A patient inspired a new career trajectory for Dr. Ellen Smith, whose research is now a source of hope for people suffering from chronic pain.

October, 2013

“I remember this so clearly,” says Assistant Professor Ellen Lavoie Smith, Ph.D., ANP-BC, AOCN, of the experience that would essentially change the path of her career. Dr. Smith was working as a nurse practitioner in a thoracic oncology clinic when she began caring for a patient suffering from severe arm pain because of his spreading cancer.

“He had this terrible, painful numbness and tingling involving his entire right arm,” explains Dr. Smith. “I remember being very sad about what he was dealing with and frustrated that I couldn’t do more to help him. I wanted to know more and I wanted to be able to help others like him.”

The experience gave Dr. Smith a new focus. She began working with another nurse on a research project, then submitted her own grant for a related project, went back to school to get her Ph.D., and became a researcher at UMSN.

“I never imagined that I would become a researcher,” says Dr Smith. “I grew up in a tiny little town, went to small schools, and didn’t really know much about it. But, I gained a lot of understanding about the importance of research by working as a nurse in a research-intensive cancer center. Wonderful mentors kept encouraging me to go back to school, and as I gained confidence, I realized that I had the potential to improve patient care through research.”

Dr. Smith has earned national attention for her research on the drug duloxetine and its success in relieving painful chemotherapy-induced neuropathy. Hers was the first clinical trial to find an effective treatment for this pain.

Dr. Smith is expanding her research to figure out why some people are more susceptible than others to chronic, painful peripheral neuropathy. “We’re trying to extrapolate from what we know about other chronically painful conditions such as fibromyalgia. There are physiologic, psychosocial, and environmental factors that influence whether some people will develop chronic pain. If we can figure out if similar factors predict the development of painful chemotherapy-induced peripheral neuropathy, we might be able to develop treatments that can stop the pain before it starts.”

Dr. Smith is also a co-investigator on a study focused on peripheral neuropathy and associated chronic pain in children. “It can be hard to determine if a one or two-year-old is suffering from neuropathy, but from our work, we’ve made recommendations for clinical practice that will help clinicians determine which neuropathy and pain assessment approaches should be used based on the age of the child.”

Getting results for patients is what makes the difficult work worth the effort. “I get goose bumps whenever I think back to one of my first research studies,” says Dr. Smith. She tells the story of a patient suffering from very painful neuropathy caused by an experimental chemotherapy drug. The pain was so severe that he was going to have to cut back on the cancer drug that was prolonging his life. Dr. Smith recruited him to be a part of a project testing medications for people with that type of intense pain.

“He was very skeptical and didn’t really understand that nurses could be scientists, but he agreed to participate in my study. We gave him medicines that controlled his painful neuropathy so he could keep receiving the experimental chemotherapy drug that was controlling his cancer. When the study ended, I remember escorting him out into the cancer center lobby. Just before we said goodbye, he picked me up, swung me around and said, ‘you made a difference in my life.’ I get very emotional even now when I think about it. My experience with this man continues to motivate me to do what I do.”