A  A  A   Print
Understanding Your Stage of Testicular Cancer

Understanding Your Stage of Testicular Cancer

If cancer is found in your testicles, your doctor will need to find out how far along the cancer is. This is called staging.

Testicular cancer staging includes the traits of the primary tumor. It also considers whether your cancer has spread to your lymph nodes or if your cancer has spread to your lungs or other organs. The staging system also takes into account the blood level of your tumor markers.

The TNM system

The International Union Against Cancer and the American Joint Committee on Cancer have developed a standard system of describing the extent of a cancer's growth. It is known as the TNM system.

In the TNM system, the T indicates how far the main tumor has grown and where it is located. The N indicates whether the lymph nodes in the area of your original tumor have become cancerous. The M indicates whether your cancer has spread (metastasized) to other organs in the body. In addition, the letter S indicates the serum levels of certain tumor markers (AFP, HCG, and LDH) in your body that testicular cancer produces. The blood tests done after surgical removal of the testicle are used for staging purposes. When chemotherapy is used for metastatic cancer, the marker levels on the first day of chemo are the values recorded for staging. Numbers after each of these letters provide more details about each piece of information. 

Once a man's T, N, M, and S factors have been determined, a doctor puts this information together in what is called stage grouping. Stage grouping is used to determine your overall cancer stage. It is expressed in numerals. Stage I is the earliest stage. Stage III is the most advanced stage. The letter after the numeral further describes the cancer, for example, Stage IIC.

Stage 0. Stage 0 is a cancer that has not spread beyond the tiny tubules where the sperm cells begin to develop. This is also called carcinoma in situ.

Stage I. For this stage, the main tumor (T) can be any level. The cancer has not spread to the lymph nodes (N0) or distant parts of the body (M0). Serum tumor marker levels are not available (SX).

Stage IA. Cancer is only in the testicle and has not invaded the lymphatic or blood vessels in the testicle. The tumor may have invaded the inner membrane surrounding the testis (the tunica albuginea) but not the outer membrane (the tunica vaginalis) (T1). The cancer has not spread to lymph nodes (N0) or distant sites (M0). Serum tumor markers are normal after the cancerous testicle is removed (S0).

Stage IB. The tumor may have grown further into or outside of the testicle (T2, T3, or T4), but the cancer has not spread to lymph nodes (N0) or distant sites (M0). Serum tumor markers are normal after the cancerous testicle is removed (S0).

Stage IS. The tumor may or may not have grown outside of the testicle (any T), but the cancer has not spread to lymph nodes (N0) or distant sites (M0). Serum tumor markers are abnormal, even after the cancerous testicle is removed (S1, S2, or S3).

Stage II: The tumor may or may not have grown outside of the testicle (any T). The cancer has spread to nearby lymph nodes (N1, N2, or N3), but not to lymph nodes in other parts of the body or distant organs (M0). Serum tumors markers are unavailable (SX).

Stage IIA: The tumor may or may not have grown outside of the testicle (any T). The cancer has spread to five or fewer nearby lymph nodes, none of which is larger than two centimeters across (N1). The cancer has not spread to lymph nodes in other parts of the body or distant organs (M0). Serum tumor markers are either normal (S0) or slightly elevated (S1) after the cancerous testicle is removed.

Stage IIB: The tumor may or may not have grown outside of the testicle (any T). The cancer has spread to nearby lymph nodes, at least one of which is between two centimeters and five centimeters across, or it has spread to more than five lymph nodes, none of which is more than five centimeters across (N2). The cancer has not spread to lymph nodes in other parts of the body or distant organs (M0). Serum tumor markers are either normal (S0) or slightly elevated (S1) after the cancerous testicle is removed.

Stage IIC: The tumor may or may not have grown outside of the testicle (any T). The cancer has spread to nearby lymph nodes, at least one of which is larger than five centimeters across (N3). The cancer has not spread to lymph nodes in other parts of the body or distant organs (M0). Serum tumor markers are either normal (S0) or slightly elevated (S1) after the cancerous testicle is removed.

Stage III: The tumor may or may not have grown outside of the testicle (any T) and may or may not have reached nearby lymph nodes (any N). Cancer has spread to lymph nodes in other parts of the body or to distant organs (M1). Serum tumor marker levels are unknown (SX).

Stage IIIA: The tumor may or may not have grown outside of the testicle (any T) and may or may not have reached nearby lymph nodes (any N). Cancer has spread to lymph nodes in other parts of the body or to the lungs (M1a). Serum tumor markers are either normal (S0) or slightly elevated (S1) after the cancerous testicle is removed.

Stage IIIB: The tumor may or may not have grown outside of the testicle (any T). At least one serum tumor marker is significantly elevated (S2) after the cancerous testicle is removed. The cancer has spread to nearby lymph nodes (N1, N2, or N3) or it has spread to lymph nodes in other parts of the body or to the lungs (M1a).

Stage IIIC: The tumor may or may not have grown outside of the testicle (any T), and one of the following applies:

  • At least one serum tumor marker is highly elevated (S3) after the cancerous testicle is removed. The cancer has spread to nearby lymph nodes (N1, N2, or N3) or it has spread to lymph nodes in other parts of the body or to the lungs (M1a).

  • The cancer has spread to distant organs other than the lungs, such as the liver, brain, or bones (M1b).

For testicular cancers that have spread outside the testicles, doctors also use risk groups, which are based on how easy or hard it is likely to be to treat these cancers successfully. These risk groups depend on whether the cancer is a seminoma or nonseminoma, the extent and location of the cancer, and serum tumor marker levels. 

 

The third-party content provided in the Health Library of phoebeputney.com is for informational purposes only and is not designed to diagnose or treat a health problem or disease, or replace the professional medical advice you receive from your physician. If you or your child has or suspect you may have a health problem, please consult your primary care physician. If you or your child may have a medical emergency, call your doctor or 911 or other emergency health care provider immediately in the United States or the appropriate health agency of your country. For more information regarding site usage, please visit: Privacy Information, Terms of Use or Disclaimer.

Follow us online:

© 2014 Phoebe Putney Health System  |  417 Third Avenue, Albany, Georgia 31701  |  Telephone 877.312.1167

Phoebe Putney Health System is a network of hospitals, family medicine clinics, rehab facilities, auxiliary services, and medical education training facilities. Founded in 1911,
Phoebe Putney Memorial Hospital (the flagship hospital) is one of Georgia's largest comprehensive regional medical centers. From the beginning, Phoebe's mission and vision
has been to bring the finest medical talent and technology to the citizens of Southwest Georgia, and to serve all citizens of the community regardless of ability to pay.