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.
Prostate cancer is diagnosed from the results of a biopsy
of the prostate gland. If the digital rectal exam of the prostate or the PSA
blood test is abnormal, a prostate cancer is suspected. A biopsy of the
prostate is usually then recommended. The biopsy is done from the rectum
(trans-rectally) and is guided by ultrasound images of the area. A small piece of prostate tissue is withdrawn through a cutting needle. The TRUS-guided Tru-Cut biopsy is currently the standard method to diagnose prostate cancer. Although initially a 6-core set was the standard, currently most experts advocate sampling a minimum of 10-12 pieces of the prostate to improve the chances of detection of the cancer and also to provide a better idea regarding the extent and areas of involvement within the prostate. Multiple pieces are taken by sampling the base, apex, and mid gland on each side of the gland. More cores may be sampled to increase the yield, especially in larger glands.
A pathologist, a specialist physician who analyzes tissue samples under a microscope, then examines the pieces under the microscope to assess the type of cancer present in the prostate and the extent of involvement of the prostate with the tumor. One also can get an idea about the areas of the prostate that are involved by the tumor by assessing which of the pieces contain the cancer and which of them do not. Another very important assessment that the pathologist makes form the specimen is the grade (Gleason's score) of the tumor. This indicates how different the cancer cells are from normal prostate tissue. Grade gives an indication of how fast a cancer is likely to grow and has very important implications on the treatment plan and the chances of cure after treatment. A Gleason score of 6 is supposed to indicate low-grade (less aggressive) disease while that of 8-10 demonstrates high grade (more aggressive) cancer; 7 is regarded as somewhere in between these two.
Prostate Cancer - Symptoms At Onset Of DiseaseQuestion: The symptoms of prostate cancer can vary greatly from patient to patient. What were your symptoms at the onset of your disease?
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.
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.
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.
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.
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.
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.
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.
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