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Testicular cancer stages

Men and woman discussing testicular cancer

This page is about the different stages of testicular cancer. There is information about

 

A quick guide to what's on this page

Testicular cancer stages

The stage of a cancer tells the doctor how far the cancer has spread. It is important because treatment is decided according to the stage of a cancer. It is possible to cure testicular cancer at all stages, even if it has spread.

The staging systems

There are different ways of staging cancers. The two main ways are the TNM system and number systems. TNM stands for Tumour, Node, Metastasis. This system describes

  • The size of the primary tumour (T)
  • Whether the cancer has spread to the lymph nodes (N)
  • Whether the cancer has spread to a different part of the body (metastasis, M)

There is another level to TNM staging for testicular cancer, called S stage. This relates to the levels of testicular cancer proteins (markers) in the blood.

Under the number staging system, testicular cancer is numbered from stage 1 to stage 3. Stage 1 is the earliest stage and stage 3 is the most advanced stage of testicular cancer. Many doctors in the UK divide testicular cancer into just 2 groups when deciding on treatment. Stage 1 is localised testicular cancer. If the cancer has spread beyond the testicle (stages 2 or 3) or if there are raised markers after surgery (stages S1 to S3) the cancer is considered to have spread. 
 

CR PDF Icon You can view and print the quick guides for all the pages in the Treating testicular cancer section.

 

 

What staging is

The stage of a cancer tells the doctor how far the cancer has spread. It is important because doctors decide on treatment according to the stage of a cancer. Your doctor will find the stage of your cancer by looking at the results of your tests and scans.

 

The different staging systems used

There are different ways of staging cancers. The two main ways are the TNM system and number systems. Understanding your cancer stage may help you understand why your specialist has recommended a particular treatment for you. If you don't understand and would like to know more, you can ask your doctor or specialist nurse. There is a list of questions for your doctor at the end of this section that may help you. There is also detailed information about staging cancers in the about cancer section.

It is possible to cure testicular cancer at all stages, even if it has spread.

 

TNM stages of testicular cancer

TNM stands for Tumour, Node, Metastasis. The TNM system describes

  • The size of a primary tumour (T)
  • Whether the cancer has spread to the lymph nodes (N)
  • Whether the cancer has spread to a different part of the body (M)

There are 5 T stages for testicular cancer

  • TIS (testicular intraepithelial neoplasia) means that cancerous cells have been found but they have not yet begun to move into surrounding tissues in the testicle
  • T1 means the tumour is contained within the testicle and epididymis
  • T2 means there are signs that the cancer has grown into blood vessels or lymph vessels
  • T3 means the tumour has grown as far as the spermatic cord and may also have grown into blood vessels or lymph vessels
  • T4 means the tumour has grown into the scrotum

There are 4 lymph node categories in the TNM classification for testicular cancer. The bigger the lymph nodes, the higher the stage. This is because bigger nodes contain more cancer cells, so the cancer is thought to be more advanced. It is often possible to cure even advanced testicular cancer. The 4 categories are

  • N0 means there are no lymph nodes containing cancer cells
  • N1 means that one or more lymph nodes contain cancer cells but they are smaller than 2cm across
  • N2 means at least one of the lymph nodes is bigger than 2cm, but smaller than 5cm across
  • N3 means at least one of the lymph nodes is bigger than 5cm across

There are 3 categories of tumour spread in the TNM classification for testicular cancer

  • M0 means there are no signs of spread to other body organs
  • M1a means there is cancer spread to the lungs OR there are cancer cells in lymph nodes a long way away from the testicles
  • M1b means there is spread to other body organs such as the liver or brain

TNM staging for testicular cancer also looks at the levels of particular testicular proteins in the blood. It calls this the S stage. The proteins are called markers

  • S0 means markers are at normal levels
  • S1 means markers are slightly raised
  • S2 means markers are moderately raised
  • S3 means markers are very high
 

Number stages of testicular cancer

Testicular cancer has 3 main number stages.

Stage 1 – this is the earliest stage of invasive testicular cancer. The cancer is contained within the testicle and has not spread to nearby lymph nodes or other organs. Stage 1S means that there are raised markers after surgery. 

Stage 2 – the cancer cells have spread into nearby lymph nodes in your abdomen or pelvis. This is split into 2A, 2B and 2C.

  • Stage 2A means the lymph nodes are all smaller than 2cm
  • Stage 2B means the nodes are between 2cm and 5cm
  • Stage 2C means at least one lymph node is bigger than 5cm 

Stage 3 – this is split into 3A, 3B and 3C

  • Stage 3A means the cancer has spread to distant lymph nodes (for example near the collarbone) or your lungs. Your marker level may be normal (S0) or slightly raised (S1)
  • Stage 3B means the cancer has spread to nearby lymph nodes and you have a moderately high marker level (S2), OR your cancer has spread to your lungs or distant lymph nodes and you have a moderately high marker level
  • Stage 3C can be the same as stage 3B but you have a very high marker level (S3), OR your cancer has spread to another body organ, such as the liver or brain – this used to be called stage 4 testicular cancer
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Updated: 20 February 2013