Alongside high tumor marker levels, stage 3 testicular cancer has either spread to distant areas or nearby lymph nodes. The most common treatment options are surgery and chemotherapy.

Stage 3 testicular is the most advanced stage of testicular cancer under the American Joint Committee on Cancer’s (AJCC)’s TNM staging system.

This system stages testicular cancer based on:

  • the size and extent of the tumor
  • the number of lymph nodes the cancer has spread to
  • whether the cancer has spread to distant areas
  • whether tumor markers are elevated on a blood test

Stage 3 testicular cancer is the most difficult stage to treat, but it’s still often curable.

Read on to learn more about stage 3 testicular cancer, including its treatment options, symptoms, and outlook.

The 4 stages of testicular cancer

Here’s a look at the AJCC’s four stages of testicular cancer:

  • Stage 0: Stage 0 testicular cancer is considered precancerous. The cancer is contained in the small tubes inside your testicle.
  • Stage 1: Stage 1 testicular cancer may have spread outside of your testicles but has not spread to lymph nodes or distant areas.
  • Stage 2: In stage 2, cancer has spread to nearby lymph nodes but has not spread to distant areas.
  • Stage 3: Stage 3 testicular cancer has spread to distant areas and is causing high tumor marker levels.

Stage 3 is the final stage of testicular cancer. It has either spread to distant tissues or nearby lymph nodes and is causing very high levels of tumor markers on a blood test.

Less than 15% of people are diagnosed with stage 3 testicular cancer.

Stage 3 testicular cancer is divided into substages depending on its features:

StageDescription
Stage 3The tumor may have grown outside of your testicle, or the extent can’t be assessed. It may have spread to nearby lymph nodes and has spread to distant body parts. Tumor marker test results aren’t available.
Stage 3A• Your tumor might have grown outside your testicle, or its extent can’t be assessed. The cancer has spread to at least 1 nearby lymph node but not to distant body parts. At least 1 tumor marker is much higher than usual, or
• The tumor might have grown outside your testicle, or its extent can’t be assessed. The cancer may have spread to nearby lymph nodes. It has spread to distant lymph nodes or the lungs. At least 1 tumor marker level is much higher than normal.
Stage 3B• The tumor might have grown outside your testicle, or its extent can’t be assessed. The cancer has spread to at least 1 nearby lymph node but not to distant body parts. At least 1 tumor marker is much higher than usual, or
• The tumor might have grown outside your testicle, or its extent can’t be assessed. The cancer may have spread to nearby lymph nodes. It has spread to distant lymph nodes or your lungs. At least 1 tumor marker level is much higher than normal.
Stage 3C• The tumor might have grown outside of your testicle, or its extent can’t be assessed. The tumor has spread to 1 or more nearby lymph nodes. At least 1 tumor marker is very high, or
• The tumor may have grown outside your testicle, or its extent can’t be assessed. The cancer may have spread to distant lymph nodes. It has spread to distant lymph nodes or your lungs. At least 1 tumor marker is very high, or
• The tumor may have grown outside of your testicle, or its extent can’t be assessed. It has spread to distant areas besides your lungs or distant lymph nodes. Tumor marker levels might be higher than usual.

Is stage 3 testicular cancer terminal?

Stage 3 testicular cancer is often curable. Factors associated with better outcomes include:

  • having seminoma cancer instead of nonseminoma
  • the cancer spreads to the lungs instead of bones or other organs
  • fewer lymph nodes involved
  • lower tumor marker levels

The most common initial symptom of testicular cancer is a lump on your testicle. Other symptoms of stage 3 cancer may include:

According to the American Cancer Society, most testicular cancers can be cured.

Treatment for seminoma tumors may include:

  • surgery to remove the cancerous testicle followed by chemotherapy. After surgery, your doctor may place you on active surveillance to watch for recurrence. If the cancer returns, then doctors can surgically remove “residual” tumors
  • a chemotherapy clinical trial

Treatment for nonseminoma tumors may include:

  • testicle removal followed by chemotherapy
  • chemotherapy followed by testicle removal, possibly with additional chemotherapy if cancer cells remain
  • a chemotherapy clinical trial

How many rounds of chemotherapy are needed for stage 3 testicular cancer?

Typically, three to four cycles of chemotherapy are needed for stage 3 cancer. Each cycle generally lasts 3–4 weeks.

In the United States, the 5-year relative survival rate for people with testicular cancer that has spread to distant areas is 73.4%. Data is from 2013–2019. In this case, the 5-year relative survival rate means people survived at least 5 years almost three-quarters as often as people without cancer.

The survival rate for stage 3 nonseminoma testicular tumors also depends on your risk level. Factors that determine your risk level include:

  • tumor marker levels
  • histopathology
  • size of metastatic tumors
  • presence of cervical lymph node enlargements
  • size of pulmonary metastases

Here is a breakdown of risk level and 5-year overall survival rates:

Level of risk5-year overall survival
low risk92%
intermediate risk80%
high risk48%

Stage 3 is the final stage of testicular cancer. The cancer has either spread to distant body parts or to nearby lymph nodes with high levels of tumor markers.

The most common treatment options for stage 3 testicular cancer are surgery and chemotherapy. Stage 3 testicular cancer is usually curable.