Routine Health Screenings

Determined upon the average of two or more properly measured readings at each of two or more office visits after an initial screening.

Hypertension blood pressure readings show a systolic of 140 mmHg or higher and diastolic of 90 mmHg or higher

Frequency of Screening:

Normal: every 2 years

Prehypertension: every year Stage I Hypertension: Confirm within two months (systolic blood pressure of 140-159 mmHg or diastolic blood pressure of 90-99 mmHg).

Stage II: Evaluate within one month (systolic blood pressure of 160 mmHg or higher or diastolic blood pressure of 100 mmHg or higher).

Hypertensive crisis: immediate attention required (higher than 180/110 mmHg)

Prevention:

Weight loss

Low sodium diet

Reduced alcohol consumption 

Increased physical activity  

Hyperlipidemia 
(high cholesterol)
 

Diagnosed by the results of a fasting lipoprotein profile including total cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein cholesterol (HDL), and triglycerides.

Frequency of Screening; **
Men older than 35: every 5 years (if results are normal)

Men aged 20-35: every 5 years unless they are at increased risk for heart disease

Women older than 20: screen only if at an increased risk for heart disease

Prevention: 
Weight control 

Dietary changes

Regular physical activity

Smoking prevention or cessation

Skin Cancer
(Collection of abnormal skin cells. Usually found in moles or other spots on the skin)

Screening: 
Visual examination criteria: 

 A = asymmetry (one half of the mole does not match the other half).

B = border irregularity (edges of the mole are ragged, notched, or blurred).

C = color (pigmentation of the mole is not uniform, with varying degrees of tan, brown, or black)

.
D = diameter of more than ¼ inch (about the size of a pencil eraser).

E = evolving (the mole is changing over time).

Stool Test: checks for the presence of blood in the stool

Colonoscopy: To check inside the colon and rectum for abnormalities

Flexible sigmoidoscopy: To check the lower colon for abnormalities

Multi-targeted stool DNA testing: stool sample that checks for DNA mutations and blood

CT colonography: Using X-rays to see images of the colon

Two types of screening: 

1.    Prostate-specific antigen (PSA) blood test: Checks for high amounts of PSA. However high PSA does not always indicate prostate cancer

2.    Digital rectal exam: doctor inserts a gloved, lubricated finger into the rectum to feel the prostate for lumps or anything else unusual

Diabetes Mellitus Type 2 

The pancreas struggles to produce enough insulin. 

Myeloma patients have increased blood sugar levels, especially those on a long-term steroid therapy treatment.

Various kinds of blood tests, including:

A1C (reflects average blood sugar levels for the past 2-3 months)

Glucose tolerance test (determines how well your body processes sugar)

Fasting blood glucose

Frequency: 

Before age 50, tests should be conducted every 10 years 

Patients 50 and older should be screened every 3 years

Smoking
Patients with myeloma are already at greater risk for shortness of breath (dyspnea) and smoking will worsen this condition

Can also cause other cancers

Increases the risk of pulmonary infections

Health care providers will ask if you are an active smoker

Counseling following guidelines to stop the use of tobacco in myeloma patients

Alcohol 

Contributes to increased risk for liver disease, high blood pressure, inflammation of the pancreas, cancer, and mental dysfunction

Health care providers will ask if you about your alcohol consumption

Counselling: 

Face-to-face sessions

Written self-help materials

Computer-based programs

Telephone counselling

During counseling, healthcare professionals work with patients on various strategies, such as action plans, drinking diaries, stress management, and problem-solving.

For the general population, but also essential for immunocompromised (myeloma) patients. 

Should be offered in early autumn, however, can be offered year-round when an outbreak is detected in the community. 

Immunocompromised patients with multiple myeloma are at risk for developing pneumococcal disease. 
There are two types of the vaccination: 

1. the pneumococcal polysaccharide vaccine

2. the pneumococcal conjugate vaccine

Tetanus Booster 

After transplantation, a patient remains immunocompromised for 6-12 months. 

Immunizations such as polio, tetanus toxoid, diphtheria toxoid, pneumococcus, hepatitis B, haemophilus influenzae type B conjugate, and measles, mumps, and rubella, should be given to the patient as per the recommendations of the transplantation center.

General dental care includes brushing teeth twice daily, cleaning between the teeth daily with floss or an interdental cleaner, and seeing the dentist regularly for examinations (including X-rays, if warranted), and professional cleaning.

Minimum twice-yearly visits to the dentist is required to maintain good oral hygiene.

For myeloma patients there is risk of reduced blood flow to the bone in the jaw which can be prevented, diagnosed, and treated by an oral health care provider

Direct inspection and palpation (feeling with the fingers or hands) of the oral cavity is the most recommended method of screening for oral cancer, which can be completed by a dentist during routine visits.

Smoking: increases risk for oral cancer

Alcohol Combined with Smoking: increases risk of oral cancer