Bladder cancer (BCa) is the second most common urological malignancy after prostate cancer and a major cause of morbidity and death with enormous health-related cost. Approximately, 75% of newly diagnosed BCa patients have non-muscle invasive bladder cancer (NMIBC). Of this group, 70% of patients experience post-treatment recurrence that requires lifelong monitoring and up to 25% progress to more advanced disease [1,2]. In contrast to NMIBC, muscle-invasive bladder cancer (MIBC) is highly metastatic with a 5-year survival rate of approximately 50% in patients undergoing treatment [3].

Alpha methylacyl A coenzyme racemase (AMACR) has shown to be an excellent immunohistological biomarker for prostate cancer (CaP). Given the connection between prostate and urethra, we hypothesized that semen ejaculate would be an ideal specimen for detection of CaP specific biomarkers, such as AMACR. This study explores the detection of semen AMACR protein in men with and without CaP.

Bladder cancer is the ninth most frequently diagnosed cancer worldwide, with the highest incidence rates observed in North America and Europe [1]. At the time of diagnosis, approximately 75% of bladder cancers are nonmuscle invasive, 50% of which are high-grade [2,3]. Progression rates of nonmuscle invasive bladder cancer (NMIBC) range from 10% to 30% at 5years [3]. Intravesical Bacillus Calmette-Guérin (BCG) immunotherapy is the mainstay of treatment for high-grade tumors; however, patients who fail BCG immunotherapy are at the highest risk of disease progression and may benefit from early radical cystectomy [4].