Further tests for testicular cancer
If the pathology report on the removed testicle and other test results show that you have cancer, you will have further tests to see whether the cancer has spread to other parts of the body, such as the lymph nodes or other organs. These tests may also be used during or after treatment to check how well the treatment has worked.
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All tests and scans have risks and benefits, and you should discuss these with your doctor. Before having scans, tell the doctor if you have any allergies or have had a reaction to dye (contrast) during previous scans. You should also let them know if you have diabetes or kidney disease.
You will have a CT (computerised tomography) scan of your chest, abdomen and pelvis. Sometimes this is done before the orchidectomy.
A CT scan uses x-rays to take pictures of the inside of your body and then compiles them into one detailed, cross-sectional picture. To make the scan pictures clearer and easier to read, you may have to fast (not eat or drink) for a period of time before your appointment.
Before the scan, you may be given an injection of a dye into a vein in your arm to make the pictures clearer. This injection can make you feel hot all over for a few minutes. You might also feel like you need to urinate, but this sensation won’t last long. You may be asked to drink a liquid instead of having an injection.
The CT scanner is large and round like a doughnut. You will lie still on a table that moves slowly through the scanner while it takes pictures. The test is painless and takes about 15 minutes.
In some circumstances, such as if you have an allergy to the dye normally used for a CT scan, you may instead have an MRI (magnetic resonance imaging) scan. An MRI uses a powerful magnet and radio waves to create detailed pictures of areas inside the body.
Before the scan, let your medical team know if you have a pacemaker or any other metallic object in your body, as the magnet can interfere with the metal. Newer pacemakers are often MRI-compatible.
You will lie on a table that slides into the scanner, which is a metal cylinder that is open at both ends. Sometimes, a dye (known as contrast) will be injected into a vein before the scan to help make the pictures clearer. The scanner makes a series of bangs and clicks and can be quite noisy.
The scan is painless, but some people feel anxious lying in the narrow cylinder. Tell your doctor or nurse beforehand if you are prone to anxiety or claustrophobia. They can suggest breathing exercises or give you medicine to help you relax. The scan takes about 30 minutes, and most people are able to go home as soon as it is over.
In some limited circumstances, you may also be given a PET (positron emission tomography) scan combined with a CT scan. You will be injected with a small amount of a glucose (sugar) solution containing some radioactive material, then asked to rest for 30–60 minutes while the solution spreads throughout your body before you have the scan. Cancer cells show up more brightly on the scan because they absorb more of the glucose solution than normal cells do.
It may take a few hours to prepare for a PET–CT scan, but the scan itself usually takes about 15 minutes. The radioactive material in the glucose solution is not harmful and will leave your body within a few hours.
Podcast: Tests and Cancer
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Dr Benjamin Thomas, Urological Surgeon, The Royal Melbourne Hospital and The University of Melbourne, VIC; A/Prof Ben Tran, Genitourinary Medical Oncologist, Peter MacCallum Cancer Centre, Walter and Eliza Hall Institute of Medical Research and The University of Melbourne, VIC; Dr Nari Ahmadi, Urologist and Urological Cancer Surgeon, Chris O’Brien Lifehouse, NSW; Helen Anderson, Genitourinary Cancer Nurse Navigator, Gold Coast University Hospital, QLD; Anita Cox, Youth Cancer – Cancer Nurse Coordinator, Gold Coast University Hospital, QLD; Dr Tom Ferguson, Medical Oncologist, Fiona Stanley Hospital, WA; Dr Leily Gholam Rezaei, Radiation Oncologist, Chris O’Brien Lifehouse and Royal Prince Alfred Hospital, NSW; Dheeraj Jain, Consumer; Amanda Maple, 13 11 20 Consultant, Cancer Council SA; Jessica Medd, Senior Clinical Psychologist, Department of Urology, Concord Repatriation General Hospital and Headway Health, NSW.
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