What May Cause Lung Cancer in Nonsmokers?

Posted on January 22, 2026 by Patrick Hercules

Lung cancer is the leading cause of cancer-related deaths in the United States. Tobacco smoking is the leading cause of lung cancer. However, people who smoke tobacco aren’t the only ones at risk of developing lung cancer.

The Centers for Disease Control and Prevention (CDC) estimates that 10% to 20% of lung cancer cases each year happen in people who never smoke.

Nonsmokers can develop lung cancer if they are exposed to secondhand smoke, air pollution, radioactive gases such as radon, asbestos, diesel exhaust, or other harmful chemicals.

According to the CDC, about 50% to 60% of lung cancers found in nonsmokers are adenocarcinomas, which is a type of non-small cell lung cancer that begins in the cells that line the tiny air sacs in the lungs and make substances such as mucus. Additionally, about 10% to 20% are squamous cell carcinomas, cancer that forms in the thin, flat cells lining the inside of the lungs, and 6% to 8% are small cell lung cancers, and the rest are other types of lung cancer.

Lung cancers in nonsmokers are often different than those that are in smokers, as they usually develop in younger people, and often have certain gene changes that differ from those in tumors found in smokers.

A person’s genes can influence their risk of developing certain diseases, including some types of cancer, as some genes help control when cells grow, divide into new cells, and die. These genes are oncogenes and tumor suppressor genes.

Oncogenes help cells grow, divide, or stay alive. Tumor suppressor genes help control cell division or cause cells to die at the right time.

Cancer can develop when any DNA changes that activate oncogenes or deactivate tumor suppressor genes occur. These changes in many different genes are usually needed to cause cancer to develop. The two primary types of gene changes are inherited gene changes and acquired gene changes.

Inherited gene changes are gene changes passed down from a person’s parents. These inherited changes to a person’s DNA may increase their risk of developing certain cancers.

Acquired gene changes cannot be inherited but are acquired during a person’s lifetime and may occur in any individual cell. Certain acquired gene changes can affect the cell’s ability to control how it grows and will ultimately mutate a non-cancer cell into a cancer cell.

It is more common for nonsmoking women, especially Asian nonsmoking women, to develop lung cancer, as they are more than twice as likely to develop it as male nonsmokers. This is due to women having an acquired gene change, such as epidermal growth factor receptor (EGFR).

Symptoms of lung cancer are the same for smokers and nonsmokers. Lung cancer symptoms include:

Feeling tired or weak all the time

Loss of appetite

A cough that doesn’t go away or gets worse

Coughing up blood or rust-colored phlegm

Chest pains

Shortness of breath

Unexplained weight loss

Hoarseness

Bronchitis or pneumonia that doesn’t go away or keeps coming back

Wheezing

If a smoker is exhibiting symptoms of lung cancer, they should see a healthcare provider.

Although there isn’t any screening guidance for nonsmokers, taking steps such as being aware of lung cancer symptoms and reducing exposure to air pollutants and radon can help reduce your risk of developing lung cancer. Some additional steps include:

Avoid secondhand smoke

Monitor the air quality in your community

Test your home for radon

Protect yourself at work by avoiding any chemicals or cleaning products that contain carcinogens

If you would like to learn more about cancer treatments for lung cancer, or to learn more about our cancer care program, you can schedule an appointment with an oncologist at our MediSys Health Network Cancer Center by calling (718) 206-6742.

All content of this newsletter is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions on this page. You must never disregard professional medical advice or delay seeking medical treatment based upon any content of this newsletter. PROMPTLY CONSULT YOUR PHYSICIAN OR CALL 911 IF YOU BELIEVE YOU HAVE A MEDICAL EMERGENCY.

Lung Cancer Awareness Month

Posted on November 21, 2025 by Patrick Hercules

November is Lung Cancer Awareness Month, an annual observance dedicated to increasing awareness about lung cancer, its risk factors, early detection, and treatment options.

Lung cancer is the number one cause of cancer death, claiming more lives each year than breast, prostate, ovarian, and kidney cancers combined.

Lung cancer is a kind of cancer that starts with the growth of cells in the lungs. It doesn’t usually cause symptoms early on; however, the symptoms of lung cancer occur when the disease is advanced. Signs and symptoms of lung cancer that happen in and around the lungs include:

A new cough that doesn’t go away

Chest pain

Coughing up blood

Hoarseness

Shortness of breath

Wheezing

In addition to the signs and symptoms of lung cancer in the lungs, some symptoms occur when the cancer spreads to other parts of the body, including:

Bone pain

Headaches

Losing weight without trying

Loss of appetite

Swelling in the face or neck

Lung cancer occurs when cells in the lungs develop changes in their DNA. A cell’s DNA holds instructions that tell a cell what to do. In healthy cells, the DNA gives instructions to grow and multiply at a set rate. The instructions also tell the cells to die at a set time.

In cancer cells, DNA changes give different instructions. The changes tell the cancer cells to make many more cells quickly. Cancer cells can keep living when healthy cells die, causing too many cells.

Cancer cells might form a tumor. The tumor can grow to invade and destroy healthy body tissue. In time, cancer cells can break away and spread to other parts of the body, causing metastatic cancer.

Smoking causes most lung cancer. It can cause lung cancer in both smokers and non-smokers who have been exposed to secondhand smoke. However, people who have never smoked or been exposed to secondhand smoke can develop lung cancer.

Researchers believe smoking causes lung cancer by damaging the cells that line the lungs. Cigarette smoke contains cancer-causing substances known as carcinogens. When cigarette smoke is inhaled, carcinogens immediately cause changes in the lung tissue. The body may be able to repair the damage at first, but with each repeated exposure, healthy cells lining the lungs become more damaged. Over time, the damage causes cells to change, eventually developing into cancer.

Lung cancer is divided into two major types based on the appearance of cells under a microscope. The two general types of lung cancer include:

Small-cell lung cancer

Non-small cell lung cancer

A lung cancer diagnosis often starts with an imaging test to look at the lungs for signs of cancer before it develops. Other tests used to diagnose lung cancer include:

Sputum cytology

Biopsy

There are also additional tests that can be performed if a person is diagnosed with lung cancer to see if the cancer has spread. These tests allow a healthcare provider to know what stage the cancer is in. The stages of lung cancer range from 1 to 4. These staging tests often involve imaging tests such as an MRI, CT scan, bone scans, and a PET scan. If the cancer is in stage 1, the cancer is small and only in the lung. As cancer grows larger or spreads outside of the lungs, the numbers get higher. Stage 4 lung cancer means the cancer has spread to other parts of the body.

Treatment for lung cancer usually begins with surgery to remove the cancer. However, if the cancer is very large or has spread to other parts of the body, surgery may not be possible. As an alternative, treatment may start with medicine and radiation instead. A healthcare team will consider many factors when creating a treatment plan. These factors may include:

Overall health

The type and stage of cancer

The patient’s preferences

Another type of treatment for lung cancer is palliative care. Palliative care specialists will work with the patient, their family, and healthcare team to provide extra support while the patient goes through their cancer treatment.

Unfortunately, there isn’t a sure way to prevent lung cancer. However, you can reduce your risk by not smoking or quitting smoking, avoiding secondhand smoke, eating a diet of fruits and vegetables, and exercising most days of the week.

If you would like to learn more about lung cancer treatments, or to learn more about our cancer care program, you can schedule an appointment with an oncologist at our MediSys Health Network Cancer Center by calling (718) 206-6742.

COPD Myths

Posted on March 7, 2025 by Patrick Hercules

Chronic obstructive pulmonary disease, or COPD, is a group of health conditions, such as chronic bronchitis and emphysema, that limit airflow in the lungs.

Many myths and misconceptions exist about COPD. Here are some misconceptions surrounding COPD:

Myth #1: Only people who smoke get COPD

COPD is often associated with smoking, as smoking cigarettes and other tobacco products is the most common cause of the damage done to the lungs and airways. However, nearly 30% of people with COPD have never smoked a cigarette. Nonsmoking causes of COPD include:

Long-term exposure to polluted air, such as smog in an urban area or dust and fumes at a workplace
Genetics plays a role, specifically a condition called Alpha-1 antitrypsin deficiency (Alpha-1)
Asthma that’s active or even inactive. Researchers have found that 29% of people with asthma eventually receive a COPD diagnosis
Childhood respiratory illnesses, such as pneumonia

Myth #2: COPD is rare

According to estimates from the Centers for Disease Control and Prevention (CDC), over six in 100 adults in the U.S. had a COPD diagnosis in 2022.

That means millions of adults across the country have received a diagnosis of COPD. The actual proportion of adults with COPD may be higher due to delays in obtaining a diagnosis.

Myth #3: Exercise is too hard if you have COPD

Shortness of breath, wheezing, a chronic cough, and fatigue can all be a part of COPD. Any one of these symptoms can make exercising challenging.

Moderate exercise may not affect your lungs. In some cases, exercise can minimize the symptoms of COPD while strengthening the heart and helping reduce stress.

Try to build up to 20 to 30 minutes of exercise three to four times a week. Combine safe cardiovascular activities such as walking or biking with stretching and strength-building. It won’t be easy to start exercising. Speak with your healthcare provider about building an exercise plan that works for you. They may be able to connect you with a respiratory therapist for breathing techniques and exercises you can do. It is recommended that you speak to your doctor about your health before starting a new exercise regimen.

Myth #4: Only older people develop COPD

COPD is more common in people 65 or older. However, younger people can also develop this condition.

A 2023 study found that COPD affected more than 1.6% of adults ages 20 to 50 in the U.S. Adults aged 35 to 50 had a higher risk of COPD than those under the age of 35.

A history of smoking or secondhand smoke exposure significantly increases the risk of COPD in young adults.

Myth #5: COPD is a man’s disease

The Centers for Disease Control (CDC) reports that women are more likely to develop COPD than men in the U.S.

More women than men have also died from COPD since 2000 in the U.S.

Exposure to tobacco smoke and other pollutants raises the risk of COPD for anyone; however, women can experience more harmful effects than men from these pollutants.

Women with COPD also tend to get a diagnosis later than men, after the disease has progressed and treatment is less effective. This may contribute to reduced survival in women with COPD.

Myth #6: Nothing can be done to treat COPD

COPD treatments are available to help limit symptoms and potentially slow the progression of COPD.

Your treatment plan can include lifestyle changes like quitting smoking (if you smoke), as well as one or more of the following:

Vaccinations
Medications
Pulmonary rehabilitation
Supplemental oxygen
Lung transplant
Surgery

Talk with your healthcare provider to learn more about your treatment options.

Myth #7: There’s no point in quitting smoking after you develop COPD

Avoiding tobacco smoke is one of the most important things you can do to manage COPD.

If you smoke, cutting back and quitting can help limit symptoms and slow the progression of COPD.

Although more research is necessary, it may also be helpful to avoid e-cigarettes and other vaping products.

Avoiding smoking and vaping altogether is likely your healthiest option. Talk with a healthcare provider to learn about smoking cessation counseling, medication, or other resources that can help you cut back and quit smoking or vaping.

Jamaica Hospital’s Medical Home Department has partnered with the American Lung Association to bring you Freedom from Smoking, a comprehensive and successful group-based smoking cessation program. For more information or to register, call: 718-206-8494

Patient Testimonial: Dwayne Bull says, “I could never find words to express how thankful and how grateful I am”, After Dr. Mangla, his team, and the Jamaica Hospital Staff Save His Husband Arthur’s Life

Posted on December 5, 2024 by Patrick Hercules

“I could never find words to express how thankful and how grateful I am”, is what Dwayne Bull said after his husband Arthur’s surgery at Jamaica Hospital Medical Center. On September 11^th, 2024, Mr. Arthur Dower Bull took a short walk with his husband Dwayne to shop in their neighborhood. After about a block of walking, Arthur began to show signs of passing out. At that moment, Dwayne immediately called 911. Leading up to that moment Arthur passed out, Dwayne explained, “Arthur had been complaining about pain in his left leg and shortness of breath since having two surgeries two weeks prior.” The ambulance arrived and Arthur was taken to Jamaica Hospital Medical Center.

Arthur was being evaluated in the ER while Dwayne waited for news on his condition in the waiting room. A doctor approached Dwayne and told him that Arthur’s heart had stopped and he had to be revived. When the doctor told him that, Dwayne said, “My heart stopped, and I had never experienced that mental state in my life.” Dwayne recounted seeing a team of people standing over Arthur attempting to revive him again. He says, “I felt the pain of losing someone for the first time in my life and the hardest part was not being able to do anything about it.” For Dwayne, sitting in the waiting room feeling alone, nervous, and scared and not knowing what was happening, was the hardest thing for him.

Then, Dr. Aditya Mangla appeared. Dwayne recalls that Dr. Mangla was “extremely calm” and had a “positive presence about him”. “He gave me peace”, said Dwayne. Dr. Mangla told Dwayne that Arthur had blood clots in his lungs and blood stopped flowing to his heart. He expressed that if he did not perform immediate surgery Arthur wouldn’t make it and if he does perform the surgery, there still might be a chance that he wouldn’t make it because of the severity of his condition. Dr. Mangla told Dwayne there was a “30% chance that Arthur could survive the surgery”. Dwayne says Dr. Mangla, “assured me that he was extremely knowledgeable in this area of medicine and that he and Arthur were in the right place.”

Dr. Mangla allowed Dwayne to see Arthur one last time before surgery. Dr. Mangla told Dwayne, “I will treat him like he’s one of mine”. Dwayne waited in the waiting room for 90 minutes but remained positive because he knew Arthur was in good hands due to Dr. Mangla’s sincerity and level of experience. Then Dr. Mangla appeared with a certainty and enduring smile expressing that the surgery was successful. He then showed Dwayne pictures of the blood clots that were removed from Arthur’s lungs. When Dwayne finally got to see Arthur after the surgery, Arthur’s first words to him were, “You’re here.”

Dwayne would like to thank Dr. Mangla for the impeccable service he received. “Dr. Mangla is an angel,” Dwayne said. He would also like to thank Dr. Mangla’s team, the ICU nurses, and the rest of the hospital staff. “The hospital should be given an award.”

Dwayne and Arthur moved here from California last year and have been enjoying the sights and culture of the city. Thanks to Dr. Mangla, his team, and the hospital staff, they can continue to do so. “Dr. Mangla saved the life of my loved one. I wanted to say thank you, and I will never forget your unconditional support or allowing God to use you by the power of prayer.”

What Parents Should Know About Oral Nicotine Pouches

Posted on August 9, 2024 by Patrick Hercules

According to the Centers for Disease Control and Prevention, cigarette smoking hit a historic low in 2023, with the adult smoking rate dropping to 11%. Because of the steady decline of smokers over the years, tobacco companies have tried other ways to retain customers as well as attract new ones by introducing new products.

One of those new products is oral nicotine pouches. Oral nicotine pouches are small permeable pouches typically placed between the lip and the gum containing crystalized nicotine powder in various flavors. Although little is known about the product, nicotine pouches have become one of the fastest-growing categories, increasing sales from about 126 million units to over 800 million units between 2019 and 2022.

Oral nicotine pouches are aimed at adults who are looking for a tobacco-less, smoke-free alternative to cigarettes as they try to stop smoking. However, according to the 2023 National Youth Tobacco Survey conducted by the Food and Drug Administration and the Centers for Disease Control and Prevention, in October of 2023, 1.5% of middle and high school students reported using nicotine pouches in the previous 30 days.

Tobacco companies sell nicotine pouches in attractive packaging and assorted flavors, including citrus, berry, peppermint, coffee, and mango. Researchers are concerned that this marketing tactic is likely to appeal to young people who may not be aware of the harmful effects of nicotine. Some social media influencers have promoted the use of nicotine pouches by showing how they use them in their daily lives, discreetly placing them in their mouths at work and school, as well as doing taste tests.

“Nicotine pouches are marketed as a nicotine product that provides a buzz without the harmful effects of tobacco or smoking. However, people using these products should be aware that ‘tobacco-free’ does not mean ‘risk-free’”, says Alexandra Howell, DMD, Oral Medicine Specialist and Assistant Professor in the Department of Oral Diagnostic Services at Virginia Commonwealth’s University’s School of Dentistry.

Despite the long-term health impact of nicotine pouches being unknown, the side effects of its use can include:

Nicotine addiction
Irritation of the gums
Lung problems
Infertility problems
Stomach problems
Sore mouth
Hiccups
Nausea

Nicotine pouches can also present several cardiovascular risks. The use of these products can lead to increased heart rate and blood pressure increasing the risk of developing cardiovascular diseases such as hypertension, heart disease, and potential heart attacks.

To speak with a Family Medicine doctor at Jamaica Hospital Medical Center about smoking cessation, please call (718) 206-6942.

When is a Cough Serious?

Posted on January 24, 2024 by Jacob Lobosco

Coughing is a normal reflex and often does not signify a serious underlying medical condition. However, a cough could be connected to a more significant health issue and should be evaluated by a doctor when it is:

Severe
Worsening over time
Occurring frequently over several days or weeks

A cough can be either “acute,” meaning that it lasts less than three weeks, or “chronic,” meaning that it lasts longer. Some causes of acute cough, such as the common cold or exposure to airborne irritants, are not necessarily causes for concern on their own, but others, such as pneumonia and influenza, are potentially life-threatening for some people, such as older adults, infants, and people with compromised immune systems or chronic health conditions.

In many cases, chronic coughing is also not indicative of a major, life-threatening health problem, such as when it is caused by mild allergies or asthma. However, it may be a cause for concern when it is severe, frequent, or accompanied by one or more other symptoms, including (but not limited to):

Coughing up blood
Wheezing
Shortness of breath
Chest tightness
Fatigue
Unintended weight loss

These symptoms could indicate that a cough is associated with a serious underlying medical condition, such as chronic obstructive pulmonary disease (COPD), emphysema, lung cancer, cystic fibrosis, or pulmonary embolism. If you experience these symptoms, it’s important to get evaluated by a doctor as soon as possible.

You can receive diagnostic care and specialized treatment for your cough at Jamaica Hospital Medical Center’s Ambulatory Care Center. To schedule an appointment, please call (718) 206-7001.

World No Tobacco Day

Posted on May 31, 2023 by Jacob Lobosco

On May 31^st each year, the World Health Organization highlights the harmful health effects of tobacco products such as cigarettes. While tobacco usage rates among the general population have decreased over time, approximately 22.3% of people across the world continue to use it. The risks of using tobacco are well documented; however, many people around the world are not fully aware of the dangers.

A substantial amount of information exists about the harmful effects of tobacco usage. Aside from lung-related conditions such as emphysema, there are also very strong links between tobacco usage and heart disease, circulatory problems, and stroke. Coronary vascular diseases are one of the world’s leading causes of death. Tobacco use is the second leading cause of these types of diseases, with hypertension being the leading cause.

Despite the wealth of information available about the harmful effects of tobacco products, their continued usage results in over 8 million deaths each year. Approximately 1.2 million of these deaths occur due to exposure to second-hand smoke, highlighting the negative health impacts that tobacco usage can have not only on the user, but on the people around them, as well.

A few of the World Health Organization’s efforts to inform people about tobacco’s harmful effects include:

Increasing public knowledge of the risks of smoking and secondhand smoke
Encouraging healthcare providers to speak to their patients about the hazards of tobacco
Encouraging governmental support for educational programs
Seeking ways to promote smoke-free zones in buildings and public spaces
Increasing taxes on tobacco products
Making it more difficult to purchase tobacco products
Banning tobacco advertising

If you would like to quit smoking, speak to your medical provider to learn more about the resources available to help you. Jamaica Hospital Medical Center offers a tobacco cessation program that can support you in your efforts to quit. Please call 718-206-8494 to learn more.

What is Popcorn Lung and Can Vaping Cause It?

Posted on July 5, 2019 by Michael Hinck

“Popcorn lung” is the nickname for bronchiolitis obliterans, a serious and irreversible lung disease that can damage the smallest airways in your lungs, resulting in coughing and shortness of breath.

The condition got its nickname because of the chemical diacetyl, a buttery flavored chemical that was commonly found in microwave popcorn. After workers at the factories that produced microwave popcorn began to experience symptoms associated with bronchiolitis obliterans after inhaling diacetyl, manufacturers removed it from their products.

While diacetyl is no longer a threat from microwaved popcorn, many are now being exposed to it through e-cigarette vapor. Diacetyl is often added to “e-juice” liquid by some e-cigarette companies to complement flavorings such as vanilla, maple, coconut and more. In fact, recent studies have found that more than 75 percent of flavored e-cigarettes and refill liquids tested positive for diacetyl

So how does diacetyl cause popcorn lung? Your lungs are where your blood receives oxygen before carrying it to cells in the rest of your body through tiny air sacs called alveoli. Exposure to diacetyl can irritate or scar the alveoli, causing inflammation or narrowing, making it difficult for them to deliver oxygen to your blood.

The main symptoms of popcorn lung are a dry cough and shortness of breath. These show up between two weeks and two months after you’ve been around a toxic gas or had an illness. You’re especially likely to have them after exercising or heavy labor.

Other symptoms may include:

Flu-like illness with fever
Unexplained fatigue
Weight loss
Wheezing
Eye, skin, mouth, or nose irritation, if caused by chemical exposure

Popcorn lung is often misdiagnosed as asthma, bronchitis, or emphysema. To diagnose popcorn lung, your doctor will order an X-ray, CT scan or a surgical lung biopsy. Your doctor may also want to measure your lung’s function by conducting a pulmonary function test.

Unfortunately, there is no cure for popcorn lung, but there are treatments to help alleviate the symptoms or slow the progression of the disease. Treatment options include prescription corticosteroids, cough suppressants, bronchodilators to open the airways or immunosuppressant therapy to decrease your body’s immune response. In severe cases oxygen supplementation may be needed. If left untreated, popcorn lung can be fatal in some cases.

The best way to prevent developing popcorn lung is to avoid exposure to harmful chemicals like diacetyl, found in e-cigarettes.

If you are experiencing symptoms of popcorn lung, make an appointment to see your doctor. To make an appointment with a Pulmonologist at Jamaica Hospital, please call our Ambulatory Care Department at 718-206-7001.

Today is the Great American Smokeout

Posted on November 15, 2018 by Michael Hinck

Today is the Great American Smokeout, an annual event when the American Cancer Society encourages everyone to quit smoking. This event helps to make people aware of the dangers of using tobacco products as well as the tools that are available to help them quit smoking.

The Great American Smokeout started in 1970 in a small town in Massachusetts. People were asked to give up smoking for one day and to take the money that they would have spent on cigarettes and donate it to a local high school scholarship fund. The event spread to other cities both large and small and eventually led to legislation that bans smoking in workplaces, restaurants, and other public spaces both indoors and outdoors.

Smoking is responsible for one in five deaths in the United States today. Lung cancer is the leading cause of death in both men and women. Smoking is also the cause of cancer of the larynx, mouth, sinuses, throat, esophagus, and the bladder. The number of people who smoke has dramatically decreased in the United States since the anti-smoking campaigns began. In 1965 it was estimated that over 40 percent of the population were smokers and today that number is around 18 percent.

Smokers have the best chances of quitting if they use at least two of the following methods:

• Smoking Cessation Groups
• Nicotine substitute products
• Support from family and friends
• Telephone quit lines
• Counseling
• Prescription medications that help to reduce the urge to smoke

If you would like more information about quitting smoking please call the American Cancer Society at 1-800-227-2345. If you would like to schedule an appointment with a doctor at Jamaica Hospital to discuss smoking cessation, please call 718-206-8494.

Now That You’ve Quit Smoking –How Do You Resist Temptation?

Posted on January 8, 2018 by Xavia Malcolm

Congratulations, you have quit smoking. You have accomplished a major milestone in your journey to achieving good health. A challenge you may face after your Quit Day is remaining tobacco-free by resisting the temptation to smoke again. Coping with tobacco cravings can be difficult; however, by applying the following tips you can decrease the urge to smoke:

Remove yourself from situations that may trigger the urge to smoke
Spend free time in environments where smoking is not allowed
Reduce alcohol consumption
Create or join a support group
Think about how harmful tobacco is to your health
Think about the health benefits you will gain by remaining smoke-free
Try nicotine replacements such as gum, patches or prescription medications
Do not have just one cigarette to satisfy a craving- one cigarette will make you want more
If you miss the feeling of having a cigarette in your mouth try a toothpick, a stick of gum, celery -anything besides a cigarette
Exercise
Practice relaxation techniques
Give yourself credit for each day you are tobacco free
Envision being tobacco-free long-term

Quitting smoking and remaining smoke-free can be difficult and requires a life-long commitment but the benefits to your health are immeasurable.

Jamaica Hospital Medical Center offers a Freedom from Smoking Tobacco Cessation Program to help you overcome your addiction to tobacco and enjoy the benefits of better health in a fun and interactive environment. Receive personalized attention as well as the support from group members who are experiencing this journey with you. For more information, please call 718-206-8494.