Sandy Christiansen, M.D., fills a syringe inside an OHSU Comprehensive Pain Center office room. Christiansen, an assistant professor of anesthesiology and perioperative medicine at OHSU, is one of the few academics with a clinical focus on employing interventional pain methods to alleviate cancer pain. (Ohio State University/Christine Torres Hicks)
Sandy Christiansen, M.D., wants to leverage the power of science and cooperation to make her patients feel better.
Christiansen joined the OHSU School of Medicine in 2016 as an assistant professor of anesthesiology and perioperative medicine. Her research career began as an anesthesia resident at Johns Hopkins University, where she was mentored by Steven Cohen, M.D., who has continued to involve Christiansen in national studies through her job at OHSU.
“Steve encourages and supports his trainees in developing research careers,” she stated. “Having that kind of mentorship and encouragement is a fantastic way for any junior researcher to get started.” I can now develop and carry out my own research initiatives.”
She and her colleague, Alex Woodrow, D.O., will present data from a cross-sectional survey study that provides insight into how well pain medicine physician fellowships at academic health centers across the country prepare physicians to treat cancer-related pain with minimally invasive procedures during OHSU Research Week, May 1 to 5. Christiansen is one of the few researchers that focuses on employing interventional pain methods to alleviate cancer pain.
“I can think of only five other clinician-researchers with this focus across the country,” she says. “Many patients are unaware that interventional options for cancer-related pain exist, and even if they do, finding doctors with this expertise is extremely difficult.”
Christiansen employs interventional procedures such as neurolysis. The procedure entails placing needles near the spine to disrupt the pain signaling route caused by malignancies in the abdomen and pelvic organs.
“This type of pain can be extremely debilitating and difficult to manage with opioids alone,” she explained.
However, insurance coverage limits access to these sorts of interventional treatments for many patients.
Christiansen is working on a retrospective analysis of pain outcomes for Medicaid participants enrolled in the Oregon Health Plan. In 2016, Oregon Medicaid discontinued coverage of most interventional pain management treatments, such as epidural steroid injections for low back pain, while increasing coverage of alternative and complementary therapies, such as massage. Christiansen argues that alternative therapies can be beneficial to patients and have fewer adverse effects than many pain drugs.
However, they are not for everyone.
Christiansen, a first-generation Polish immigrant, believes this is causing differences in pain results among low-income Medicaid patients. Furthermore, when patients choose higher-risk spine operations as an option, it may eventually raise total expenses.
“It’s a big deal if the whole point of the policy change was to save health care resources, but instead it’s sending patients to expensive surgeries,” she added.
She is starting with a subgroup of 200 patients chosen at random from the larger cohort.
Christiansen believes that in the long run, this type of study will lead to better care for individuals suffering from chronic pain. She is glad that her employment at OHSU has allowed her to balance research with patient care, a concept she aims to instill in the first- and second-year medical students she teaches through the Clinical Skills Lab.
“My department has been extremely supportive in providing me with dedicated research time,” she remarked. “Being able to conduct research while seeing patients allows me to understand what’s going on in the field at the grassroots level.” Working with patients has inspired all of my research questions.”
Erin Balsa is a highly skilled and knowledgeable health journalist with a passion for educating the public on important health and wellness topics. With extensive experience in both traditional and digital media, Erin has established herself as a trusted voice in the field.