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Show A&EDiversions Page 6 Thursday, Feb. 28, 2013 Health officials fret as hookah use grows BY KARA ROSE Capital News Service University of Maryland student Louie Dane was 18 when he first smoked tobacco with a hookah at a friend's house. "There's nothing that's not great about it. You get to be with some friends having a good time," he said. "I personally think cigarettes are disgusting ... Hookah doesn't seem as bad ... (because) it's more of a social thing." What Dane and most other fans of this increasingly popular method of smoking tobacco do not know is that one 25 - minute hookah session is equivalent to smoking a pack of cigarettes, health officials said. "People tend to inhale very deeply when they are using a hookah. They actually, in effect, get 20 times the amount of nicotine then when you smoke a single cigarette," said Donald Shell, who works on tobacco prevention efforts at the state Department of Health and Mental Hygiene. Hookah — also referred to as a narghile, shisha or waterpipe — allows users to smoke flavored tobacco that is filtered through a liquid, typically water. The tobacco is placed in the bowl of the hookah and heated with a coal. The smoke is then pulled through decorative hoses after first passing through the liquid. The practice originated in India and the Middle East in the middle of the last millennium and has since found its way into a growing number of college towns in the states. As more hookah lounges open, health officials said they are worried users do not fully understand the risks associated with the pastime. Cafe Hookah, which is set to open in College Park, Md., this month, will be the second hookah bar in the city. The cafe's owner, 29-year-old Abid Khan, said he chose to open the establishment because the "niche was available." "I think that it will be unique in the sense that — aside from making money — it's run by young people that actually care about the students," he said. Hookah tobacco contains many of the same harmful chemicals found in cigarettes and can cause similar long-term health effects, such as mouth cancer, lung cancer and cancer of the trachea, Shell said. "Hookahs are flavored and put in a nice setting when you are sitting and relaxing ... But that kind of socially attractive setting is really the vehicle for delivering a really potent dose of tobacco and carbon monoxide and other chemicals, too," Shell said. "There is no safe level of tobacco to consume," Shell said. "If you find that once you start AMMAR ZIRLI PUFFS on a hookah along with friends Yussef Assaf and Hassan Soueid while sitting at Off The Hookah at Las Olas Riverfront, in Fort Lauderdale, Fla. MCT photo smoking hookah and you feel like you have to go back, that's kind of a red flag." Matthieu Drotar, 20, said he first smoked hookah when he was 17. He now smokes hookah once every two or three weeks near the University of Maryland. "People like to try new exotic things, and the hookah bars try to recreate the feeling of being in Lebanon, or somewhere else," Drotar said. "I don't know any- where outside of a (hookah bar) that you can get that experience." Despite knowing some of the health risks associated with smoking hookah, Drotar said he was not worried. "If I were smoking every day I would be concerned about it," he said. Isabel Slettebak, a 21-yearold student at the University of Maryland School of Nursing in Baltimore City, said she smoked hookah for the first — and last — time when she was 20. "I guess I decided to do it `cause I was over 18 and I could. It seemed like a cool, older thing to try out," she said. "The place, it was way too smoky for me. After sitting for a while, it felt like I wasn't getting enough air. Then I tried smoking the hookah and it just felt like I had drank a cup of ashes," she said. `You're never too young:• Woman fighting breast cancer reaches out BY PATRICIA MONTEMURRI Detroit Free Press DETROIT — More than 2.5 million Americans are breast cancer survivors. Meghan Malley, 29, a physical therapist from Berkley, Mich., wants her name on that list. She's networking, rallying and blogging publicly about her disease to bring attention to the times when breast cancer isn't a lump. For about 5 percent to 10 percent of breast cancers, the warning signs may be a change in the feel of the breast or breast skin that becomes dimpled, puckered or reddened. "I want women to know that breast cancer doesn't always begin with a lump," said Malley, whose hair has grown back pixiecute after chemotherapy. "I want people to be aware that unfortunately you're never too young to get breast cancer." During a monthly self-breast exam in January 2010, Malley sensed something different about her right breast. She had experienced some jolts of pain in the breast, and felt a denseness, almost a change in its weight. After an ultrasound and mammogram, doctors said she had fibrocystic breasts, which can make breasts painful and lumpy in response to women's changing hormones, but isn't cancerous. A little over a year later, Malley was undergoing fertility treatments. She still was concerned about the changes she felt in her right breast and pressed her doctor for additional testing. She had an ultrasound, MEGHAN MALLEY HUGS friend Kyle Dorcey at a cancer group fundraiser in Royal Oa, Michigan, on Sept. 27, 2011. She was diagnosed with breast cancer at 29 and has recently finished a five-month round of chemotheraphy. She is starting a support group for young adults with cancer. MCT photo which showed distinct changes, but doctors thought it might be related to the hormones she was receiving for fertility treatments. But to be sure, she underwent a biopsy. On March 23 — two days after her 29th birthday — she learned that she had invasive lobular breast cancer, which occurs in about 5 percent of breast cancer patients. She started chemotherapy one day after she learned additional tests had detected cancerous spots on her spine, making it a Stage ■ I Where Utah Gets Engaged! S.E. Needham quality at Internet pricing. S.E. Needham jewelers since 1896 141 North Main • www.seneedham.com • 435-752-7149 • 4 — the deadliest of cancer diagnoses. "There's a lot of misconceptions about metastatic disease. They look at you like you're going to die any day," said Malley. And although it's scary, I feel that with more research and more funding, we can live a long time and live very fulfilling lives." Invasive lobular breast cancer forms in the milk-producing glands and causes an area of thickening in parts of the breasts, or sensations of fullness or swelling. It may also make the skin over the breast dimple or thicken. Malley's oncologist, Dr. Lawrence Flaherty of the Karmanos Cancer Institute, describes lobular breast cancer by likening breast tissue to spaghetti. "Most breast cancers are like a meatball in a bowl of spaghetti, so they're easy to find," said Flaherty. "Her particular type is more like a glob of meat sauce in a bowl of spaghetti." Malley will have a double mastectomy at Beaumont Hospital in Royal Oak, Mich., later this month after undergoing 15 rounds of chemotherapy to shrink the cancer in her right breast and take out the spots on her spine. The survival rate for women diagnosed with Stage 4 breast cancer is about 23 percent after five years. "She's gotten an excellent response in her treatment and her cancer is in remission," said Flaherty. "And based on that, her outlook is certainly a more favorable one. I have people in my practice who are five and 10 years and more years out with that stage of the disease." Flaherty says Malley may be a candidate for clinical trials of new drugs down the road. In 2010, about 27 percent of breast cancer patients at Karmanos participated in some 30 clinical trials involving drugs and other research. "We try to steer people into getting those opportunities when it makes good sense to do that in their care," he said. Malley has chosen to undergo a double-mastectomy and reconstruction, a choice she elected although no cancer has been found in her left breast. She will take tamoxifen, a drug that inhibits estrogen's impact on breast tissue, for at least the next five years. "For my own peace of mind, I wanted them gone. It was a very, very personal decision," said Malley, acknowledging that other women in her position might choose otherwise. "Many women could do the chemo, the radiation and the hormone therapy and see what happens. For me, I just wanted the original site gone." Because medical protocol doesn't require regular screenings of young women for breast cancer, delays in diagnosing can be a problem. Some medical providers may brush away patients' concerns about breast cancer because of their youth. Also, it is more difficult to detect abnormalities in the breasts of younger women because their tissue is denser. From an early age, Malley began self exams. When she was 21, her gynecologist felt a lump in Malley's right breast during an annual exam. A biopsy revealed that it was a benign cyst. Doctors said she didn't need to have it removed, but Malley opted to have it surgically excised. Malley, fit and lithe, was a regular runner before her illness, took yoga classes and did weight-training. She hopes to resume regular exercise, but needs to be vigilant about what kind of pressure she puts on her spine, as it heals. "Being a physical therapist, I know how to modify things for exercises to be safe for my own back," said Malley. She wants to take up swimming because it is gentle on the joints and will help her build up the range of motion in her arms after her mastectomy. Her friends and family have buoyed her in every way. In May, nine friends ran in the annual Komen Race for the Cure in her honor, raising more than $5,000. Another group of nine friends and co workers trudged through the 60-mile Susan G. Komen 3-Day for the Cure in August, raising $30,000 for research. Malley organized a support group meeting for young cancer survivors like herself at the Karmanos Institute's Weisberg Cancer Treatment Center in Farmington Hills, Mich., with Kathleen Hardy, an oncology social worker, as facilitator. "The issues are so different when you're young," said Hardy. "As much as family and friends love and care for you and support you in every way, they don't really get it in the same way as the others with cancer get it." Hardy said numerous studies show the benefit of support groups. "The quality of their life is better. They have less side effects. They share a lot of practical information, feel less alone, feel less frightened," Hardy said. Hardy counsels her Stage 4 patients to think of the diagnosis as a chronic illness rather than a death sentence. "The encouraging thing is that over the last five or 10 years is that many new therapies have entered the field," said Flaherty. "We hope to see many in the next five or 10 years to personalize therapy better and for outcomes that are more favorable, even when they start out in an unfavorable circumstance." |