thumb The<unk>  is part of the male reproductive system that helps make and store seminal fluid. In adult men, a typical<unk>  is about 3 cm long and weighs about 20 g. It is located in the pelvis, under the urinary bladder and in front of the rectum. The<unk>  surrounds part of the urethra, the tube that carries urine from the bladder during urination and semen during ejaculation. The<unk>  contains many small glands, which make about 20% of the fluid constituting semen. Superiorly, the<unk>  base is contiguous with the bladder outlet. Inferiorly, the<unk> 's apex heads in the direction of the urogenital diaphragm, which is pointed anterio-inferiorly. The<unk>  can be divided into four anatomic spaces: peripheral, central, transitional, and anterior fibromuscular stroma. The peripheral space contains the posterior and lateral portions of the<unk> , as well as the inferior portions of the<unk> . The central space contains the superior portion of the<unk>  including the most proximal aspects of the urethra and bladder neck. The transitional space is located just anterior to the central space and includes urethra distal to the central gland urethra. The neurovascular bundles course along the posterolateral<unk>  surface and penetrate the<unk> c<unk> sule there as well. Most of the glandular tissue is found in the peripheral and central zones (peripheral zone: 70-80% of glandular tissue; central zone: 20% of glandular tissue). Some is found in the transitional space (5% of glandular tissue). Thus, most cancers that develop from glandular tissue are found in the peripheral and central spaces, while about 5% is found in the transitional space. None is found in the anterior fibromuscular stroma since no glands are in that anatomic space. The<unk>  glands require male hormones, known as androgens, to work properly. Androgens include testosterone, which is made in the testes; dehydroepiandrosterone, made in the adrenal glands; and dihydrotestosterone, which is converted from testosterone within the<unk>  itself. Androgens are also responsible for secondary sex characteristics such as facial hair and increased muscle mass. Because of the<unk> 's location,<unk>  diseases often affect urination, ejaculation, and rarely defecation. In<unk> , the cells of these glands mutate into cancer cells.<unk>  that has metastasized to the lymph nodes<unk>  that has metastasized to the bone Most<unk> s are classified as adenocarcinomas, or glandular cancers, that begin when semen-secreting gland cells mutate into cancer cells. The region of the<unk>  gland where the adenocarcinoma is most common is the peripheral zone. Initially, small clumps of cancer cells remain within otherwise normal<unk>  glands, a condition known as carcinoma in situ or<unk> c intraepithelial neoplasia (PIN). Although no proof establishes that PIN is a cancer precursor, it is closely associated with cancer. Over time, these cells multiply and spread to the surrounding<unk>  tissue (the stroma) forming a tumor. Eventually, the tumor may grow large enough to invade nearby organs such as the seminal vesicles or the rectum, or tumor cells may develop the ability to travel in the bloodstream and lymphatic system.<unk>  is considered a malignant tumor because it can invade other areas of the body. This invasion is called metastasis.<unk>  most commonly metastasizes to the bones and lymph nodes, and may invade the rectum, bladder, and lower ureters after local progression. The route of metastasis to bone is thought to be venous, as the<unk> c venous plexus draining the<unk>  connects with the vertebral veins. The<unk>  is a zinc-accumulating, citrate-producing organ. Transport protein ZIP1 is responsible for the transport of zinc into<unk>  cells. One of zinc's important roles is to change the cell's metabolism to produce citrate, an important semen component. The process of zinc accumulation, alteration of metabolism, and citrate production is energy inefficient, and<unk>  cells require enormous amounts of energy (ATP) to accomplish this task.<unk>  cells are generally devoid of zinc.<unk>  cells save energy by not making citrate, and use the conserved energy to grow, reproduce and spread. The absence of zinc is thought to occur via silencing the gene that produces ZIP1. It is called a tumor suppressor gene product for the gene SLC39A1. The cause of the epigenetic silencing is unknown. Strategies that transport zinc into transformed<unk>  cells effectively eliminate these cells in animals. Zinc inhibits NF-κB pathways, is antiproliferative, and induces apoptosis in abnormal cells. Unfortunately, oral ingestion of zinc is ineffective since high concentrations of zinc into<unk>  cells is not possible without ZIP1. Loss of cancer suppressor genes, early in<unk> c carcinogenesis, have been localized to chromosomes 8p, 10q, 13q, and 16q. P53 mutations in the primary<unk>  are relatively low and are more frequently seen in metastatic settings, hence, p53 mutations are a late event in the pathology. Other tumor suppressor genes that are thought to play a role include PTEN and KAI1. "Up to 70 percent of men with<unk>  have lost one copy of the PTEN gene at the time of diagnosis". Relative frequency of loss of E-cadherin and CD44 has also been observed. Loss of the retinoblastoma (RB) protein induces androgen receptor deregulation in castration-resistant<unk>  by deregulating 'E2F1 expression. The factors that drive disease progression and clinical prognosis remain only partly understood but a variety of molecular determinants has been identified that appear to be involved. The most important of these might be the tyrosine phosphatase ACP1 of which the expression might outperform the Gleason grading system for predicting disease course. Other molecules identified include the transcription factor RUNX2 which may prevent cancer cells from undergoing apoptosis, the PI3k/Akt signaling cascade in conjunction with the transforming growth factor beta/SMAD signaling cascade that also protect against apoptosis. Pim-1 is upregulated in<unk> . X-linked inhibitor of apoptosis (XIAP) is hypothesized to promote cancer cell survival and growth, the Macrophage inhibitory cytokine-1 (MIC-1) that stimulates the focal adhesion kinase (FAK) signaling pathway. Nevertheless, it is fair to say that the molecular factors that determine why some patients have quiescent disease while otherdisplay prognosis remain largely obscure. The androgen receptor helps cancer cells to survive.<unk> -specific membrane antigen (PSMA) stimulates cancer development by increasing folate levels, helping the cancer cells to survive and grow; it increases available folates for use by hydrolyzing glutamated folates.
Prostate cancer
Benign prostatic hyperplasia
Bladder cancer
Penile cancer
Testicular cancer
Urethral cancer
Breast cancer
Kidney cancer