Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Dr. Lee was born in Shanghai, China, and received his college and medical training in the United States. He is fluent in English and three Chinese dialects. He graduated with chemistry departmental honors from Harvey Mudd College. He was appointed president of AOA society at UCLA School of Medicine. He underwent internal medicine residency and gastroenterology fellowship training at Cedars Sinai Medical Center.
Benjamin Miller* was shocked to learn he had prostate cancer.
"I had absolutely no family history of prostate cancer," Miller says. "I was very active, had no symptoms, and had an excellent diet."
Miller has since spent a great deal of time over the past five years mentoring men who have been recently diagnosed with prostate cancer, and although he generally avoids suggesting one treatment option over another, he spends even more time answering the questions he says that doctors won't answer.
"There are so many details that the doctors don't tell you because they don't want to spook you," Miller says.
He believes the biggest piece of advice he can give other men experiencing the same condition he struggled through would be that it never hurts to double-check, stressing the importance of testing and re-testing to ensure complete accuracy.
The prostate gland is an organ that
is located at the base or outlet (neck) of the urinary bladder. (See the
diagram that follows.) The gland surrounds the first part of the urethra. The urethra is the passage through which urine drains from the bladder to exit from the penis. One function of the prostate gland is to help control urination by pressing directly against the part of the urethra that it surrounds. The main function of the prostate gland is to produce some of the substances that are found in normal semen, such as minerals and sugar. Semen is the fluid that transports the sperm to assist with reproduction. A man can manage quite well, however, without his prostate gland. (See the section on surgical treatment for prostate cancer.)
In a young man, the normal prostate gland is the size of a walnut (<30g). During normal aging, however, the gland usually grows larger. This hormone-related enlargement with aging is called benign prostatic hyperplasia (BPH), but this condition is not associated with prostate cancer. Both BPH and prostate cancer, however, can cause similar problems in older men. For example, an enlarged prostate gland can squeeze or impinge on the outlet of the bladder or the urethra, leading to difficulty with urination. The resulting symptoms commonly include slowing of the urinary stream and urinating more frequently, particularly at night. Patients should seek medical advice from their urologist or primary-care physician if these symptoms are present.
What is prostate cancer?
Prostate cancer is a malignant (cancerous) tumor (growth) that consists of cells from the prostate gland. Generally, the tumor usually grows slowly and remains confined to the gland for many years. During this time, the tumor produces little or no symptoms or outward signs (abnormalities on physical examination). However, all prostate cancers do not behave similarly. Some aggressive types of prostate cancer grow and spread more rapidly than others and can cause a significant shortening of life expectancy in men affected by them. A measure of prostate cancer aggressiveness is the Gleason score (discussed in more detail later in this article), which is calculated by a trained pathologist observing prostate biopsy specimens under the microscope.
As the cancer advances, however, it can spread beyond the
prostate into the surrounding tissues (local spread). Moreover, the cancer also
can metastasize (spread even farther) throughout other areas of the body, such
as the bones, lungs, and liver. Symptoms and signs, therefore, are more often
associated with advanced prostate cancer.
Why is prostate cancer
important?
Prostate cancer is the most common malignancy in American men and the second leading cause of deaths from cancer, after lung cancer. According to
the American Cancer Society's most recent estimates, 192,280 new cases of prostate cancer would be diagnosed in 2009 and 27,360 would die from the disease.
The estimated lifetime risk of being diagnosed with the disease is 17.6% for Caucasians and 20.6% for African Americans. The lifetime risk of death from prostate cancer similarly is 2.8% and 4.7% respectively. As reflected in these numbers, prostate cancer is likely to impact the lives of a significant proportion of men that are alive today.
Over the years, however, the death rate from this disease has shown a steady decline, and currently, more than 2 million men in the U.S. are still alive after being diagnosed with prostate cancer at some point in their lives.
Although it is subject to some controversy, many experts in this field, therefore, recommend that beginning at age 40, all men should undergo screening for prostate cancer.
Prostatitis is a painful condition of the prostate gland. There are four types of prostatitis, acute bacterial, chronic bacterial, chronic pelvic pain syndrome, and asymptomatic inflammatory prostatitis. Diagnosis is made with a digital rectal exam, urinalysis, ultrasound, MRI, biopsy, or blood test. Treatment depends upon the type of prostatitis.
Cancer is a disease caused by an abnormal growth of cells, also called malignancy. It is a group of 100 different diseases, and is not contagious. Cancer can be treated through chemotherapy, a treatment of drugs that destroy cancer cells.
Impotence, also known as erectile dysfunction, is a common
problem among men characterized by the consistent inability to sustain an
erection sufficient for sexual intercourse or the inability to achieve
ejaculation, or both. Impotence can have emotional causes but most often it is
due to a physical problem.
Hydronephrosis is a condition in which the kidney swells, due to a backup of urine. Hydronephrosis generally occurs with another disease.Symptoms of hydronephrosis include nausea, vomiting, urinary tract infection, fever, painful urination, increased urinary frequency and urgency, flank pain, and swelling of the abdomen. Treatment of hydronephrosis depends on the cause.
Benign prostatic hyperplasia (BPH or enlarged prostate) is very common in men over 50 years of age. This noncancerous enlargement of the prostate can impede urine flow, slow the flow of urine, create the urge to urinate frequently and cause other symptoms like complete blockage of urine and urinary tract infections. Treatment may involve watchful waiting, medication, or surgery.
Though it's difficult to say why some people develop cancer while others don't, research shows that certain risk factors increase a person's odds of developing cancer. These risk factors include growing older, family history of cancer, diet, alcohol and tobacco use, and exposure to sunlight, ionizing radiation, certain chemicals, and some viruses and bacteria.
There are many types of urinary incontinence (UI), which is the accidental leakage of urine. These types include stress incontinence, urge incontinence, and overflow incontinence. Urinary incontinence in men may be caused by prostate or nerve problems. Treatment depends upon the type and severity of the UI and the patient's lifestyle.
Enjoying a satisfying sex life as we age is important to both physical and mental health. As we age, diseases and conditions may pose challenges in our sexual health, and sexual experiences. Learn how to manage your conditions and still have a gratifying sex life as you age.
Men's health is an important component to a happy lifestyle and healthy relationships. Eating healthy, exercise, managing stress, and knowing when to have medical tests for a particular age is key to disease prevention in men.
Most often, caregivers take care of other adults who are ill or disabled. Less often, caregivers are grandparents raising their grandchildren. The majority of caregivers are middle-aged women. Caregiving can be very stressful, so it's important to recognize when it's putting to much strain on you and to take steps to prevent/relieve stress.
Disease prevention in men includes routine screening tests that are part of basic prevention medicine. Take an active role in your own health care and discuss screening tests with your doctor early in life. Age of screening and timing of screening depends upon the condition being assessed.
Routine screening tests are part of basic prevention medicine. All of the
following screening tests are commonly available through your doctor. Take an active role
in your own health care and discuss screening tests with your doctor early in
life. Following is a list of diseases for which screening is recommended along
with mention of the commonly used screening tests, which usually are safe and
simple and can help detect many diseases before they become harmful.
High blood pressure (hypertension)
About one-sixth of all Americans have
high blood pressure and the incidence
of this disease increases with age. African-Americans are more likely than other
races to have high blood pressure.
High blood pressure can cause arterial disease (atherosclerosis) that can
lead to heart attack, congestive heart failure, stroke, and kidney failure.