Biopsies for testicular cancer are rarely done because biopsies for this particular cancer increase the risk of the cancer spreading. If a tumor is detected via a clinical diagnosis, ultrasound, and blood tests, then the doctor will remove the tumor in a process called a radical inguinal orchiectomy.  In addition to the tumor, the testicle and spermatic cord will also be removed. If you remove the entire testicle, you have the option of getting a testicular implant.  The tumor and other tissue is then sent to a lab to be examined for cancerous cells. If the analysis of the tumor shows that there are cancerous cells, then your doctor will order imaging tests, such as an ultrasound (to check for fluid or for a solid mass), x-rays, MRIs, CT, PET, or bone scans. The doctor will need images of your body to determine certain important things about your cancer.  Imaging tests will be used to determine if and where the cancer has spread. These tests can help the doctor detect if the cancer has spread to other areas, like the lymph nodes or other organs. A CT scan is recommended if there is suspected metastatic spread to the pelvis and thorax. Imaging tests are also used to see if the treatment is working and if the cancer is returning after treatment. Testicular cancer is divided in stages. The stage of the cancer refers to the severity of the cancer. The stage is determined from the examination of the tumor, where the cancer cells are studies in a lab. Your treatment depends on the stage of cancer, so you will always get your cancer staged when you get diagnosed.  Stage 0 testicular cancer occurs when abnormal cells are found in the testicles. The cells may evolve into cancer, but at this stage they are just abnormal. This may be something like a testicular scar. Stage I cancer is discovered after the testicle(s) is removed. Stage I cancer occurs when the cancer is either in the testicle or the membranes around the testicle. Stage I may also be in the spermatic cord or scrotum. Surgery and close monitoring may be all the treatment that is needed for stage I. Sometimes, chemotherapy or radiation is also used. Stage II cancer is when the cancer is in the testicle, scrotum, and spermatic cord, along with the lymph nodes in the abdomen. Stage II often is treated with radiation therapy. Sometimes, mild chemotherapy is also used. Stage III cancer has the same markers as stage II but has also spread to lymph nodes beyond the abdomen, to the lungs, or other parts of the body. Surgery is often needed to remove tumors in other parts of the body, along with chemotherapy. Chemotherapy may involve cisplatin based combination therapy with three cycles of  bleomycin, etoposide, and cisplatin.  However, men with compromised pulmonary function have to be careful if they are on bleomycin because this chemotherapy can cause lung injury. You will work with a treatment team when you undergo treatment for testicular cancer. Your team will vary depending on what the stage of your cancer is and your options for treating that stage.  You will probably have a urologist, physician assistant, nurses, and nurse practitioners. If you have radiation therapy, you will have a radiation oncologist. If you undergo chemotherapy, you will have a medical oncologist. You may also have social workers or other mental health professionals, physical therapists, or other professionals.

Summary:
Have the tumor surgically removed. Get imaging tests. Determine the stage of the cancer. Develop your treatment team.