Prevention Clinic

Medical examinations The preventive examinations that everyone should have at every stage of their life, under the guidance of their family doctor, are blood tests, imaging, endoscopic and even invasive in some cases.

Prevention is divided into primary and secondary. The tests we should have as part of primary prevention are based on our age, gender and family history. Secondary prevention involves monitoring an already diagnosed health condition in order to detect any deterioration or recurrence in time, i.e. it involves the patient's individual history. A fairly common example is that the first thyroid ultrasound is performed as part of primary prevention when indicated by our doctor, whereas once a nodule is detected in the gland, subsequent thyroid ultrasounds at a frequency that will again be indicated by the treating physician are now part of secondary prevention since we now monitor whether the nodule changes in size or ultrasound characters in order to intervene accordingly such as with FNA puncture or further imaging tests such as elastography or scintigraphy. There is of course tertiary prevention which often equates to the treatment of a condition and its complications, in the above case would be for example surgical removal of the thyroid gland if malignancy of the nodule is found from the primary or secondary prevention checks.

To better understand how family history influences primary prevention, a good example is the first screening colonoscopy. A man should undergo the first screening colonoscopy around the age of 45-50 years according to global guidelines but in the case where, for example, his father had colorectal cancer at the age of 50 years, then it should start much earlier, around the age of 40 years. A similar example is the first screening mammogram which, while it should be done around the age of 38 for a woman, if there is a positive history in her mother, for example, then it should be done several years earlier. It goes without saying that if a finding is found in the above primary prevention checks such as polyps in the bowel or morphomas in the breast, then regular follow-up as directed by the treating physician is part of secondary and possibly tertiary prevention.

Vaccinations: Vaccinations are an essential part of primary prevention and the need for specific vaccines is determined in each case by age, gender, the individual history of the patient, i.e. the co-morbidities that affect his/her vulnerability, as well as the epidemics and pandemics that occur around the world at various times. Examples are childhood and adult vaccines for the repeat dose every ten years of tetanus, vaccines for influenza, pneumococcal, shingles, Sars Cov2 due to the Covid 19 pandemic, but also adult vaccines in cases of major outbreaks of childhood diseases that affect the adult population as was the case a few years ago with measles.

Lifestyle: A particularly optimistic message is that an overall healthy lifestyle can be part of primary, secondary and even tertiary prevention. A Mediterranean diet, aerobic exercise and muscle strengthening with pilates-type exercises, adequate and quality sleep, avoiding harmful habits such as smoking and excessive alcohol consumption, managing stress and avoiding toxic interpersonal relationships, as well as strengthening the mental background through constant mental activity are all part of our path to a better quality of life. The ideal scenario is that we have managed to adopt all of the above as a lifestyle from a young age and that is where we talk about lifestyle as primary prevention. But even if we have not managed to do so and eventually some physical and mental health problems arise, it is not too late to change our lifestyle in order to slow down the progression of these diseases or even reverse them, and in this case we are of course talking about lifestyle as secondary prevention. But still in some cases lifestyle becomes a tertiary prevention, i.e. part of the treatment of the disease condition affecting our patient. A fairly obvious example is prediabetes and type 2 diabetes mellitus, as the Mediterranean diet and exercise are a valuable weapon in our quiver to prevent someone from developing prediabetes or type 2 diabetes even when they do develop it, with the right healthy dietary interventions we can slow down the progression from prediabetes to diabetes but also reverse prediabetes and if we finally reach the diagnosis of type 2 diabetes, the healthy lifestyle along with medication will shield our patient to slow down the disease and its macrovascular and microvascular complications, that is, it becomes part of the treatment and therefore part of tertiary prevention. There are, however, countless everyday examples of this, such as the fact that, as several valid and reliable studies have shown, learning a foreign language at the age of 50 can strengthen our cognitive background, shielding us against dementia, or even that a healthy social life with real relationships with people and animals can strengthen us mentally by enhancing our mental resilience against the psychologically stressful events of life and thus against the onset of mental disorders.

To sum up, with the help of our family doctor and the specialized doctors of other specialties, that is, with all the members of the medical world that each of us will initially choose and then trust, we can, with simple means of prevention, shield and protect our physical and mental health even in an era when morbidity seems inevitable.