Northwest Health Fall 2010

Conquering Illness

Helping Patients Breathe Easier

Improving quality of life is the goal of a surgical technique offered at Group Health Medical Centers.

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A lung tumor was compressing the airways of a 55-year-old Group Health patient, causing her to gasp for breath. She was literally strangling from within.

When she was referred to Priscilla Madsen, MD, with Group Health Physicians, she learned that while her condition couldn't be cured — her remaining time could be made much more pleasant.

Dr. Priscilla MadsenDr. Madsen, who practices at our Capitol Hill Campus, is one of only three pulmonologists in Washington state with formal training to perform interventional pulmonology (IP) — a surgical technique that helps patients breathe easier. For the patient with the lung tumor, Dr. Madsen inserted a stent, or silicone tube, into her trachea and right bronchi, opening her airways to normal breathing.

"Being treated by Dr. Madsen made the difference between being able to walk across the room or having to crawl," the patient said after her surgery. "I went from being barely able to breathe to feeling 100 percent better."

There are few doctors trained in this technique, but the need for Madsen's work is great. Her patients usually have lung cancer, which is the most common cause of cancer death. Complications from the cancer, including tumors pressing against the lungs, create shortness of breath and greatly limit patient activity and movement.

While this surgery doesn't cure her patients, it does sometimes help them live longer and almost always more comfortably.

"Cancer can sneak up on people and take opportunities away," says Dr. Madsen. "Our work allows them to tie up loose ends. It's absolutely priceless."

Dr. Madsen joined Group Health's pulmonary specialty group in 2006 following a combined fellowship in interventional pulmonology at the University of California at San Diego and The Academic Hospital Free University of Brussels in Belgium. In addition to stent placement, IP includes techniques that allow doctors to improve the speed of lymph cancer diagnoses and remove tumors of the lungs and chest without inpatient surgery.

As a resident at Virginia Mason Medical Center from 1999 to 2000, Dr. Madsen worked alongside Group Health critical care doctors where she was impressed by their intelligence and commitment to patient care. She says it's what eventually brought her back to Group Health. "I thought, 'these guys are awesome — I want to come work with them!'"

Dr. Madsen emphasizes that the success of her procedures depends on a partnership with the pulmonary care team and the follow-up care they provide. "It's the post-care management that really makes a difference," Dr. Madsen says.

Training Others in a New Diagnostic Technique

Dr. Madsen, who was honored in 2009 by 425 magazine as a "Doctor Making a Difference," has trained several of her colleagues at Group Health and Overlake Hospital Medical Center in endobronchial ultrasound (EBUS), a procedure that can eliminate multiple steps and the need for surgery to make a lung cancer diagnosis.

"It's been a great experience to learn from Priscilla. She was one of the first people on the West Coast to learn to do this revolutionary procedure and has a tremendous depth of knowledge in this and other important treatments," says Dave Lewis, MD, chief of Pulmonary, Critical Care, and Sleep Medicine.

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