Last updated: 14-Oct-2026
Dr Swati Shah
MS, DrNB (Surgical Oncology)
Testicular Cancer Surgeon
Apollo Hospital, Bhat, Gandhinagar · Gota OPD, Ahmedabad · 18 years of experience
★★★★★ 4.99 from 84 Google reviews (Gota clinic) · 5.0 from 35 (Apollo, Bhat)
IN SHORT
Stage II means the cancer has spread from the testis to lymph nodes at the back of the belly. It has not gone beyond those nodes.
Testicular cancer usually responds well to treatment, even after it has spread. So the aim is enough treatment to control it, and no more than that.
Three things set the plan: the size of the nodes, the tumour type and the marker results. For most men the plan is chemotherapy. A few can have less.
The testis has been removed through the groin. The CT scan done after that shows swollen lymph nodes at the back of the abdomen, near the large blood vessels. Nothing is seen beyond them. That is stage II. Doctors split it by node size: IIA for nodes up to 2 cm, IIB for 2 to 5 cm, and IIC for larger nodes. How the stage is worked out is explained in testicular cancer stages and risk groups. This page covers one question only: how much treatment is right for nodes at this stage.
No single result decides the treatment. The tumour type, the node size and the markers taken after the operation are read together by the tumour board.
| Result | What it can show | What it changes |
|---|---|---|
| Tumour type in the report | Seminoma or non-seminoma. | Only seminoma has the smaller options below. |
| Node size on CT | Up to 3 cm, or larger. | Small nodes may allow less treatment. Larger nodes mean chemotherapy. |
| Markers after the operation | Normal, or still raised. | A raised marker points to chemotherapy, not a smaller option. |
| Spread beyond the nodes | Lungs or other organs. | That is no longer stage II. The plan is on the spread disease page. |
For seminoma with normal markers and nodes of 3 cm or less, a smaller treatment is now accepted. Chemotherapy is still a sound choice too.
Node surgery at this stage is expert work. It belongs in a centre with keyhole skill, back-up for the large blood vessels, and regular experience of this operation. If that is not in place, referral is the honest advice. More is on the testicular cancer surgery and fertility page.
When the nodes are larger, the markers stay raised, or the tumour is a non-seminoma, chemotherapy comes first. It is given on time, cycle after cycle.
The usual drugs are bleomycin, etoposide and cisplatin, given together as BEP. The number of cycles depends on the risk group. Where bleomycin is not suitable, a version without it is used. The dates matter a great deal. A cycle is not stretched or delayed because a man feels weak, since keeping to time is part of what makes the treatment work. Day-by-day details are in treatment of spread testicular cancer.
A scan after chemotherapy checks whether a mass is left. What happens next depends on the tumour type, because a leftover mass means different things.
| Tumour type | What is done | Why |
|---|---|---|
| Non-seminoma | Any leftover mass of 1 cm or more, with normal markers, is removed by node surgery. | It may hold teratoma. Teratoma does not respond to chemotherapy and can grow. |
| Seminoma | A PET-CT is done only for a mass of 3 cm or more, at least six to eight weeks after chemotherapy. | If the PET-CT is positive, surgery is planned. Otherwise the mass is watched. |
Nerve-sparing is tried in every node operation where it is safe for the cancer. After chemotherapy, the area can become scarred, and saving the nerves is often not possible then. You are told this before the operation, not after. If the nerves cannot be saved, semen no longer comes out, and natural conception would need help such as IVF. This is why sperm banking comes first.
Yes. Testicular cancer usually responds well to treatment, even after it has spread to the lymph nodes. The plan is chosen so that the treatment is enough, and not more than needed.
Not always. For seminoma with normal markers and nodes of 3 cm or less, nerve-sparing node surgery, or focused radiotherapy with one dose of carboplatin, can be considered.
Keeping each cycle on time is part of what makes it work. Delays and stretched gaps are an avoidable reason for the cancer to come back.
It can. If the nerves cannot be saved, semen no longer comes out. Natural conception would then need help, so sperm is banked before treatment.
For non-seminoma, a leftover mass of 1 cm or more is usually removed. For seminoma, a PET-CT helps decide, and only larger masses are tested.
Testicular cancer as a whole is covered on the testicular cancer surgery page. For questions, call +91-63590-11009.
Shah’s Gastro, Cancer & Robotic Surgery Centre
Dr Swati Shah — MS, DrNB (Surgical Oncology) · Testicular Cancer Surgeon
Consultation: Gota OPD, Gota, Ahmedabad. Surgery: Apollo Hospital, Bhat, Gandhinagar.
Gota OPD — Gota, Ahmedabad, Gujarat
Apollo Hospital, Bhat, Gandhinagar — Apollo Hospital International Limited, Plot No. 1 A, GIDC Bhat Industrial Estate, Bhat, Gandhinagar, Gujarat
Call: +91-63590-11009 · WhatsApp: +91-63590-11009
Told the cancer has reached the lymph nodes in your belly? Your histology report, marker results with dates and the CT report can be sent ahead on WhatsApp, so the visit starts with them already read. The plan itself is made at the consultation, with you. Call +91-63590-11009 Send reports before your visit
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