Stage 2 testicular cancer refers to cancer that has spread to the lymph nodes and the abdominal region.
Testicular cancer spreads via a predictable route. Although it usually originates in the testicle, it can spread first to the abdominal lymph nodes. From there it can spread to the lymph nodes of the chest. And from there it can actually spread to the brain.
Stage 2 cancer suggests that there is some involvement of the lymph nodes within the abdominal area without any involvement higher up. And stage 2 cancers can be subcategorized into A, B, or C. The subcategorization has to do with how large your lymph nodes are within the abdominal cavity. If your lymph nodes are less then two centimeters in diameter, then you would be a 2A. If they are greater than two centimeters but less than five centimeters, we call that a stage 2B. And if they are greater than five centimeters, that would be called a stage 2C. These are all important distinctions because it determines the type of therapy that would be recommended or available to you.
The treatments that we do for stage 2 cancer may involve surgery to remove the involved lymph nodes or chemotherapy or radiation therapy. And again, these treatments depend on several factors. A couple main factors are whether you have a seminoma or a non-seminomonous germ cell tumor. Also the status of your tumor markers. If you have tumor markers that are elevated, and remain elevated after removal of the testicle, that implies that there is viable cancer there. Usually, in those cases, we will not talk about doing surgery to remove the lymph nodes.
If your tumor markers have normalized or are within the normal range after the testes is removed, then the treatments depend on whether you have a seminoma or a non-seminoma. If you have seminoma, and you have disease in the abdominal area, then we talk about either radiation or chemotherapy.
If you have non-seminoma, and you have an involvement of the abdominal area, then it really depends on the size of your nodes. If you are a stage 2A or 2B, which means you have lymph nodes less than five centimeters in diameter, and your tumor markers are normal, then we offer patients the option of surgery to remove the lymph nodes or chemotherapy in the form of two or three separate agents that are used to treat that area and to kill the cancer there.
Regardless, stage 2 testicular cancer refers to cancer that has spread to the abdominal area. And the treatments that are available depend on various factors such as the type of tumor, the level of your tumor markers, and the extent of disease that you have there.