Stage I Testicular Cancer
Stage II Testicular Cancer
Stage III Testicular Cancer

A link to a list of current clinical trials is included for each treatment section. For some types or stages of cancer, there may not be any trials listed. Check with your doctor for clinical trials that are not listed here but may be right for you.

Treatment of stage I testicular cancer depends on whether the cancer is a seminoma or a nonseminoma.

Treatment of seminoma may include the following:

• Surgery to remove the testicle, with or without radiation therapy to lymph nodes in the abdomen after the surgery, with lifelong follow-up.
• Surgery to remove the testicle, followed by chemotherapy and lifelong follow-up.

Treatment of nonseminoma may include the following:

• Surgery to remove the testicle and lymph nodes in the abdomen, with lifelong follow-up.
• Surgery to remove the testicle, with lifelong follow-up.
• Surgery followed by chemotherapy for patients at high risk of recurrence, with lifelong follow-up.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage I malignant testicular germ cell tumor ¹. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site ².

Treatment of stage II testicular cancer depends on whether the cancer is a seminoma or a nonseminoma.

Treatment of seminoma may include the following:

• When the tumor is 5 centimeters or smaller, treatment is usually surgery to remove the testicle followed by radiation therapy to lymph nodes in the abdomen and pelvis, with lifelong follow-up.
• When the tumor is larger than 5 centimeters, treatment is usually surgery to remove the testicle followed by combination chemotherapy or radiation therapy to lymph nodes in the abdomen and pelvis, with lifelong follow-up.

Treatment of nonseminoma may include the following:

• Surgery to remove the testicle and lymph nodes, with lifelong follow-up.
• Surgery to remove the testicle and lymph nodes, followed by combination chemotherapy and lifelong follow-up.
• Surgery to remove the testicle followed by combination chemotherapy and a second surgery if cancer remains, with lifelong follow-up.
• Combination chemotherapy before surgery to remove the testicle, for cancer that has spread and is thought to be life-threatening.
• A clinical trial of combination chemotherapy instead of removing the lymph nodes.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage II malignant testicular germ cell tumor ³. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site ².

Treatment of stage III testicular cancer depends on whether the cancer is a seminoma or a nonseminoma.

Treatment of seminoma may include the following:

• Surgery to remove the testicle followed by combination chemotherapy. Any tumor remaining after treatment will need lifelong follow-up.
• A clinical trial of a new therapy.
• A clinical trial of high-dose chemotherapy with bone marrow transplant.

Treatment of nonseminoma may include the following:

• Surgery to remove the testicle, followed by combination chemotherapy.
• Combination chemotherapy followed by surgery to remove any remaining tumor. Additional chemotherapy may be given if the tumor tissue removed contains cancer cells that are growing.
• Combination chemotherapy combined with radiation therapy to the brain for cancer that has spread to the brain.
• Combination chemotherapy before surgery to remove the testicle, for cancer that has spread and is thought to be life-threatening.
• A clinical trial of a new therapy.
• A clinical trial of high-dose chemotherapy with bone marrow transplant.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage III malignant testicular germ cell tumor ⁴. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site ².

Glossary Terms

The area of the body that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs.

A procedure to replace bone marrow that has been destroyed by treatment with high doses of anticancer drugs or radiation. Transplantation may be autologous (an individual's own marrow saved before treatment), allogeneic (marrow donated by someone else), or syngeneic (marrow donated by an identical twin).

Cancer that has spread from the original (primary) tumor to the brain.

A term for diseases in which abnormal cells divide without control and can invade nearby tissues. Cancer cells can also spread to other parts of the body through the blood and lymph systems. There are several main types of cancer. Carcinoma is a cancer that begins in the skin or in tissues that line or cover internal organs. Sarcoma is a cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue. Leukemia is a cancer that starts in blood-forming tissue such as the bone marrow, and causes large numbers of abnormal blood cells to be produced and enter the blood. Lymphoma and multiple myeloma are cancers that begin in the cells of the immune system. Central nervous system cancers are cancers that begin in the tissues of the brain and spinal cord. Also called malignancy.

The individual unit that makes up the tissues of the body. All living things are made up of one or more cells.

A measure of length in the metric system. There are 100 centimeters in a meter and 2½ centimeters in an inch.

Treatment with drugs that kill cancer cells.

A type of research study that tests how well new medical approaches work in people. These studies test new methods of screening, prevention, diagnosis, or treatment of a disease. Also called clinical study.

Treatment using more than one anticancer drug.

Monitoring a person's health over time after treatment. This includes keeping track of the health of people who participate in a clinical study or clinical trial for a period of time, both during the study and after the study ends.

An intensive drug treatment to kill cancer cells, but that also destroys the bone marrow and can cause other severe side effects. High-dose chemotherapy is usually followed by bone marrow or stem cell transplantation to rebuild the bone marrow.

A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Lymph nodes filter lymph (lymphatic fluid), and they store lymphocytes (white blood cells). They are located along lymphatic vessels. Also called lymph gland.

A group of testicular cancers that begin in the germ cells (cells that give rise to sperm). Nonseminomas are identified by the type of cell in which they begin and include embryonal carcinoma, teratoma, choriocarcinoma, and yolk sac carcinoma.

The lower part of the abdomen, located between the hip bones.

The use of high-energy radiation from x-rays, gamma rays, neutrons, protons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body near cancer cells (internal radiation therapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that travels in the blood to tissues throughout the body. Also called irradiation and radiotherapy.

Cancer that has recurred (come back), usually after a period of time during which the cancer could not be detected. The cancer may come back to the same place as the original (primary) tumor or to another place in the body. Also called recurrent cancer.

A type of cancer of the testicles. Seminomas may spread to the lung, bone, liver, or brain.

The extent of a cancer in the body. Staging is usually based on the size of the tumor, whether lymph nodes contain cancer, and whether the cancer has spread from the original site to other parts of the body.

Stage I is divided into stage IA, stage IB, and stage IS, and is determined after a radical inguinal orchiectomy (surgery to remove the testicle) is done. In stage IA, cancer is in the testicle and epididymis and may have spread to the inner layer of the membrane surrounding the testicle; all tumor marker levels are normal. In stage IB, the cancer is in the testicle and the epididymis and has spread to the blood or lymph vessels in the testicle; or has spread to the outer layer of the membrane surrounding the testicle; or is in the spermatic cord or the scrotum and may be in the blood or lymph vessels of the testicle; all tumor marker levels are normal. In stage IS, cancer is found anywhere within the testicle, spermatic cord, or the scrotum, and either all tumor marker levels are slightly above normal or one or more tumor marker levels are moderately above normal or high.

Stage II is divided into stage IIA, stage IIB, and stage IIC, and is determined after a radical inguinal orchiectomy (surgery to remove the testicle) is done. In stage IIA, the cancer is anywhere within the testicle, spermatic cord, or scrotum; and has spread to up to 5 lymph nodes in the abdomen (none larger than 2 centimeters). In stage IIB, the cancer is anywhere within the testicle, spermatic cord, or scrotum; has spread to up to 5 lymph nodes in the abdomen (at least one of the lymph nodes is larger than 2 centimeters, but none is larger than 5 centimeters) or has spread to more than 5 lymph nodes (the lymph nodes are not larger than 5 centimeters). In stage IIC, the cancer is anywhere within the testicle, spermatic cord, or scrotum; and has spread to a lymph node in the abdomen that is larger than 5 centimeters. All tumor marker levels are normal or slightly above normal.

Stage III is divided into stage IIIA, stage IIIB, and stage IIIC, and is determined after a radical inguinal orchiectomy (surgery to remove the testicle) is done. In stage IIIA, the cancer is anywhere within the testicle, spermatic cord, or scrotum; may have spread to one or more lymph nodes in the abdomen; and has spread to distant lymph nodes or to the lungs. In stage IIIB, the cancer is anywhere within the testicle, spermatic cord, or scrotum; and may have spread to one or more nearby or distant lymph nodes or to the lungs. In stage IIIC, the cancer is anywhere within the testicle, spermatic cord, or scrotum; and may have spread to one or more nearby or distant lymph nodes or to the lungs or anywhere else in the body. The level of one or more tumor markers may range from normal to very high.

A procedure to remove or repair a part of the body or to find out whether disease is present. An operation.

One of two egg-shaped glands inside the scrotum that produce sperm and male hormones. Also called testis.

Treatment.

A group or layer of cells that work together to perform a specific function.

An abnormal mass of tissue that results when cells divide more than they should or do not die when they should. Tumors may be benign (not cancer), or malignant (cancer). Also called neoplasm.