Prostate Cancer and Seminal Vesicles Cancer – Lessons Learned from the Commonest and the Rarest Malignancy Types in Men
Main Article Content
Abstract
Purpose: The prostate and the seminal vesicles (SVs) are analogous in terms of pelvic location, function, and response to hormones; however, prostate cancer (PC) is the most common cancer in men, whereas adenocarcinoma of the SVs is one of the rarest cancer types. This manuscript studies the similarities and dissimilarities between these organs and through them attempts to provide insights into the pathogenesis of PC.
Views: The number of prostatic luminal (the origins cells of PC) and SV cells is similar (1.5 × 109 and 1.9 × 109 cells), and so is the number of daily mitotic cycles in these organs (3 × 106 in the prostate and 3.8 × 106 in the SVs). Thus, numerical differences cannot account for the difference in cancer incidence. Nevertheless, remarkable anatomical and physiological differences can be noted. The SVs are surrounded by loose connective tissue, whereas the prostate is surrounded by a non-expandable collagenous-muscular capsule. The SVs excrete into two thin and long ducts, whereas the prostate into multiple short ducts. The prostate is subjected to the high pressure generated by the contractions of the levator ani muscle on which it lies. By the end of the contraction, the intra-prostatic pressure drops, and urine is sucked from the urethra to the acini, exposing them to high concentrations of pro-inflammatory substances, such as monosodium-urate. Repeated exposures to high pressure and to urine initiate prostatic inflammation, commonly observed in prostate biopsies, but exceedingly rare in SVs. Inflammation promotes proliferative inflammatory atrophy which can degenerate into prostatic intraepithelial neoplasia and to PC. Neutralizing the deleterious components of urine could possibly prevent PC.
Conclusions: The prostate and SVs are similar in number of cells and in daily mitotic cycles. The prostate with its non-expandable capsule and short excretory ducts is repeatedly exposed to urine at high pressures. This offence initiates a chain of events that starts with inflammation and continues with proliferative inflammatory atrophy and PC. The SVs are not exposed to these insults.
Keywords:
Prostate cancer, Adenocarcinoma of the seminal vesicles, Urine reflux, Intraprostatic pressure, Proliferative inflammatory atrophy
Article Details
How to Cite
GOFRIT, Ofer N..
Prostate Cancer and Seminal Vesicles Cancer – Lessons Learned from the Commonest and the Rarest Malignancy Types in Men.
Medical Research Archives, [S.l.], v. 13, n. 5, may 2025.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/6566>. Date accessed: 21 june 2025.
doi: https://doi.org/10.18103/mra.v13i5.6566.
Section
Research Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
References
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2. Lee YI, Lee HM, Jo JK, Lee S, Hong SK, Byun SS, Lee SE, Oh JJ. Association between Seminal Vesicle Invasion and Prostate Cancer Detection Location after Transrectal Systemic Biopsy among Men Who Underwent Radical Prostatectomy. PLoS One. 2016;11:e0148690. doi: 10.1371/journal.pone.0148690. PMID: 26848747; PMCID: PMC4743841.
3. Galosi AB, Milanese G, Montesi L, Cimadamore A, Franzese C, Palagonia E, Chiacchio G, Castellani D. The pathway of isolated seminal vesicle invasion has a different impact on biochemical recurrence after radical prostatectomy and pelvic lymphadenectomy. Urol Oncol. 2023;41:293.e9-293.e14. doi: 10.1016/j.urolonc.2023.03.011. Epub 2023 May 2. PMID: 37142452.
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12. Wadhera P. An introduction to acinar pressures in BPH and prostate cancer. Nat Rev Urol. 2013;10:358-66. doi: 10.1038/nrurol.2013.86. Epub 2013 May 14. PMID: 23670181.
13. Hegarty PK, Watson RW, Coffey RN, Webber MM, Fitzpatrick JM. Effects of cyclic stretch on prostatic cells in culture. J Urol. 2002;168:2291-5. doi: 10.1016/S0022-5347(05)64373-X. PMID: 12394777.
14. Nelson G, Culberson DE, Gardner WA Jr. Intraprostatic spermatozoa. Hum Pathol. 1988 May;19(5):541-4. doi: 10.1016/s0046-8177(88)80201-6. PMID: 3371978.
15. Kirby RS, Lowe D, Bultitude MI, Shuttleworth KE. Intra-prostatic urinary reflux: an aetiological factor in abacterial prostatitis. Br J Urol. 1982;54:729-31. doi: 10.1111/j.1464-410x.1982.tb13635.x. PMID: 7150931.
16. Mitty HA. Roentgen features of reflux into the prostate, seminal vesicles and vasa deferentia. Am J Roentgenol Radium Ther Nucl Med. 1971;112:603-6. doi: 10.2214/ajr.112.3.603. PMID: 5570373.
17. Hekimsoy T, Gorur GD, Isgoren S, Uslu H, Demir H. Urinary Reflux Into the Prostate Gland and Seminal Vesicles: A Potential Pitfall in 18F-FDG and 68Ga-PSMA PET/CT. Clin Nucl Med. 2020;45:536-537. doi: 10.1097/RLU.0000000000003069. PMID: 32433177.
18. Chen X, Zhao J, Salim S, Garcia FU. Intraprostatic spermatozoa: zonal distribution and association with atrophy. Hum Pathol. 2006;37:345-51. doi: 10.1016/j.humpath.2005.11.011. PMID: 16613330.
19. Pettersson L, Tranberg J, Abrahamsson K, Pettersson S, Sillen U, Jonsson O. Half century of followup after ureterosigmoidostomy performed in early childhood. J Urol. 2013;189:1870-5. doi: 10.1016/j.juro.2012.11.179. Epub 2012 Dec 5. PMID: 23220244.
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21. Filmer RB, Spencer JR. Malignancies in bladder augmentations and intestinal conduits. J Urol. 1990;143:671-8. doi: 10.1016/s0022-5347(17)40055-3. PMID: 2179579.
22. Castellan M, Gosalbez R, Perez-Brayfield M, Healey P, McDonald R, Labbie A, Lendvay T. Tumor in bladder reservoir after gastrocystoplasty. J Urol. 2007;178(4 Pt 2):1771-4; discussion 1774. doi: 10.1016/j.juro.2007.05.100. Epub 2007 Aug 17. PMID: 17707009.
23. Buson H, Diaz DC, Manivel JC, Jessurun J, Dayanc M, Gonzalez R. The development of tumors in experimental gastroenterocystoplasty. J Urol. 1993;150:730-3. doi: 10.1016/s0022-5347(17)35599-4. PMID: 8326635.
24. Li XH, Zhang YT. Skene gland adenocarcinoma of the urethra: A systematic review. Asian J Surg. 2024;47:1587-1588. doi: 10.1016/j.asjsur.2023.12.023. Epub 2023 Dec 14. PMID: 38102007.
25. Puhr M, De Marzo A, Isaacs W, Lucia MS, Sfanos K, Yegnasubramanian S, Culig Z. Inflammation, Microbiota, and Prostate Cancer. Eur Urol Focus. 2016;2:374-382. doi: 10.1016/j.euf.2016.08.010. Epub 2016 Aug 28. PMID: 28723469.
26. Aglamis E, Tasdemir C, Ceylan C. The role of National Institutes of Health category IV prostatitis in accurately staging the newly diagnosed prostate cancer. Ir J Med Sci. 2013;182:463-7. doi: 10.1007/s11845-013-0914-1. Epub 2013 Feb 1. PMID: 23370973.
27. Aglamis E, Ceylan C, Akin MM. Is there a correlation between the aggressiveness of chronic asymptomatic prostatitis National Institutes of Health category IV and the Gleason score in patients with prostate cancer? Can Urol Assoc J. 2020;14:E568-E573. doi: 10.5489/cuaj.6284. PMID: 32520704; PMCID: PMC7673826.
28. Irani J, Goujon JM, Ragni E, Peyrat L, Hubert J, Saint F, Mottet N. High-grade inflammation in prostate cancer as a prognostic factor for biochemical recurrence after radical prostatectomy. Pathologist Multi Center Study Group. Urology. 1999;54:467-72. doi: 10.1016/s0090-4295(99)00152-1. PMID: 10475356.
29. Platz EA, Kulac I, Barber JR, Drake CG, Joshu CE, Nelson WG, Lucia MS, Klein EA, Lippman SM, Parnes HL, et al. A Prospective Study of Chronic Inflammation in Benign Prostate Tissue and Risk of Prostate Cancer: Linked PCPT and SELECT Cohorts. Cancer Epidemiol Biomarkers Prev. 2017;26:1549-1557. doi: 10.1158/1055-9965.EPI-17-0503. Epub 2017 Jul 28. PMID: 28754796; PMCID: PMC5626618.
30. Guerville F, Bourdel-Marchasson I, Déchanet-Merville J, Pellegrin I, Soubeyran P, Appay V, Lemoine M. Does Inflammation Contribute to Cancer Incidence and Mortality during Aging? A Conceptual Review. Cancers (Basel). 2022;14:1622. doi: 10.3390/cancers14071622. PMID: 35406394; PMCID: PMC8996949.
31. Henrique R, Jerónimo C. Molecular detection of prostate cancer: a role for GSTP1 hypermethylation. Eur Urol. 2004;46:660-9; discussion 669. doi: 10.1016/j.eururo.2004.06.014. PMID: 15474280.
32. De Marzo AM, Platz EA, Sutcliffe S, Xu J, Grönberg H, Drake CG, Nakai Y, Isaacs WB, Nelson WG. Inflammation in prostate carcinogenesis. Nat Rev Cancer. 2007;7:256-69. doi: 10.1038/nrc2090. PMID: 17384581; PMCID: PMC3552388.
33. De Marzo AM, Marchi VL, Epstein JI, Nelson WG. Proliferative inflammatory atrophy of the prostate: implications for prostatic carcinogenesis. Am J Pathol. 1999;155:1985-92. doi: 10.1016/S0002-9440(10)65517-4. PMID: 10595928; PMCID: PMC1866955.
34. Dinarello CA. An expanding role for interleukin-1 blockade from gout to cancer. Mol Med. 2014;20 Suppl 1(Suppl 1):S43-58. doi: 10.2119/molmed.2014.00232. PMID: 25549233; PMCID: PMC4374514.
35. Martinon F, Pétrilli V, Mayor A, Tardivel A, Tschopp J. Gout-associated uric acid crystals activate the NALP3 inflammasome. Nature. 2006;440:237-41. doi: 10.1038/nature04516. Epub 2006 Jan 11. PMID: 16407889.
36. Kuo CF, Luo SF, See LC, Chou IJ, Fang YF, Yu KH. Increased risk of cancer among gout patients: a nationwide population study. Joint Bone Spine. 2012;79:375-8. doi: 10.1016/j.jbspin.2011.09.011. Epub 2011 Nov 15. PMID: 22088929.
37. Shih HJ, Kao MC, Tsai PS, Fan YC, Huang CJ. Long-term allopurinol use decreases the risk of prostate cancer in patients with gout: a population-based study. Prostate Cancer Prostatic Dis. 2017;20:328-333. doi: 10.1038/pcan.2017.14. Epub 2017 Apr 11. PMID: 28398294.
38. Kukko V, Kaipia A, Talala K, Taari K, Tammela TLJ, Auvinen A, Murtola TJ. Allopurinol and the risk of prostate cancer in a Finnish population-based cohort. Prostate Cancer Prostatic Dis. 2019;22:483-490. doi: 10.1038/s41391-019-0129-2. Epub 2019 Jan 29. PMID: 30696944.
39. Lai SW, Hwang BF, Kuo YH, Liu CS, Liao KF. A meta-analysis of allopurinol therapy and the risk of prostate cancer. Medicine (Baltimore). 2022;101:e28998. doi: 10.1097/MD.0000000000028998. PMID: 35356907; PMCID: PMC10684161.
40. Thompson IM Jr, Goodman PJ, Tangen CM, Parnes HL, Minasian LM, Godley PA, Lucia MS, Ford LG. Long-term survival of participants in the prostate cancer prevention trial. N Engl J Med. 2013;369:603-10. doi: 10.1056/NEJMoa1215932. PMID: 23944298; PMCID: PMC4141537.
41. DuPre NC, Flavin R, Sfanos KS, Unger RH, To S, Gazeeva E, Fiorentino M, De Marzo AM, Rider JR, Mucci LA; Transdisciplinary Prostate Cancer Partnership(ToPCaP). Corpora amylacea in prostatectomy tissue and associations with molecular, histological, and lifestyle factors. Prostate. 2018;78:1172-1180. doi: 10.1002/pros.23692. Epub 2018 Jul 15. PMID: 30009541; PMCID: PMC6501556.