The seminal vesicles are a pair of small glands located behind the bladder and above the prostate gland in males. These glands produce a significant portion of the fluid that makes up semen, providing nutrients and aiding sperm motility. Primary cancer originating directly in the seminal vesicles is exceptionally rare.
What is Seminal Vesicle Cancer
Seminal vesicle cancer refers to malignant growths affecting these glands, which can be categorized as either primary or secondary. Primary seminal vesicle cancer originates within the seminal vesicles themselves, a condition so uncommon that only a few hundred cases have been documented in medical literature.
Secondary seminal vesicle cancer involves cancer that has spread to the seminal vesicles from a primary tumor located elsewhere in the body. Cancers of the prostate, bladder, or rectum are common sources for such metastatic spread due to their proximity. When primary seminal vesicle cancer does occur, it is most frequently diagnosed in men between 50 and 80 years old, with adenocarcinomas being the most prevalent histological type.
Identifying Symptoms
Symptoms associated with seminal vesicle cancer can be non-specific, making early detection challenging. Common indicators often involve changes in urinary or ejaculatory function.
Individuals may experience hematuria, which is the presence of blood in the urine, or hematospermia, characterized by blood in the semen. Pelvic pain, discomfort during ejaculation, or lower urinary tract symptoms such as frequent urination or difficulty emptying the bladder can also arise. These symptoms warrant medical evaluation.
How Seminal Vesicle Cancer is Diagnosed
Diagnosing seminal vesicle cancer typically begins with a comprehensive medical history review and a physical examination. The physical exam may include a digital rectal examination to assess the prostate and surrounding structures, including the seminal vesicles.
Imaging techniques play a significant role in visualizing potential tumors and determining their extent. Magnetic Resonance Imaging (MRI) of the pelvis offers detailed images of soft tissues, allowing clinicians to identify masses within the seminal vesicles and evaluate their relationship to nearby organs. Computed Tomography (CT) scans can also be used to assess the tumor’s size, spread to lymph nodes, or distant metastases.
A definitive diagnosis requires a biopsy, often performed using a transrectal ultrasound-guided approach. During this procedure, a needle is inserted through the rectum to obtain tissue samples from the suspected mass in the seminal vesicle. These samples are then examined under a microscope by a pathologist to confirm the presence of cancer cells and determine the specific type of tumor.
Blood tests, such as Prostate-Specific Antigen (PSA) levels, might be checked to rule out prostate cancer involvement, given the close anatomical proximity. Once confirmed, the cancer is typically staged using the TNM (Tumor, Node, Metastasis) classification system to describe the tumor’s size, involvement of lymph nodes, and presence of distant spread, guiding treatment decisions.
Treatment Options
Treatment for seminal vesicle cancer is often tailored based on the tumor’s stage, the patient’s overall health, and the specific characteristics of the cancer. Given its rare nature, treatment strategies are frequently guided by approaches used for more common genitourinary cancers like prostate or bladder cancer. Surgical resection is generally considered the primary treatment for localized disease.
This can involve a radical prostatectomy with seminal vesiculectomy, where the prostate gland and seminal vesicles are removed together. For more extensive disease, a pelvic exenteration, which involves removing multiple organs in the pelvic region, might be considered if the cancer has spread locally but remains resectable.
Radiation therapy, specifically external beam radiation, may be used as an adjuvant treatment after surgery to eliminate any remaining cancer cells or as a primary treatment if surgery is not feasible. Chemotherapy, a systemic treatment, is typically reserved for advanced or metastatic disease to target cancer cells throughout the body. In cases where standard treatments are not effective or for very rare or aggressive forms, targeted therapies that focus on specific molecular pathways involved in cancer growth or enrollment in clinical trials investigating new treatments may be considered.