Like other cancers, testicular cancer is classified by stages. Each stage tells you whether the cancer has spread and if other organs are affected. These stages are used to make decisions about treatment and prognosis.
Testicular cancer originates in the testicles and may spread to other parts of the body. It is one of the more treatable types of cancer.
Testicular cancer affects about 1 out of every 250 males, with the average age of diagnosis about 33, according to the
Early diagnosis significantly increases the chances of successful treatment and outcome.
Like other cancers, testicular cancer is classified by stages, which represent how much cancer has spread and what other organs or tissue, if any, have been affected. Treatment, if necessary, is guided by the cancer’s stage and the overall health and age of the individual.
Diagnosing testicular cancer usually involves a review of your medical history and any current symptoms. A physical examination of the testicles is done to check for any lumps, swelling, or firmness. Any of these signs can indicate the presence of a tumor.
A testicular ultrasound, which uses sound waves to create inside images of the testicle, can show details about a suspicious lump. Blood tests are also done to check for tumor markers. However, not all types of testicular cancers produce tumor markers.
A biopsy is
Cancer stages
When testicular cancer is diagnosed, it is described as stage 1, 2, or 3, based on several characteristics. These include when testicular cancer spreads to a lymph node and to other tissue, either near the tumor or in a distant part of the body. Unlike most other cancers, testicular cancer does not include a stage 4.
TNM system
The American Joint Committee on Cancer uses the TNM system when defining each stage. T describes the tumor. N indicates whether the cancer has spread to nearby lymph nodes. M indicates whether the cancer has metastasized, or spread to a distant part of the body.
Within the T category, the terms “clinical T” and “pathological T” may be used. Clinical T refers to the doctor’s assessment of the cancer based on tests and a physical examination. Pathological T is an assessment of how much the cancer has or hasn’t spread based on an analysis of the tumor after it has been surgically removed.
Stage 0 cancer means the tumor is isolated in the seminiferous tubules — the hundreds of small sperm-producing tubes inside each testicle. This stage is also known as “carcinoma in situ,” meaning it has not spread beyond the place where the cancer originated.
Your doctor may recommend that the cancer be monitored with regular physical examinations, ultrasounds, and periodic blood tests measuring the levels of cancer markers. No treatment may be needed if it appears the cancer isn’t spreading and invading other tissue.
However, surgical removal of the testicle or radiation therapy may be recommended if your doctor suspects the cancer is likely to spread.
Stage 1 means the cancer is no longer isolated in the seminiferous tubules but may still be contained in the testicle or may have grown beyond the testicle into neighboring tissue.
Observation and monitoring may be appropriate, with CT scans recommended every 3 to 6 months, and then less frequently, depending on what the imaging and other tests show.
Chemotherapy, radiation therapy, or both may be recommended if the cancer has spread. The American Cancer Society reports that about
At stage 2, the cancer has spread to at least one lymph node. The only way to determine whether cancer has reached a lymph node is to do a biopsy. Cancer that has spread to a lymph node means that even with successful surgery, there is a greater chance the cancer could return.
Treatment for stage 2 testicular cancer usually involves surgery to remove the affected testicle, followed by radiation or chemotherapy, or both. For some types of stage 2 testicular cancer, a retroperitoneal lymph node dissection (RPLND) is recommended. RPLND is a surgical procedure to remove lymph nodes at the back of the abdomen.
Stage 3 testicular cancer means the cancer has spread to other parts of the body beyond the abdominal lymph nodes. The cancer may have reached distant lymph nodes or organs, such as the lungs.
Treatment for stage 3 seminomas and nonseminomas includes a radical inguinal orchiectomy (surgical removal of the testicle and spermatic cord) and then rounds of chemotherapy.
Stages of testicular cancer
| Stage | Stage of Testicular Cancer Defined |
| 0 | Cancer has not spread beyond seminiferous tubules in testicle; blood tests show tumor marker levels within standard ranges |
| 1 | Cancer has spread beyond seminiferous tubules and may extend beyond the testicle, but cancer has not reached a lymph node or distant region of the body; tumor marker tests either have yet to be performed or the results are unavailable |
| 1A | Cancer has grown outside the seminiferous tubules but is still within the testicle; cancer has not reached any lymph nodes or distant parts of the body; tumor markers are still within standard ranges |
| 1B | Cancer has spread outside of the testicle and into neighboring tissue; cancer has not spread to any lymph nodes or distant parts of the body; tumor marker levels are still within standard ranges |
| 1S | Cancer may or may not have spread outside of the testicle or the tumor’s range cannot be determined; cancer has not reached any lymph nodes or distant parts of the body; one or more tumor marker levels are elevated |
| 2 | Cancer has spread to at least one nearby lymph node but not to any distant parts of the body; tumor marker tests have yet to be performed or test results aren’t available |
| 2A | Cancer has spread to at least one to five lymph nodes and no affected lymph node is more than 2 centimeters (cm) across; cancer has not spread to distant parts of the body; either all tumor markers are standard or no more than one tumor marker level is elevated |
| 2B | Cancer has spread to at least one lymph node that is greater than 2 cm across but no more than 5 cm across, or the cancer has spread outside a lymph node or more than five lymph nodes are affected |
| 2C | Cancer has spread to at least one nearby lymph node that is greater than 5 cm across but has not spread to distant parts of the body; either all tumor markers are standard or at least one tumor marker level is elevated |
| 3 | Cancer may or may not have spread to nearby lymph nodes, but it has spread to distant parts of the body; tumor marker tests haven’t been performed or test results aren’t available |
| 3A | Cancer has spread to distant lymph nodes or the lungs; the cancer may have spread to at least one nearby lymph node; either all tumor markers are standard or at least one tumor marker level is elevated |
| 3B | Cancer has spread to one or more nearby lymph nodes but not to distant parts of the body, or the cancer may or may not have spread to a nearby lymph node but has spread to distant lymph nodes or the lungs; at least one tumor marker level is elevated |
| 3C | The cancer has spread to at least one nearby lymph node but not to any distant parts of the body, at least one tumor marker level is elevated; or the cancer may or may not have spread to at least one nearby lymph node but has spread to distant lymph nodes or the lungs, and at least one tumor marker level is elevated; or the cancer may or may not have spread to at least one nearby lymph node but has spread to distant parts of the body other than the lymph nodes or the lungs, and tumor marker levels may or may not be elevated |
Though testicular cancer staging can seem complicated, talking with your doctor to understand your health status and treatment methods will be beneficial.
Testicular cancer is highly curable in many cases, but it’s important to do self-checks and stay current with annual physical examinations to ensure that any problems are discovered early.