Why Are Three Tumor Markers Used for Testicular Cancer?
Testicular cancer often develops from germ cells, the cells involved in sperm production.
Doctors commonly measure three blood markers when testicular cancer is suspected: AFP, beta-hCG and LDH.
Each provides different information. Measuring them together can help doctors assess the disease, plan treatment and monitor recovery.
However, some testicular cancers do not increase any of these markers.
What Does AFP Tell You?
AFP stands for alpha-fetoprotein, a protein normally produced in large amounts before birth.
In adults, AFP may increase in certain testicular cancers, particularly non-seminomatous germ cell tumors.
Pure seminomas, another major type of testicular cancer, do not produce AFP. An elevated AFP level in a patient whose tumor appears to be a seminoma therefore requires further assessment.
AFP can also rise in liver disease, so an elevated result is not automatically caused by testicular cancer.
What Does Beta-hCG Tell You?
Beta-hCG is part of human chorionic gonadotropin, a hormone best known for its role in pregnancy.
Certain testicular tumors can also produce this hormone.
Beta-hCG may increase in both seminomas and non-seminomatous germ cell tumors, although the pattern varies.
An elevated result can provide useful information, but it does not establish a diagnosis by itself. Other medical conditions and occasional laboratory interference may also affect the measurement.
What Does LDH Tell You?
LDH stands for lactate dehydrogenase, an enzyme found in many tissues throughout the body.
LDH can increase when cells are damaged or when certain tumors are present.
In testicular cancer, doctors may use LDH as one indicator of disease burden and prognosis.
However, LDH is much less specific than AFP or beta-hCG. It may also rise after muscle injury, in liver disease or when blood cells break down.
How Are These Markers Used During Treatment?
When testicular cancer is suspected, doctors usually combine blood tests with a physical examination and ultrasound of the testes.
AFP, beta-hCG and LDH are generally measured before surgery and again afterward.
Falling marker levels may indicate that the tumor producing them has been removed or is responding to treatment.
If levels remain elevated or begin rising again, further investigation may be necessary.
Doctors interpret these changes alongside imaging, the tumor’s microscopic characteristics and the patient’s treatment history.
Can Normal Tumor Markers Rule Out Testicular Cancer?
No. Some testicular cancers produce little or none of these markers.
A painless lump, swelling, a change in testicular size or a persistent feeling of heaviness should be assessed even when blood test results are normal.
Testicular ultrasound is the key initial imaging examination when a tumor is suspected.
Routine measurement of these three markers in healthy men has not been established as an effective screening strategy.
