Your stage tells your care team how far the cancer had spread when it was found, and it shapes your treatment plan. It is not a verdict: at every stage, most testicular cancer can be cured.
Before continuing, be sure you can answer the question “What is testicular cancer?”
The short answer: testicular cancer has three main stages. Stage 1 means the cancer is only in the testicle. Stage 2 means it has reached lymph nodes in the back of the belly. Stage 3 means it has spread further, such as to the lungs or distant lymph nodes, or that tumor marker levels in the blood are very high. There is no stage 4.
Your stage describes where the cancer was when it was found. Your care team puts it together from three things:
Doctors in the US use the American Joint Committee on Cancer (AJCC) system. It scores the tumor (T), nearby lymph nodes (N), distant spread (M) and, unlike most cancers, the tumor markers (S). Those scores combine into a stage from 1 to 3, with letters (A, B, C or S) that add detail.
There is also a stage 0, sometimes called germ cell neoplasia in situ (GCNIS). It means abnormal cells were found inside the tiny tubes of the testicle but have not grown beyond them.
Testicular cancer is one of the most treatable cancers, even after it has spread. These are five-year relative survival rates from the American Cancer Society, for men diagnosed from 2015 to 2021.
These groups are broader than the stages below, and the numbers come from men diagnosed years ago. Treatment keeps improving, so someone diagnosed today may do better. Your own outlook depends on your cancer type, your marker levels and your health, so ask your care team what the numbers mean for you.
The cancer has not spread beyond the testicle and the tissue around it. No lymph nodes are involved.
Common next steps: many men with stage 1 cancer go on surveillance, meaning regular scans and blood tests instead of more treatment right away. Depending on the cancer type and risk factors, some have one round of chemotherapy, radiation (for seminoma), or surgery to remove lymph nodes (RPLND).
The cancer has spread to lymph nodes in the back of the belly (the retroperitoneum) but not to distant organs. Markers are normal or only slightly high.
Common next steps: chemotherapy is the standard treatment. For some stage 2A and early 2B cancers, radiation or RPLND may be an option instead.
The cancer has spread beyond the nearby lymph nodes, or marker levels are high.
Common next steps: chemotherapy, with the type and number of cycles based on your risk group (good, intermediate or poor). Surgery to remove any leftover tumor sometimes follows. According to the National Cancer Institute, most testicular cancers can be cured, even when they are found at an advanced stage.
No. The staging system used for testicular cancer stops at stage 3, and both the American Cancer Society and the National Cancer Institute list only stages 0 to 3. Cancer that has spread to the liver, bone or brain is stage 3C, not stage 4.
If you have heard someone say "stage 4," they probably mean cancer that has spread far from the testicle. For advanced cancer, doctors also use a risk group (good, intermediate or poor) to plan treatment. Ask your care team which risk group you are in.
A new stage can bring a lot of questions. TCF's free TC Navigator is there 24/7, our weekly survivor Zoom call connects you with men who have been through it, and the newly diagnosed guide walks you through what comes next.
This page is for general information and does not replace advice from your doctor.
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