This page was reviewed under our medical and editorial policy by
Maurie Markman, MD, President, Medicine & Science at CTCA.
This page was updated on June 8, 2022.
Making an educated treatment decision begins with the stage, or progression, of the disease. The stage of testicular cancer is one of the most important factors in evaluating treatment options.
At Cancer Treatment Centers of America® (CTCA), our cancer doctors use a variety of diagnostic tests to evaluate testicular cancer and develop an individualized treatment plan. If you have been recently diagnosed, we will review your pathology to confirm you’ve received the correct diagnosis and staging information and develop a personalized treatment plan. If you have a recurrence, we will perform comprehensive testing and identify a treatment approach suited to your needs.
Testicular cancer staging describes how large a cancer is, whether the disease has spread and whether it is producing tumor markers, in addition to noting the level of those proteins in the serum, or blood. The TNM staging guidelines developed by the American Joint Committee on Cancer are often used in testicular cancer staging.
The stages are based on four categories:
T (tumor): This describes whether the tumor has spread to tissues near the testicle.
N (node): This indicates whether the testicular cancer cells have spread to regional lymph nodes.
M (metastasis): This refers to whether the cancer has metastasized (spread to distant areas of the body).
S (serum): This indicates the level of tumor marker proteins in the serum, or blood.
Once the individual T, N, M and S components are scored, they are combined to determine the overall testicular cancer stage group. The stages of testicular cancer are:
Stage 0: The cancer cells have not spread beyond the testicle. At this stage, tumors are also referred to as carcinomas in situ.
Stage 1 testicular cancer: The cancer has invaded tissues next to the testicle, but has not spread to lymph nodes, or more distant sites in the body. Levels of tumor marker proteins may be normal or elevated. The three subcategories of stage 1 testicular cancer are:
Stage 2 testicular cancer: Testicular cancers at this stage have invaded tissues next to the testicle and can now be found in at least one nearby lymph node. Tumor marker levels may be normal or slightly elevated. Stage 2 testicular cancer has three subcategories:
Stage 3 testicular cancer: Testicular cancers at this stage have spread to distant lymph nodes or organs. Stage 3 testicular cancer has three subcategories:
Sometimes, testicular cancer returns after treatment has concluded. This is called recurrent testicular cancer. Cancer may come back:
If you’re in remission (no evidence of cancer), you still need to schedule regular exams to ensure the cancer hasn’t returned. Follow-up exams are likely to be most frequent in the first two years after treatment concludes, but your doctor should advise you on the right schedule for you.
If the cancer returns, doctors may order another round of testing for diagnosis and staging. The tests resemble those done to diagnose and stage the original cancer. In some cases, cancer recurs long after the initial treatment. However, if nonseminoma testicular cancer returns, it’s usually within two years. Seminoma testicular tumor recurrences tend to occur within three years.