What Is "Staging" Of Testicular Cancer?

One of the first things the doctor does when testicular cancer is diagnosed is to determine the stage of the disease. This investigation is called "staging" and was developed to describe the extent of the cancer growth. It allows the physician to customize the treatment.

Testicular cancer is "staged' by information obtained from the surgical findings as well as from one or more of the following tests:

• Tumor marker tests

• Computed tomography (CT) scan

• Magnetic Resonance Imaging (MRI)

• Ultrasound

• Surgery

There are three stages of testicular cancer:

• Stage 1: The cancer is confined to the testicle only.

• Stage 2: The cancer has spread to the retroperitoneal lymph nodes, which are the lymph nodes located in the rear of the body, below the diaphragm (the muscular wall that separated the abdomen from the chest cavity).

• Stage 3: Cancer has spread beyond the lymph nodes to other areas of the body.

Tumor Marker Tests

Tumor markers are substances found in abnormal amounts in the blood in people with certain types of cancer. Specialized laboratory tests have been designed to identify tumor markers.

Tumor marker tests may help to determine the type of testicular cancer by identifying blood levels of the tumor markers present.

The tumor marker sought is HCG (human chorionic gonadotrophin), a hormone secreted by certain types of testicle tumors.

Computed Tomography (CT) Scan

CT scans are diagnostic techniques that use X-rays passed through the body at different angles to produce images.

A computer analyzes the images of the testis and shows them as cross-sections, or "slices," of the tissue being studied.

For further information about CT scan, go to CT Scan.

Magnetic Resonance Imaging (MRI)

Magnetic Resonance Imaging is a diagnostic technique that produces high-quality cross-sectional images of organs and structures within the body, in this case the testis, without x-rays or other radiation.

During the imaging, the patient lies within a large, hollow, cylindrical magnet and is exposed to short, harmless bursts of a powerful magnetic field.

For further information about MRI, go to MRI.

Ultrasound

Ultrasound is a technique that uses very high frequency sound waves inaudible to the human ear. After the sound waves are passed into the body, the reflected echoes are detected and analyzed by computer to produce a picture of the tissue or organ being studied.

For further information about ultra sound, go to Ultra Sound.

Surgery

When testicular cancer is suspected, the recommended procedure is to examine the suspicious tissue under a microscope. The tissue is obtained through an operation called an inguinalorchiectomy (surgical removal of the testicle), during which the affected testicle is removed for examination.

A biopsy by itself is usually rarely done. The proper procedure is removal of the entire testicle to confirm that cancer is present and to determine the exact type. Studies show that cutting through just the outer layer of a testicle to obtain a tissue sample can cause the spread of cancer, if it is present.

The doctor also may recommend additional surgery to remove abdominal lymph nodes. After surgery, the nodes are sent to a pathologist to determine if the testicular cancer has spread.