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Doctors put cancer into categories, depending on how far cancer cells have spread in someone's body. This is called staging the cancer. There are two main ways of doing this.

One way of staging cancer is called the TNM system.¹

• T stands for tumor. This tells you how big the first lump of cancer cells has got.
• N stands for nodes. Cancer cells can start to travel round your body in a network of tiny vessels called your lymph system. For more information, see What is my lymphatic system? If cancer cells reach a lymph node (a collection of cells that are part of your immune system), the cancer cells can start to grow there and make the lymph node swollen.
• M stands for metastasis. This tells you whether cancer cells have spread to another part of your body.

Here's what the different TNM classifications for testicular cancer mean.¹

Most types of cancer are divided into stages using just these three categories, T, N and M. But if you have testicular cancer, you may have higher-than-normal levels of some chemicals in your blood. These chemicals are sometimes called tumor markers.

You can have a blood test to check for raised levels of these chemicals. The amount of these chemicals in your blood is described using a number, from S0 to S3. The higher the number, the higher the level of these chemicals in your blood.

However, not all men with testicular cancer have high levels of these chemicals. And it's possible to have higher levels of tumor markers in your blood without having testicular cancer.¹

Another system of describing how far testicular cancer has spread is called the Royal Marsden Hospital staging system. It uses a number to say how far cancer cells have spread. Stage 1 is the earliest stage of cancer. Stage 4 is the most advanced.

• Stage 1 means there's no sign that your cancer has started to spread
• Stage 1M means that a blood test has shown you have higher levels of chemicals called tumor markers in your blood. But there's no sign from any other tests that your cancer has spread from the testicle that is affected.

• Stage 2A means none of your lymph nodes have swollen to more than 2 centimeters in size (about 1 inch).
• Stage 2B means that some of your lymph nodes have swollen to between 2 and 5 centimeters across (1 to 2 inches).
• Stage 2C means that some of your lymph nodes have swollen to 5 centimeters (more than 2 inches) across or bigger.

• Cancer cells have spread to some of the lymph nodes in your chest or higher up. These could be the lymph nodes in your armpit or above your collarbone.

• Cancer cells have spread to other organs in your body. They may have spread to your lungs, liver, your brain or your bones.

In general, the further cancer has spread, the more serious it is. But testicular cancer is easier to treat than most other kinds of cancer. Even men whose cancer has spread have a good chance of recovering.² For more information, see What will happen to me?

This information is for educational use only, and is not a substitute for prompt professional medical advice. Readers should always consult a physician or other professional for advice and treatment. ©BMJ Publishing Group Limited 2008. All rights reserved.