Testicular cancer stages

• A quick guide to what's on this page
• What staging is
• The different staging systems used
• TNM stages of testicular cancer
• Number stages of testicular cancer

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

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, ask your doctor. There is a list of questions for your doctor at the end of this section that may help you. Also, there is more about staging cancers in the About cancer section of CancerHelp UK.

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

‘TNM’ stands for Tumour, Node, Metastasis. There is another level to TNM staging for testicular cancer, called S stage. 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 five T stages for testicular cancer

• TIS, or in situ, 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 there may also be blood vessel or lymph vessel involvement)
• T4 means the tumour has grown into the scrotum

There are four 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 the lymph nodes are all 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 lymph nodes a long way from the testicles, for example near the collarbone
• M1b means there is spread to other body organs such as the liver or brain

For testicular cancer, there is another category in the TNM classification. It is to do with the marker levels

• S0 means markers are not raised
• S1 means markers are slightly raised
• S2 means markers are moderately raised
• S3 means markers are very high

Testicular cancer has 4 main number stages.

Stage 1

The cancer is only in the testicle. So in TNM staging, you could have any T size, but must be N0 and M0. Stage 1S means the same, but with raised markers.

Stage 2

Cancer cells have spread to the lymph nodes in your abdomen or pelvis. Stage 2A means the nodes are all smaller than 2cm (N1). Stage 2B means the nodes are between 2cm and 5cm (N2). Stage 2C means at least one node is bigger than 5cm across (N3).

Stage 3

This means that cancer cells have spread to the lymph nodes in your chest or above your collarbone.

Stage 4

This means cancer cells have spread to another body organ, for example the lungs. This is called secondary cancer. Testicular cancer is often cured, even if it is Stage 4.

There is more about these tests in the diagnosing testicular cancer section.