Assessing how far the cancer has spread is called staging. The stages are:

• stage 1 - cancer is only in the testicle
• stage 2 - cancer has spread to the lymph nodes in the abdomen
• stage 3 - there are cancer cells in the lymph nodes in the chest or above the collarbone
• stage 4 - cancer has spread to other organs, often the lungs

The type of treatment used depends on the type of cancer and how far it has spread. Chemotherapy and radiotherapy can temporarily lower your fertility. As a precaution, many men store (cryopreserve) their sperm in a sperm bank before treatment.

Surgical removal of the affected testicle (orchidectomy) is the standard initial treatment for testicular cancer. If the cancer has spread further, you may need to have chemotherapy first, so the removal of your testicle will be delayed. You may wish to have an artificial testicle (an implant or prosthesis) inserted into your scrotum - you can discuss this with your doctor before the surgery. The removal of one testicle will not affect your ability to have erections or father children.

After surgery, you will be referred to a team of specialists and seen by an oncologist - a doctor specialising in cancer - to decide on the best course of further treatment.

Early stage seminomas are treated with radiotherapy, or sometimes chemotherapy (see Related topics). More advanced stages are treated with radiotherapy, if the cancer is confined to a small area, or chemotherapy if it's more spread out.

If you have an early stage non-seminoma, you probably won't need treatment, but you will be monitored for any signs of the cancer coming back (relapsing). This is because if testicular cancer does come back, there is a good chance that it can be cured with chemotherapy. Chemotherapy can leave the remains of tumours behind, and these may need to be surgically removed to make sure the cancer doesn't come back.