Stages of Testicular Cancer

Testicular cancer is classified by stages that describe how severe the cancer is and how far it has spread. A pathologist examines the affected testicle to determine if cancer exists and whether it has spread into other lymph nodes or tissues. Understanding the stages of testicular cancer can help patients to better understand their prognosis.

Stage 0

Stage 0 is also known as carcinoma in situ. In this stage of testicular cancer, abnormal cells are identified in the tubules where sperm development occurs. Abnormal cells may eventually become cancerous and spread into other tissues. In stage 0, tumor marker levels are normal.

Stage I

In stage I, cancer has developed from abnormal cells. Stage I cancer can be classified as stage IA, stage IB or stage IS. This staging can only be determined after the affected testicle has been removed. Stage IA testicular cancer affects the epididymis and testicle and can spread into the membrane that surrounds the testicle. Tumor marker levels are normal in this stage of testicular cancer.

Stage IIB affects the testicle and epididymis and has spread into other tissues. The cancer may have spread into the blood, lymph vessels, spermatic cord, scrotum or the outer layer of the testicular membrane. In this stage, all tumor marker levels remain normal. Stage IS indicates that the cancer is found within the testicle, scrotum or spermatic cord and that tumor marker levels have been affected. In this stage, all tumor markers may be elevated slightly or one or more tumor marker levels may be high.

Stage II

Stage II indicates a more serious form of testicular cancer. This stage can be divided into stage IIA, IIB and IIC and can be determined only once the testicle has been removed and examined by a pathologist. Stage IIA testicular cancer is located anywhere within the scrotum, spermatic cord or testicle and has spread to up to five abdominal lymph nodes. None of the affected lymph nodes is larger than 2 cm. Tumor marker levels may be normal or slightly elevated.

Stage IIB testicular cancer also affects the testicle, scrotum or spermatic cord. However, the cancer can spread to more than five lymph nodes, but none of these lymph nodes are larger than 5 cm. Tumor markers are normal or slightly elevated in stage IIB testicular cancer. Stage IIC indicates that the cancer has spread to an abdominal lymph node that is larger than 5 cm. In this stage, tumor markers are normal or only slightly above normal.

Stage III

Stage III is the most serious form of cancer and can be classified as stage IIIA, IIIB and IIIC once the testicle has been removed. In stage IIIA, the cancer may have spread to abdominal lymph nodes and may have also spread to distant tissue sites, such as the lungs. Tumor markers may be slightly elevated during this testicular cancer stage. In stage IIIB, the cancer affects the testicle, scrotum or spermatic cord, has spread into the abdominal lymph nodes and may have spread to distant lymph nodes or tissues. Tumor marker levels may be normal or high. Stage IIIC indicates that the cancer may have spread anywhere in the body. While tumor marker levels may be normal, they may also be very elevated.