by TheVisualMD
Stages of Testicular Cancer
After testicular cancer has been diagnosed, tests are done to find out if cancer cells have spread within the testicles or to other parts of the body.
The process used to find out if cancer has spread within the testicles or to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment.
The following tests and procedures may be used in the staging process:
Chest x-ray: An x-ray of the organs and bones inside the chest. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.
CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, such as the abdomen, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body, such as the abdomen. This procedure is also called nuclear magnetic resonance imaging (NMRI).
Abdominal lymph node dissection: A surgical procedure in which lymph nodes in the abdomen are removed and a sample of tissue is checked under a microscope for signs of cancer. This procedure is also called lymphadenectomy. For patients with nonseminoma, removing the lymph nodes may help stop the spread of disease. Cancer cells in the lymph nodes of seminoma patients can be treated with radiation therapy.
Serum tumor marker test: A procedure in which a sample of blood is examined to measure the amounts of certain substances released into the blood by organs, tissues, or tumor cells in the body. Certain substances are linked to specific types of cancer when found in increased levels in the blood. These are called tumor markers. The following 3 tumor markers are used in staging testicular cancer:
Alpha-fetoprotein (AFP)
Beta-human chorionic gonadotropin (beta-hCG).
Lactate dehydrogenase (LDH).
Tumor marker levels are measured again, after inguinal orchiectomy and biopsy, in order to determine the stage of the cancer. This helps to show if all of the cancer has been removed or if more treatment is needed. Tumor marker levels are also measured during follow-up as a way of checking if the cancer has come back.
There are three ways that cancer spreads in the body.
Cancer can spread through tissue, the lymph system, and the blood:
Tissue. The cancer spreads from where it began by growing into nearby areas.
Lymph system. The cancer spreads from where it began by getting into the lymph system. The cancer travels through the lymph vessels to other parts of the body.
Blood. The cancer spreads from where it began by getting into the blood. The cancer travels through the blood vessels to other parts of the body.
Cancer may spread from where it began to other parts of the body.
When cancer spreads to another part of the body, it is called metastasis. Cancer cells break away from where they began (the primary tumor) and travel through the lymph system or blood.
Lymph system. The cancer gets into the lymph system, travels through the lymph vessels, and forms a tumor (metastatic tumor) in another part of the body.
Blood. The cancer gets into the blood, travels through the blood vessels, and forms a tumor (metastatic tumor) in another part of the body.
The metastatic tumor is the same type of cancer as the primary tumor. For example, if testicular cancer spreads to the lung, the cancer cells in the lung are actually testicular cancer cells. The disease is metastatic testicular cancer, not lung cancer.
An inguinal orchiectomy is done in order to know the stage of the disease.
The following stages are used for testicular cancer:
Stage 0
In stage 0, abnormal cells are found in the tiny tubules where the sperm cells begin to develop. These abnormal cells may become cancer and spread into nearby normal tissue. All tumor marker levels are normal. Stage 0 is also called germ cell neoplasia in situ.
Stage I
In stage I, cancer has formed. Stage I is divided into stages IA, IB, and IS.
In stage IA, cancer is found in the testicle, including the rete testis, but has not spread to the blood vessels or lymph vessels in the testicle.
All tumor marker levels are normal.
In stage IB, cancer:
is found in the testicle, including the rete testis, and has spread to the blood vessels or lymph vessels in the testicle; or
has spread into the hilar soft tissue (tissue made of fibers and fat with blood vessels and lymph vessels), the epididymis, or the outer membranes around the testicle; or
has spread to the spermatic cord; or
has spread to the scrotum.
All tumor marker levels are normal.
In stage IS, cancer is found anywhere in the testicle and may have spread into the spermatic cord or scrotum.
Tumor marker levels range from slightly above normal to high.
Tumor sizes are often measured in centimeters (cm) or inches. Common food items that can be used to show tumor size in cm include: a pea (1 cm), a peanut (2 cm), a grape (3 cm), a walnut (4 cm), a lime (5 cm or 2 inches), an egg (6 cm), a peach (7 cm), and a grapefruit (10 cm or 4 inches).
Stage II
Stage II is divided into stages IIA, IIB, and IIC.
In stage IIA, cancer is found anywhere in the testicle and may have spread into the spermatic cord or scrotum. Cancer has spread to 1 to 5 nearby lymph nodes and the lymph nodes are 2 centimeters or smaller.
All tumor marker levels are normal or slightly above normal.
In stage IIB, cancer is found anywhere in the testicle and may have spread into the spermatic cord or scrotum. Cancer has spread to:
1 nearby lymph node and the lymph node is larger than 2 centimeters but not larger than 5 centimeters; or
more than 5 nearby lymph nodes and the lymph nodes are not larger than 5 centimeters; or
a nearby lymph node and the cancer has spread outside the lymph node.
All tumor marker levels are normal or slightly above normal.
In stage IIC, cancer is found anywhere in the testicle and may have spread into the spermatic cord or scrotum. Cancer has spread to a nearby lymph node and the lymph node is larger than 5 centimeters.
All tumor marker levels are normal or slightly above normal.
Stage III
Stage III is divided into stages IIIA, IIIB, and IIIC.
In stage IIIA, cancer is found anywhere in the testicle and may have spread into the spermatic cord or scrotum. Cancer may have spread to one or more nearby lymph nodes. Cancer has spread to distant lymph nodes or to the lungs.
All tumor marker levels are normal or slightly above normal.
In stage IIIB, cancer is found anywhere in the testicle and may have spread into the spermatic cord or scrotum. Cancer has spread:
to one or more nearby lymph nodes and has not spread to other parts of the body; or
to one or more nearby lymph nodes. Cancer has spread to distant lymph nodes or to the lungs.
The level of one or more tumor markers is moderately above normal.
In stage IIIC, cancer is found anywhere in the testicle and may have spread into the spermatic cord or scrotum. Cancer has spread:
to one or more nearby lymph nodes and has not spread to other parts of the body; or
to one or more nearby lymph nodes. Cancer has spread to distant lymph nodes or to the lungs.
The level of one or more tumor markers is high.
or
Cancer is found anywhere in the testicle and may have spread into the spermatic cord or scrotum. Cancer has not spread to distant lymph nodes or the lung, but has spread to other parts of the body, such as the liver or bone.
Tumor marker levels may range from normal to high.
Source: National Cancer Institute (NCI)
Additional Materials (4)
3D medical animation TNM Staging System
3D medical illustration depicting the Tumor (left), Node (middle) and Metastasis (right) staging system for cancer
Image by https://www.scientificanimations.com
Cancer staging
Staging Cancer : Staging is the process of finding out the amount of cancer in the body and if it has spread. Most tumorous cancers are staged using the TNM system. In the TNM system, T = extent of the primary tumor, N = extent of spread to lymph nodes, M = presence of metastasis. After the TNM description has been decided, the cancer can be designated as Stage 0-IV. Stage 0 =carcinoma in situ. In Stage I, Stage II, and Stage III, higher numbers indicate more extensive disease, ie, greater tumor size, and/or spread of the cancer to nearby lymph nodes, and/or organs adjacent to the primary tumor. In Stage IV, the cancer has spread to another organ.
Image by TheVisualMD
Stage 1 Testicular Cancer | Testicular Cancer
Video by Howcast/YouTube
Stage 2 Testicular Cancer | Testicular Cancer
Video by Howcast/YouTube
3D medical animation TNM Staging System
https://www.scientificanimations.com
Cancer staging
TheVisualMD
2:44
Stage 1 Testicular Cancer | Testicular Cancer
Howcast/YouTube
3:30
Stage 2 Testicular Cancer | Testicular Cancer
Howcast/YouTube
Treatment
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Orchiectomy
Image by Cancer Research UK / Wikimedia Commons
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Orchiectomy
Diagram showing how the testicle is removed (orchidectomy).
Image by Cancer Research UK / Wikimedia Commons
What Are the Treatment Options for Testicular Cancer?
There are different types of treatment for patients with testicular cancer.
Different types of treatments are available for patients with testicular cancer. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.
Testicular tumors are divided into 3 groups, based on how well the tumors are expected to respond to treatment.
Good Prognosis
For nonseminoma, all of the following must be true:
The tumor is found only in the testicle or in the retroperitoneum (area outside or behind the abdominal wall); and
The tumor has not spread to organs other than the lungs; and
The levels of all the tumor markers are slightly above normal.
For seminoma, all of the following must be true:
The tumor has not spread to organs other than the lungs; and
The level of alpha-fetoprotein (AFP) is normal. Beta-human chorionic gonadotropin (beta-hCG) and lactate dehydrogenase (LDH) may be at any level.
Intermediate Prognosis
For nonseminoma, all of the following must be true:
The tumor is found in one testicle only or in the retroperitoneum (area outside or behind the abdominal wall); and
The tumor has not spread to organs other than the lungs; and
The level of any one of the tumor markers is more than slightly above normal.
For seminoma, all of the following must be true:
The tumor has spread to organs other than the lungs; and
The level of AFP is normal. Beta-hCG and LDH may be at any level.
Poor Prognosis
For nonseminoma, at least one of the following must be true:
The tumor is in the center of the chest between the lungs; or
The tumor has spread to organs other than the lungs; or
The level of any one of the tumor markers is high.
There is no poor prognosis grouping for seminoma testicular tumors.
Five types of standard treatment are used:
Surgery
Surgery to remove the testicle (inguinal orchiectomy) and some of the lymph nodes may be done at diagnosis and staging. Tumors that have spread to other places in the body may be partly or entirely removed by surgery.
After the doctor removes all the cancer that can be seen at the time of the surgery, some patients may be given chemotherapy or radiation therapy after surgery to kill any cancer cells that are left. Treatment given after the surgery, to lower the risk that the cancer will come back, is called adjuvant therapy.
Radiation therapy
Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. External radiation therapy uses a machine outside the body to send radiation toward the area of the body with cancer.
Chemotherapy
Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping the cells from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy).
Surveillance
Surveillance is closely following a patient's condition without giving any treatment unless there are changes in test results. It is used to find early signs that the cancer has recurred (come back). In surveillance, patients are given certain exams and tests on a regular schedule.
High-dose chemotherapy with stem cell transplant
High doses of chemotherapy are given to kill cancer cells. Healthy cells, including blood-forming cells, are also destroyed by the cancer treatment. Stem cell transplant is a treatment to replace the blood-forming cells. Stem cells (immature blood cells) are removed from the blood or bone marrow of the patient or a donor and are frozen and stored. After the patient completes chemotherapy, the stored stem cells are thawed and given back to the patient through an infusion. These reinfused stem cells grow into (and restore) the body's blood cells.
Stem cell transplant. (Step 1): Blood is taken from a vein in the arm of the donor. The patient or another person may be the donor. The blood flows through a machine that removes the stem cells. Then the blood is returned to the donor through a vein in the other arm. (Step 2): The patient receives chemotherapy to kill blood-forming cells. The patient may receive radiation therapy (not shown). (Step 3): The patient receives stem cells through a catheter placed into a blood vessel in the chest.
New types of treatment are being tested in clinical trials.
Treatment for testicular cancer may cause side effects.
Patients may want to think about taking part in a clinical trial.
For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment.
Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment.
Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward.
Patients can enter clinical trials before, during, or after starting their cancer treatment.
Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring (coming back) or reduce the side effects of cancer treatment.
Clinical trials are taking place in many parts of the country.
Follow-up tests may be needed.
Some of the tests that were done to diagnose the cancer or to find out the stage of the cancer may be repeated. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests.
Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your condition has changed or if the cancer has recurred (come back). These tests are sometimes called follow-up tests or check-ups.
Men who have had testicular cancer have an increased risk of developing cancer in the other testicle. A patient is advised to regularly check the other testicle and report any unusual symptoms to a doctor right away.
Long-term clinical exams are very important. The patient will probably have check-ups frequently during the first year after surgery and less often after that.
Source: National Cancer Institute (NCI)
Additional Materials (3)
Chemotherapy IV
Seen are two hands manipulating an IV for chemotherapy administration to a black patient.
Image by National Cancer Institute / Linda Bartlett (Photographer)
Orchiectomy and RPLND - Testicular Cancer Canada Patient Symposium 2014
Video by Testicular Cancer Canada/YouTube
Radiation Therapy for Testicular Cancer | Testicular Cancer
Video by Howcast/YouTube
Chemotherapy IV
National Cancer Institute / Linda Bartlett (Photographer)
37:18
Orchiectomy and RPLND - Testicular Cancer Canada Patient Symposium 2014
Testicular Cancer Canada/YouTube
2:43
Radiation Therapy for Testicular Cancer | Testicular Cancer
Howcast/YouTube
Treatment by Stage
Diagram showing the scar line and prosthesis after an orchidectomy CRUK 370
Image by Cancer Research UK/Wikimedia
Diagram showing the scar line and prosthesis after an orchidectomy CRUK 370
Diagram showing the scar line and prosthesis after an orchidectomy.
Image by Cancer Research UK/Wikimedia
Treatment Options by Stage
Treatment of Stage 0 (Testicular Intraepithelial Neoplasia)
Treatment of stage 0 may include the following:
Radiation therapy.
Surveillance.
Surgery to remove the testicle.
Treatment of Stage I Testicular Cancer
Treatment of stage I testicular cancer depends on whether the cancer is a seminoma or a nonseminoma.
Treatment of seminoma may include the following:
Surgery to remove the testicle, followed by surveillance.
For patients who want active treatment rather than surveillance, treatment may include:
Surgery to remove the testicle, followed by chemotherapy.
Treatment of nonseminoma may include the following:
Surgery to remove the testicle, with long-term follow-up.
Surgery to remove the testicle and lymph nodes in the abdomen, with long-term follow-up.
Surgery followed by chemotherapy for patients at high risk of recurrence, with long-term follow-up.
Treatment of Stage II Testicular Cancer
Treatment of stage II testicular cancer depends on whether the cancer is a seminoma or a nonseminoma.
Treatment of seminoma may include the following:
When the tumor is 5 centimeters or smaller:
Surgery to remove the testicle, followed by radiation therapy to lymph nodes in the abdomen and pelvis.
Combination chemotherapy.
Surgery to remove the testicle and lymph nodes in the abdomen.
When the tumor is larger than 5 centimeters:
Surgery to remove the testicle, followed by combination chemotherapy or radiation therapy to lymph nodes in the abdomen and pelvis, with long-term follow-up.
Treatment of nonseminoma may include the following:
Surgery to remove the testicle and lymph nodes, with long-term follow-up.
Surgery to remove the testicle and lymph nodes, followed by combination chemotherapy and long-term follow-up.
Surgery to remove the testicle, followed by combination chemotherapy and a second surgery if cancer remains, with long-term follow-up.
Combination chemotherapy before surgery to remove the testicle, for cancer that has spread and is thought to be life-threatening.
Treatment of Stage III Testicular Cancer
Treatment of stage III testicular cancer depends on whether the cancer is a seminoma or a nonseminoma.
Treatment of seminoma may include the following:
Surgery to remove the testicle, followed by combination chemotherapy. If there are tumors remaining after chemotherapy, treatment may be one of the following:
Surveillance with no treatment unless tumors grow.
Surveillance for tumors smaller than 3 centimeters and surgery to remove tumors larger than 3 centimeters.
A PET scan two months after chemotherapy and surgery to remove tumors that show up with cancer on the scan.
A clinical trial of chemotherapy.
Treatment of nonseminoma may include the following:
Surgery to remove the testicle, followed by combination chemotherapy.
Combination chemotherapy followed by surgery to remove the testicle and all remaining tumors. Additional chemotherapy may be given if the tumor tissue removed contains cancer cells that are growing or if follow-up tests show that cancer is progressing.
Combination chemotherapy before surgery to remove the testicle, for cancer that has spread and is thought to be life-threatening.
A clinical trial of chemotherapy.
Treatment of Recurrent Testicular Cancer
Treatment of recurrent testicular cancer may include the following:
Combination chemotherapy.
High-dose chemotherapy and stem cell transplant.
Surgery to remove cancer that has either:
come back more than 2 years after complete remission; or
come back in only one place and does not respond to chemotherapy.
A clinical trial of a new therapy.
Source: National Cancer Institute (NCI)
Additional Materials (4)
Orchiectomy
Diagram showing how the testicle is removed (orchidectomy).
Image by Cancer Research UK / Wikimedia Commons
Testicular microlithiasis 131206091733625
Testicular microlithiasis in a patient with contralateral orchiectomy due to testicular malignancy. Echogenic foci viewed in testis as small white spots.
How is Testicular Cancer Treated? | Dana-Farber Cancer Institute
Dana-Farber Cancer Institute/YouTube
Treatment of Recurrent Cancer
3D Visualization of Cross Section of Human Testes
Image by TheVisualMD
3D Visualization of Cross Section of Human Testes
3D Visualization of Cross Section of Human Testes
Image by TheVisualMD
Treatment Options for Recurrent Testicular Cancer
Treatment of recurrent testicular cancer may include the following:
Combination chemotherapy.
High-dose chemotherapy and stem cell transplant.
Surgery to remove cancer that has either:
come back more than 2 years after complete remission; or
come back in only one place and does not respond to chemotherapy.
A clinical trial of a new therapy.
Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available.
Source: National Cancer Institute (NCI)
Additional Materials (2)
Testis with Exposed Internal Structure
Testis with Exposed Internal Structure: 3D visualization based on segmented human data of a testis. Leydig cells, which reside in the testis, produce male sex hormones called androgens. Of these, testosterone is responsible for the development of secondary sexual characteristics and the maintenance of the sperm development sites.
Image by TheVisualMD
Chemotherapy | Testicular Cancer
Video by Howcast/YouTube
Testis with Exposed Internal Structure
TheVisualMD
3:57
Chemotherapy | Testicular Cancer
Howcast/YouTube
Recurrence
Male Pelvis Showing Prostate and Bladder
Image by TheVisualMD
Male Pelvis Showing Prostate and Bladder
3D visualization of an anterior view of a male revealing the prostate and bladder.
Image by TheVisualMD
Recurrent Testicular Cancer
Recurrent testicular cancer is cancer that has recurred (come back) after it has been treated. The cancer may come back many years after the initial cancer, in the other testicle or in other parts of the body.
Source: National Cancer Institute (NCI)
Additional Materials (1)
How to Cope with Testicular Cancer | Testicular Cancer
Video by Howcast/YouTube
3:16
How to Cope with Testicular Cancer | Testicular Cancer
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Testicular Cancer
Testicular cancer mainly affects young men between the ages of 20 and 39. Symptoms include pain, swelling, or lumps in the testicles or groin area. Fortunately, most cases can be treated, especially if found early. Learn more about the symptoms, diagnosis, and treatment options for testicular cancer.