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Transrectal color dopplar shows lesion in peripheral zone of prostate - should I be worried?

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Posted 6/26/2013 5:46 PM (GMT 0)
Hi Community,

I am very confused as I just had a transrectal color dopplar done by the respected Dr. Duke Bahn in Ventura. He found a lesion in the left peripheral zone of my prostate showing increased blood flow, but said due to my PSA of 1.0 and free PSA of 46%, and my age of 31 it couldn't be cancer and that it is a sign of prostatitis and inflammation. So he did not do a biopsy.

But my prostatic fluid does not show any white blood cells under the microscope. So how could there be inflammation when there is no white blood cells?

My PSA went from 0.9 to 1.65 then came back down to 1.0.

Should I be worried about this lesion showing increased blood flow and slightly dark area on the sonograph?

I would not be worried if there were white blood cells in my prostatic fluid (indicating inflammation), but I don't have any white blood cells in my prostatic fluid, so there is no inflammation and there is this lesion there.
Posted 6/26/2013 6:11 PM (GMT 0)
Ultrasound , including with doppler, is not specific for prostate cancer. Inflammation of the prostate can occur without any patient symptoms, except elevated PSA. The odds of you having a prostate cancer at your age are extremely low. Now go enjoy life, and follow up with your doctor.
Posted 6/26/2013 11:21 PM (GMT 0)
Dr Bahn is probably the foremost expert in detecting PC in the US.
Given what you have posted the probability of you having PC is extremely low. Given the fact that Dr Bahn confirms this after a CDU makes that probability as close to zero as you can get.
Posted 6/27/2013 8:08 AM (GMT 0)
Thank you guys for the replies.
I just find it weird that there is a lesion, and Dr. Bahn saying it is an inflammation but I have no white blood cells in my prostatic fluid.

When there is non-bacterial prostatitis - there is white blood cells but no bacteria in culture.
When there is non-inflammatory prostatitis - there is no white blood cells and no inflammation.

I have never seen any papers or resources talking about inflammatory prostatitis without white blood cells.
I guess my concern is the contradicting evidence:
1) Low PSA and High FPSA, no family history of cancer means prostatitis (Dr. Bahn's logic)
2) Increased blood flow/dark area, but no white blood cells to indicate inflammation means it isn't inflammatory prostatitis.

Dr. Bahn did advice that I get a PSA test every 6-12 months and watch for trends. I guess he doesn't want to do a biopsy unless it is manifested as a progressive disease.

I changed my entire diet to anti-inflammatory and anti-oxidant with many different vegetables/fruits to counteract whatever that darkspot/high blood flow area is. Plus a high dose of vitamin D3 every day.

It probably isn't serious if we just go by PSA/FPSA, but I guess at least it caused me to change my diet completely.
Posted 6/27/2013 4:36 PM (GMT 0)
Thunder,
the way doctor Bahn performs a biopsy is to first calculate your psa density from your prostate size and look for a lesion that corresponds to the excess psa. Since you have no excess psa there is no need to biopsy. The prostatitis you may have could be very small and the bouncing around of your PSA is a reflection of prostatitis and not PC as PC is indicated by a consistent rising PSA and not one that bounces around. Keep getting PSA tests at a regular basis. Prostatitis is very difficult to cure in some cases. Did he recommend a course of antibiotics?
JT
Posted 6/27/2013 6:29 PM (GMT 0)
Dr. Bahn did not recommend antibiotics as I have no prostatitis symptoms and did not have white blood cells.
When my PSA went to 1.65 I got my prostatic fluid checked and there were no white blood cells in there, so I did not have an infection.
Prostatitis - whether bacterial or not - are generally marked by inflammation, but I did not have inflammation.

I guess whatever it is that I have now, will be helped by my drastic diet and lifestyle change.
If it is PIN or something, research has shown that diet and lifestyle changes can reverse it quite a bit.

I will continue this diet and lifestyle for the rest of my life as this legion is too mysterious and bothersome to me. The evidence are too contradicting.
Posted 6/27/2013 7:00 PM (GMT 0)
Well you know what they say, if you want to live a long life , get a chronic disease and take care of it.
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