From the Research
Seminoma is the most common testicular cancer in older men, typically occurring in men aged 30-45 years, and the workup for suspected testicular cancer should begin with a thorough physical examination of the testicles, followed by scrotal ultrasound to confirm the presence of a mass. The diagnosis and treatment of testicular cancer are crucial to optimize outcomes, with 5-year survival rates of 99%, 92%, and 85% for those diagnosed at stages I, II, and III, respectively 1.
Key Steps in Workup
- Physical examination of the testicles
- Scrotal ultrasound to confirm the presence of a mass
- Serum tumor markers including alpha-fetoprotein (AFP), human chorionic gonadotropin (hCG), and lactate dehydrogenase (LDH) should be obtained, as seminomas may elevate hCG and LDH but not AFP
- Radical inguinal orchiectomy for both diagnostic confirmation and initial treatment
- Staging should be completed with CT scans of the chest, abdomen, and pelvis to assess for metastatic disease
- In some cases, particularly with advanced disease, PET scans may be useful
Treatment and Follow-up
Seminomas are highly sensitive to radiation and chemotherapy, with treatment decisions based on the stage of disease. Early-stage seminomas have excellent prognosis with 5-year survival rates exceeding 95% 1. Regular follow-up is essential after treatment, including physical examinations, tumor marker assessments, and imaging studies to monitor for recurrence. The most recent study on testicular cancer, published in 2025, provides the most up-to-date guidance on diagnosis, treatment, and follow-up 1.