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Staging

Staging is a way to describe if and where a cancer has spread. For testicular cancer there are 3 stages: I, II, and III (1, 2, and 3). Stage I is the least advanced and stage III is the most advanced. The stage helps lead a doctor to the best treatment.

To find the best treatment, the doctor must learn the stage of disease. The stage tells us how aggressive the cancer is, and if/where it has spread. Staging is a careful process.

Stage 0 (Carcinoma in Situ)

In stage 0, abnormal cells are found in the tiny tubules where sperm cells form. These cells may become cancer and spread. In stage 0, all tumor marker levels are normal. It is also called “carcinoma in situ”.

Stage I

In stage I, cancer has formed. Stage I is divided into stage IA, IB, and IS. Details are known after an orchiectomy.

  • Stage IA - Cancer is in the testicle and epididymis. It may have spread to the inner membrane around the testicle. All tumor marker levels are normal.
  • Stage IB - Cancer is found in the testicle and has spread nearby. All tumor marker levels are normal. Cancer is in the testis and:
    • pT2 –enters blood and lymph vessels, AND/OR hilar soft tissue, epididymis, or the visceral mesothelial layer
    • pT3  - the spermatic cord soft tissue and maybe blood and lymph vessels
    • pT4 - the scrotum and maybe blood and lymph vessels
  • Stage IS - Cancer is found anywhere within the testicle, spermatic cord, or the scrotum and either:
    • All tumor marker levels are a bit above normal OR 
    • One or more marker is above normal or high.

Stage II

Stage II is divided into stage IIA, IIB, and IIC. Details are known after an orchiectomy.

  • In Stage IIA - Cancer is anywhere in the testicle, spermatic cord, or scrotum. It has spread to up to 5 lymph nodes in the abdomen. Lymph nodes are not larger than 2cm. All tumor marker levels are normal or slightly above normal.
  • In Stage IIB - Cancer is anywhere in the testicle, spermatic cord, or scrotum. It has spread to up to 5 lymph nodes in the abdomen. At least one of the lymph nodes is larger than 2cm. but none are larger than 5cm. OR, the cancer has spread to more than 5 lymph nodes but none are larger than 5cm. All tumor marker levels are normal or a bit above normal.
  • In Stage IIC - Cancer is anywhere in the testicle, spermatic cord, or scrotum. It has spread to a lymph node in the abdomen that is larger than 5cm. All tumor marker levels are normal or a bit above normal.

Stage III

Stage III is divided into stage IIIA, IIIB, and IIIC. Details are known after an orchiectomy.

  • In Stage IIIA - Cancer is anywhere in the testicle, spermatic cord, or scrotum. It has spread to one or more lymph nodes in the abdomen and to distant lymph nodes or the lungs. Tumor marker levels range from normal to a bit above normal.
  • In Stage IIIB - Cancer is anywhere in the testicle, spermatic cord, or scrotum. It has spread to one or more lymph nodes in the abdomen, distant lymph nodes, or the lungs. The level of one or more tumor markers is above normal.
  • In Stage IIIC - Cancer is anywhere in the testicle, spermatic cord, or scrotum. It has spread to one or more lymph nodes in the abdomen, distant lymph nodes, or the lungs. The level of one or more tumor markers is high. OR, Cancer is anywhere in the testicle, spermatic cord, or scrotum. It has spread to one or more lymph nodes in the abdomen plus other parts of the body. Tumor marker levels range from normal to high.