Dawaa Reference

chronic

Testicular cancer

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources3 sources

ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class GD28.03 - condition scope only, no dose · No dose - referral pathway, no medicine given in primary care · Testicular Cancer - StatPearls - NCBI Bookshelf - https://www.ncbi.nlm.nih.gov/books/NBK563159/

Verified against1 document
  • No dose - referral pathway, no medicine given in primary care

Verified date2026-08

Presentation reference

Is it this?

Reference only, to read alongside your own examination.

Symptoms — what the patient reports (8)

  • Most patients notice a painless lump on one testicle, often found incidentally [skin nodule]
  • Pain occurs less often - dull pain in roughly a third of patients and sudden acute pain in about 10%
  • Metastatic disease can bring loss of appetite, malaise, and weight loss [malaise · poor appetite · weight loss]
  • Lung spread may cause cough or breathlessness [breathlessness · cough]
  • Bulky retroperitoneal spread can cause back pain or a new varicocele from gonadal vein compression [back pain]
  • Retroduodenal spread can cause nausea, vomiting, or gastrointestinal bleeding [bleeding · nausea · vomiting]
  • Vascular obstruction or clotting from spread can cause leg swelling [leg swelling]
  • Spread to the brain, spinal cord, or nerve roots can cause central or peripheral neurologic symptoms

Signs — what you find (4)

  • Exam typically reveals a firm mass within the testicle itself [skin nodule]
  • Neck or collarbone-area lymph node swelling can indicate lymphatic spread [lymphadenopathy]
  • A tumor is present in the opposite testis at the same time in about 0.6% of patients, so both sides need examination
  • A coexisting hydrocele can block full palpation, so ultrasound is used to confirm any underlying lesion

Tests (8)

  • Scrotal ultrasound combined with the physical exam gives close to 100% diagnostic sensitivity
  • A hypoechoic, solid, vascular mass within the testis on ultrasound is suspicious for cancer
  • Serum AFP, hCG, and LDH tumor markers are checked before any surgical intervention
  • Biopsy through the scrotum raises local recurrence risk to 2.9% versus 0.4% with standard orchiectomy, so it is avoided
  • All patients get abdominal and pelvic CT staging; chest CT is added when tumor markers are elevated
  • Brain imaging is added when beta-hCG is very high, because choriocarcinoma can spread there through the bloodstream
  • Higher LDH levels tend to track with greater tumor burden, though LDH itself is a nonspecific marker
  • AFP is never raised in pure seminoma or pure choriocarcinoma, which helps distinguish tumor subtype

If not this — what else fits (10)

  • Epididymo-orchitis
  • Hematoma
  • Inguinal hernia
  • Hydrocele
  • Spermatocele or epididymal head cyst
  • Varicocele
  • Lymphoma is the most common cause of a bilateral testicular lesion in an older man
  • Metastasis from other cancers (lung, melanoma, prostate) can mimic a primary testicular tumor
  • Syphilitic gumma
  • Tuberculoma

SourceStatPearls "Testicular Cancer" - disease-level clinical article

Presentation findings are traced to the source above.

1

NO DRUG THERAPY IN PRIMARY CARE (RECOGNITION & REFERRAL)

1st line
Adult dose and duration

Testicular malignancy typically presents as a painless testicular lump; the GP's role is prompt recognition and urgent urology/oncology referral, not treatment. - Refer

Paediatric dose

Children follow the same pathway: recognise and refer. No primary-care medicine is implied.

Dose source

No dose - referral pathway, no medicine given in primary care

Why

Testicular malignancy typically presents as a painless testicular lump; the GP's role is prompt recognition and urgent urology/oncology referral, not treatment.

Cautions
  • No medicine is prescribed for this in primary care - this entry is for recognition and referral. Anything given is decided by the service it is referred to.
  • RED FLAG - A painless testicular mass or swelling, testicular hardness or irregularity, or gynecomastia or back pain suggesting metastatic spread.

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.