Stages (Prognosis)

The Spreading of Cancer

There are three ways that cancer spreads in the body:

Through tissue. Cancer invades the surrounding normal tissue.

Through the lymph system. Cancer invades the lymph system and travels through the lymph vessels to other places in the body.

Through the blood. Cancer invades the veins and capillaries and travels through the blood to other places in the body.

When cancer cells break away from the primary tumor and travel through the lymph or blood to other places in the body, another, or secondary tumor, may form. This process is called metastasis. The secondary, or metastatic, tumor is the same type of cancer as the primary tumor.

The Following Prognostic Groups Are Used For Extragonadal Germ Cell Tumors:

Good Prognosis

A Nonseminoma Extragonadal Germ Cell Tumor is in the Good Prognosis group if:

The tumor is in the back of the abdomen
and
The tumor has not spread to organs other than the lungs
and
The levels of tumor markers AFP and β-hCG are normal and LDH is slightly above normal


A Seminoma Extragonadal Germ Cell Tumor is in the Good Prognosis Group if:

The tumor has not spread to organs other than the lungs
and
The level of AFP is normal; β-hCG and LDH may be at any level


Intermediate Prognosis

A Nonseminoma Extragonadal Germ Cell Tumor is in the Intermediate Prognosis Group if:

The tumor is in the back of the abdomen
and
The tumor has not spread to organs other than the lungs
and
The level of any one of the tumor markers (AFP, β-hCG, or LDH) is more than slightly above normal


A Seminoma Extragonadal Germ Cell Tumor is in the Intermediate Prognosis Group if:

The tumor has spread to organs other than the lungs
and
The level of AFP is normal; β-hCG and LDH may be at any level


Poor Prognosis

A Nonseminoma Extragonadal Germ Cell Tumor is in the Poor Prognosis Group if:

The tumor is in the chest
or
The tumor has spread to organs other than the lungs
or
The level of any one of the tumor markers (AFP, β-hCG, or LDH) is high


In all cases, treatment should be individualized for you. Although germ cell tumors are categorized into different prognosis, each person is unique.

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