Late stage (stage 3) testicular cancer has spread beyond your testicle to surrounding or distant tissues. Although it’s difficult to treat, it has a better outlook than most other types of late stage cancer.

Testicular cancer often doesn’t cause symptoms in the early stages. A lump or swelling around your testicle is usually the first symptom, but some people don’t have any symptoms until the cancer spreads to other tissues and causes problems like difficulty breathing.

Doctors are usually able to cure late stage testicular cancer with some combination of:

  • chemotherapy
  • surgery
  • radiation therapy to treat areas where the cancer has spread

This article examines late stage testicular cancer, including its symptoms, treatment, and outlook.

Stages of testicular cancer

The most common staging system for testicular cancer is the American Joint Committee on Cancer (AJCC)’s TNM system. This staging system divides testicular cancer into stages 0–3:

  • Stage 0: Stage 0 testicular cancer is precancerous. The growth is contained in the small tubes inside your testicle.
  • Stage 1: In stage 1, your cancer is still contained to your testicle and hasn’t spread to other areas.
  • Stage 2: In stage 2, cancer has spread to your lymph nodes but hasn’t spread to distant areas, such as your lungs or brain.
  • Stage 3: Stage 3 testicular cancer has spread to distant areas or your lymph nodes and is causing elevated levels of tumor markers on a blood test.
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Late stage testicular cancer refers to cancer that has spread beyond your testicle to distant body parts or nearby lymph nodes and is causing elevated levels of tumor markers on a blood test.

Under the AJCC’s TNM staging system, late stage testicular cancer correlates with stage 3.

Where does the cancer commonly spread to?

The most common distant body parts that testicular cancer spreads to are:

  • the lymph nodes in your:
    • neck
    • chest
    • pelvis
    • abdomen
  • your lungs
  • your bones
  • your liver
  • your brain

Cancer that’s spread to distant body parts is called metastatic testicular cancer.

Can you survive late stage testicular cancer?

The survival rate for late stage testicular cancer is still relatively high compared with the survival rates for most other types of cancer.

In the United States in 2013–2019, people with testicular cancer spread to distant tissue survived for at least 5 years about 73.4% as often as people without testicular cancer.

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Testicular cancer often doesn’t cause symptoms in the early stages. Some people don’t have any symptoms until the cancer has already spread beyond one of their testicles.

The most common initial symptom of testicular cancer is swelling or a lump in one of your testicles.

Other early symptoms can include:

  • increased firmness in a testicle
  • a noticeable difference in the shape or size of your testicles
  • a dull ache in a testicle or your scrotum, which may come and go
  • heaviness in your scrotum
  • enlargement of breast tissue
  • early puberty in boys

Later signs and symptoms depend on where your cancer spreads. They can include:

These late symptoms can also be the first symptoms. For example, in a 2022 case study, researchers presented a case of a 24-year-old male with testicular cancer with a primary complaint of left sided chest pain and back pain radiating down his left leg for 1 year.

It’s important to contact a doctor any time you notice a change in the size or shape of one of your testicles. Not all lumps are cancerous, but it’s important to rule out cancer or start cancer treatment as soon as possible.

The best way to find testicular cancer early is by performing a testicular self-examination after taking a shower or bath.

Learn how to perform a testicular self-examination.

Can you have late stage testicular cancer for years without knowing?

You can have testicular cancer for years without having noticeable symptoms.

A delayed diagnosis of testicular cancer is associated with a poorer outlook, so it’s important to perform regular testicular self-examinations to try to catch cancer as early as possible.

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The goal for late stage testicular cancer treatment is usually to try to cure it. The primary treatments are chemotherapy and surgery.

The most common surgery for testicular cancer is a radical inguinal orchiectomy, during which a surgeon removes your:

  • tumor
  • testicle
  • spermatic cord

You’ll likely receive chemotherapy after surgery to kill any remaining cancer cells. Depending on which type of chemotherapy you receive, you may receive three of four cycles. Each cycle usually lasts about 3–4 weeks.

You may also receive radiation therapy to treat new tumors in other parts of your body, such as your lungs.

Doctors typically reserve radiation therapy for early stage seminoma cancers. They usually treat late stage cancers with chemotherapy.

Late stage testicular cancer is harder to treat than cancer contained to your testicles or the surrounding area. That said, it still has a better outlook than most other cancers at similar stages of metastatic involvement.

In the United States in 2013–2019, people with testicular cancer spread to distant tissues survived for at least 5 years about 73.4% as often as people without testicular cancer.

About 10–30% of people with the most common type of testicular cancer, germ cell tumors, have a recurrence and need further treatment. Recurrence usually happens in the first 2 years.

Learn more about the survival rates for testicular cancer by stage.

Late stage testicular cancer has spread to distant body parts or the area around your testicle.

Although it’s the hardest stage of testicular cancer to treat, it still has a better outlook than most other cancers at a similar stage of metastasis.

The most common initial symptom of testicular cancer is a lump in one of your testicles. It’s important to perform regular testicular self-examinations to catch testicular cancer early.