There are three stages of tumor progression related to the anatomical sites in which cancer is found (table 2). Stage I cancer is limited to the testicle with no evidence of lymph node involvement. Stage II disease signifies the presence of lymph node involvement at predictable sites known for tumor spread within the abdomen or pelvis (retroperitoneum) and can be evaluated with CT scan. With Stage III, the cancer has spread to areas outside of these usual sites and may involve the lungs, distant lymph nodes, or other organs. Patients with Stage III cancer may have very high tumor marker concentrations on blood tests without evidence of tumor spread seen.