testicular cancer:There are three stages of testicular cancer

Cancer Stages
Physicians measure the extent of the disease by conducting tests that allow the doctor to categorize, or "stage," the disease. These staging tests include blood analyses, imaging techniques, and sometimes additional surgery. Staging allows the doctor to plan the most appropriate treatment for each patient.

There are three stages of testicular cancer:
Stage 1--Cancer confined to the testicle.
Stage 2--Disease spread to retroperitoneal lymph nodes, located in the rear of the body below the diaphragm, a muscular wall separating the chest cavity from the abdomen.
Stage 3--Cancer spread beyond the lymph nodes to remote sites in the body.Through blood tests, doctors can check for tumor-associated markers, substances often present in abnormal amounts in cancer patients. Comparing levels of markers before and after surgical treatment helps doctors determine if cancer has spread beyond the testicles. Likewise, measuring marker levels before and after chemotherapy treatment can help show how well the chemotherapeutic drugs are working.

FDA has approved a test that checks blood levels of alpha-fetoprotein (AFP) as a tumor-associated marker. Other tests, such as those that gauge levels of beta-human chorionic gonadotropin (bHCG) or lactate dehydrogenase (LDH), are widely used as tumor-associated markers, but FDA has insufficient data to approve these tests.

Imaging techniques provide doctors with pictures of internal organs, giving visual clues to cancer staging. Chest x-rays can tell doctors if disease has spread to the lungs. Lymphangiography allows the lymph nodes to be visualized on an x-ray. CT scans create detailed views of cross sections of the body and can indicate possible tumors at various body sites.

Surgery to remove the retroperitoneal lymph nodes, into which the testicles drain, often is necessary for testicular cancer patients. Doctors examine lymph tissue microscopically to help determine the stage of the disease. Also, removing the tissue helps control further cancer spread.

by John Henkel....http://www.fda.gov/