OSTEOPOROSIS, CANCER, HYPERTENSION DON'T ONLY STRIKE THE OLD, SAYS EMORY HEALTHCARE INTERNIST

August 15, 1997

Media Contacts: Traci Simmons, 404/727-8599 -- tgsimmo@emory.edu
http://www.emory.edu/WHSC/

Do not be fooled by the immortality of youth, for many diseases "only old people get" are diagnosed in the robust youth, as well, says internist David Perling, M.D., of The Emory Clinic Perimeter, EMORY HEALTHCARE. Yes, osteoporosis, several types of cancers, high blood pressure and thyroid abnormalities are among the chronic illnesses that may affect college-aged teenagers and young adults, he says.

OSTEOPOROSIS: Girls and young women who have the eating disorder anorexia nervosa and/or who have lean body mass from heavy participation in sports such as running, swimming, ballet or gymnastics are at risk for developing amenorrhea: irregular menstrual cycles. And having amenorrhea is like having menopause; circulating estrogen is reduced and cannot play as active a role in building strong bones.

Amenorrheic young women can and do develop osteoporosis (bone degeneration/skeletal instability) and scoliosis (curvature of the spine) that is irreversible, Dr. Perling says. Amenorrheic women who also participate in stressful sports like running also are at high risk for bone fractures.

Amenorrhea is easily treated with weight gain and hormonal therapy with oral contraceptives, Dr. Perling says.

THYROID DISORDERS: Chronically poor memory and fatigue may signal more than too many late-night study sessions, particularly if they are accompanied by constipation, weight gain or a doughy feel to the skin, Dr. Perling says. A sluggish metabolism caused by an underactive thyroid gland (called hypothyroidism) can profoundly affect the body.

The thyroid is really the body's thermostat, he says. It regulates metabolism, pulse, blood pressure, caloric regulation and even the menstrual cycle. A number of factors can suppress the thyroid, including viruses, autoimmune responses to environmental factors and tumors (though uncommon in young adults). And if the gland is temporarily "revved up to the point it burns itself out," Dr. Perling says, its hormonal activity is, of course, inhibited. Daily, lifetime hormonal therapy is the treatment of choice for hypothyroidism, he says.

HIGH BLOOD PRESSURE: Headaches, blurred vision, decreased stamina and feeling that "I don't have the cardiovascular fitness I used to" may signal the presence of high blood pressure (hypertension), particularly if a young person has family members who are being treated for the condition. Hypertension is characterized by blood vessels that just can't relax. Like a garden hose hooked up to a fire hydrant, constricted blood vessels become highly stressed -- and put the body at risk for a variety of heart conditions, Dr. Perling says. Fortunately, having one's blood pressure checked has become synonymous with most any visit to the doctor, so the high blood pressure usually will not go undetected. Once diagnosed with hypertension, lifestyle modification and medications that dilate blood vessels keep blood pressure in check.

CANCER: Young adults are immune to most cancers, but not all, says Dr. Perling. Cancers of the cervix, testes, skin and blood all may occur in college-aged persons. Young women, he says, who are sexually active should routinely receive PAP smears to screen for cervical dysplasia Ò abnormal cervical cells that have the potential to become cancerous.

Cervical dysplasia is very common, Dr. Perling says. It is related to sexual activity and the use of certain contraceptives. During the 1930s and 40s cervical cancer was extremely devastating, but use of the routine PAP smear has changed that.

The male counterpart to cervical cancer is testicular cancer, he says. Young men should make it a habit to check the testicles for asymmetry about once a month while in the shower, just as women should routinely perform breast self exams, Dr. Perling says.

Skin cancer does occur in young adults, he says, particularly those who grew up in southern parts of the country where "baby oil was the sunscreen of choice." He advises students to wear sunblock with a minimum spf (sun protection factor) of 15 and to not be shy about showing doctors unusual spots on the skin.

The Emory Clinic Perimeter is located at 875 Johnson Ferry Rd., Atlanta.

For more general information on The Robert W. Woodruff Health Sciences Center, call Health Sciences News and Information at 404-727-5686, or send e-mail to hsnews@emory.edu.