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Pulmonary Medicine

Pulmonary Medicine —
Pulmonary Special Procedures

Not all asthma is the same. While the majority of people with asthma can find relief with standard inhalers and oral medications, those with severe asthma require more powerful treatments. Physicians at Virginia Hospital Center are working with these patients to find the right advanced therapy.

Bronchial Thermoplasty (BT) — A Breakthrough Therapy

There are 20 U.S. Hospitals that can do more for Asthma than medicate it.
We're one of them!

Removing an appendix that's causing appendicitis? Sure.
Extracting wisdom teeth that are wreaking havoc in your mouth? Definitely.
But removing part of the smooth muscle layer of your lungs to treat severe asthma? Sounds rather drastic at first. Impossible, even.
Why would doctors alter the inner layer of your lungs? Because asthma becomes more severe when that smooth muscle layer enlarges, making it very difficult to breathe. And, like your appendix, you can live just as well - if not better - without all of it.

In May 2010, Virginia Hospital Center announced that it would be the first hospital in the United States to offer a new procedure for severe asthma patients, known as bronchial thermoplasty (BT). Approved by the U.S. Food and Drug Administration (FDA), this new procedure is intended for people whose asthma is not well controlled with inhalers and other medicines. Since 2010, 250 men and women have successfully undergone bronchial thermoplasty and are today living lives they had never dared to dream of. Dr. David Duhamel, MD, Pulmonary and Medical Associates of Northern Virginia, Ltd. at the Virginia Hospital Center, is excited about the procedure and how it can impact the lives of severe asthma patients. Learn more

Interventional Bronchoscopy (IB)

David Duhamel, MD is one of the only pulmonologists in our region performing interventional bronchoscopy (IB). As Director of the Pulmonary Special Procedures Unit, Dr. Duhamel specializes in treating conditions that obstruct the trachea and bronchi, including benign and malignant tumors, stenosis (constriction) of the airway, and scarring resulting from surgery or infection.

Patients suffering from cancer of the bronchial tubes or trachea are more likely to die from an inability to breathe than from the cancer itself. Now this complication can be alleviated through a revolutionary procedure known as interventional bronchoscopy. While the patient is under general anesthesia, a tube-like instrument called a "rigid bronchoscope" is inserted into the airway, through which a tiny laser tool is delivered to the site of the tumor. The laser stops the blood supply to the tumor through a process of "photocoagulation" and the tumor is removed. To prevent the airway from subsequently collapsing, a small plastic device called a stent is inserted, providing a form of scaffolding for the bronchial passage. In cases of malignancy, removal of the tumor is often followed by radiation or chemotherapy.

Interventional bronchoscopy also has applications beyond cancer treatments. The procedure can be used to remove scar tissue—resulting from bronchial infection, tracheotomy or surgical intubation—that may be obstructing an airway.


Another procedure in Dr. Duhamel's arsenal is brachytherapy, a similar treatment which delivers localized radiation to the site of a tumor through a catheter, thus protecting healthy lung tissue from unnecessary radiation exposure.

Interventional Bronchoscopy and Brachytherapy are not curative treatments for cancer, but they can significantly enhance quality of life for patients living with the disease by eliminating the need for ventilators.

Biological Medication: NUCALA® and XOLAIR®

Virginia Hospital Center is on the forefront of a new wave of treatment options for patients who have severe asthma. These new treatments include immunomodulators—monoclonal antibodies, also known as biological medication. They act by directly changing the behavior of the immune system. Read more


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