Results of the CT scan were negative for metastases to the lungs but were positive for enlarged retroperitoneal lymph nodes. Surgery was scheduled for an orchiectomy.
- 31. What is an orchiectomy?
A biopsy of the tumor was taken during the orchiectomy. This sample of the tumor tissue was sent to a pathologist to determine the type of tumor. Based on the biopsy results and the tumor cell markers, the testicular tumor was classified as a non-seminoma. Click here to read about the main types of testicular cancers.
- 32. What are the 2 main types of testicular cancer?
- 33. What are germ cells?
Max's cancer was determined to be Stage IIB. Testicular cancers are staged using the TNM staging system. This system was created by the American Joint Committee on Cancer (AJCC). If there are serum tumor markers, an S is added to denote the levels of serum tumor markers.
| TNM(S) Staging System | |
|---|---|
| T | T stands for tumor. How much has the tumor spread to tissues next to the testicle? |
| N | N stands for node. Has the cancer spread to regional lymph nodes (those close to the testicle)? |
| M | M stands for metastases. Has the cancer metastasized to distant lymph nodes or organs of the body? |
| S | What are the serum (blood) levels of tumor markers? |
| Staging from the American Cancer Society | |
Max's individual staging scores were T2, N2, MO, S1.
T2: the tumor has spread to nearby lymph vessels.
N2: The tumor had spread to at least one lymph node between 2-5 cm in diameter.
M0: There was no evidence of distant metastasis.
S1: LDH less than 1.5 x Normal, HCG <5,000, AFP < 1,000.
These individual results are then combined to determine the stage of the cancer. The stage of the cancer usually determines how far the cancer has progressed. (See Testicular Cancer Staging).
- 34. What stage would a testicular cancer be that has spread to the lungs and the brain?
- 35. What stage would a testicular cancer be that was confined to the testicle and had not spread to regional lymph nodes?
- 36. A patient with testicular cancer has enlarged lymph nodes in the abdomen and pelvis. How would you stage this cancer?