Medical writing, with its intricate details, demands precision and clarity. Whether you’re drafting a research paper, a patient information leaflet, or a clinical trial report, establishing clear objectives is the cornerstone of a successful project. Here’s how to ensure your objectives are crystal clear:
Clear objectives are SMART
In the realm of medical writing, the stakes are high. Ambiguity can lead to misinterpretation, which can have serious consequences. Adopting the SMART criteria (Specific, Measurable, Achievable, Relevant, and Time-based) ensures that your objectives are not only clear but also actionable and trackable. For instance, instead of stating “We aim to study the effects of the drug,” a SMART objective would be “We aim to study the drug’s effects on 200 adult male patients over six months, measuring blood pressure changes weekly.” This specificity reduces ambiguity and sets the stage for success.
Use a three-step framework to align your project with broader goals
Medical writing projects often involve multiple stakeholders, from researchers to clinicians to patients. The writing project itself is typically part of a larger business goal. To ensure everyone is aligned, start by defining the desired outcome. For a clinical trial, this could be “determining the efficacy of drug X in reducing blood pressure.” Next, list the steps or actions needed, such as patient recruitment, drug administration, and data collection. Lastly, determine the metrics or indicators of success, like a 10% reduction in blood pressure. This structured approach ensures that your objectives resonate with the broader goals of the project and are actionable. (For more on the three-step framework, check out the blog post “A 3-Step Framework for Writing Better Project Objectives“.)
Use clear language with examples to inform and engage your audience
The medical field is rife with jargon. While these terms are second nature to professionals, they can be confusing to others. For example, a company may use specific acronyms that are not industry standards. This can result in confusion for an external audience. When setting objectives, use straightforward language. Providing examples can further clarify your intent. This ensures that all stakeholders, from seasoned clinicians to laypersons, have a clear understanding of the objectives and can work towards a shared goal.
In conclusion, clear objectives are the backbone of any successful medical writing project. They provide direction, foster alignment among stakeholders, and set the stage for meaningful outcomes. By implementing the above strategies, you can ensure that your medical writing project not only starts on a solid foundation but also achieves its intended impact. So, as you embark on your next writing journey in the medical field, remember these strategies and set yourself up for success. Happy writing!
Do you have an interest in medical writing? Check out our other medical writing posts!
Do you have a medical communications project you need help with?
In the medical and pharmaceutical sectors, committee presentations are a pivotal aspect of the decision-making process. Whether it’s a formulary committee, a med review board, or a new tech evaluation committee, the importance of a well-structured and evidence-backed presentation cannot be overstated.
Here’s a comprehensive guide to mastering your presentations:
Understanding the Importance of Critical Thinking
Critical thinking is not just about presenting facts but about constructing compelling arguments. It is essential to maintain productive communication, even when disagreements arise. Committee members might come with their biases, and the presenter has the responsibility to navigate these biases. Using logic and reason, combined with a deep understanding of the subject matter, can help present a clear and persuasive case.
The Power of Simplicity in Communication
Complex ideas need to be distilled into easily digestible information. Overloading professionals with jargon can lead to disengagement. While being thorough is essential, being clear is more important. Remember, simplicity does not mean diluting the content; it means making it accessible and understandable. Even though the committee members are professionals within their respective fields, their eyes will glaze over when inundated by acronyms, jargon, and legalese.
Engaging Stakeholders: Building Trust and Alignment
Stakeholder engagement goes beyond merely stating facts in committee presentations. It’s about fostering trust, aligning goals, and understanding the needs and concerns of the committee members and who they represent. Setting clear boundaries and managing expectations can pave the way for more productive discussions and outcomes. If possible, research the members of the committee to see what their goals and interests are.
The Art of Setting Clear Objectives
Every presentation should start with a clear objective. What do you aim to achieve with this presentation? Knowing the end goal ensures that the presentation remains focused, relevant, and impactful. Tailoring the message to meet the audience’s needs is crucial for engagement and understanding.
For example, the roles of P&T (pharmacy and therapeutics) committees have been expanding to include a broader range of considerations, including access, affordability, and quality. This means you may need to touch upon topics other than safety and efficacy within the presentation.
Evidence-Based Claims: The Cornerstone of Credibility
In the medical and pharmaceutical sectors, evidence-based claims are the gold standard. This cannot be stressed enough. Any claim or argument should be rooted in solid evidence. Backing up statements with credible sources and empirical data not only enhances credibility but also reinforces the strength of the argument. Determine the decision you want to influence and use your communication skills to guide the committee towards it.
For example, you are wanting to gain positive coverage by a major payor for a diagnostic genetic panel your company has developed for a specific condition. Your goal should be getting positive coverage for diagnostic genetic panel tests for that specific condition…NOT asking for positive coverage for your company’s test at the expense of a potential competitor’s test.
The Essence of Effective Committee Presentations
Mastering presentations in the medical and pharmaceutical sectors is a blend of art and science. It is communicating with clarity, backing arguments with solid evidence, and understanding the audience’s needs and biases. In this field, credibility is the most valuable asset. With the right approach, you can make a lasting impact and drive decisions in your favor.
By following the above guidelines and structuring your content effectively, you can ensure that your presentations are not only informative but also persuasive and impactful.
If you need help with getting payor coverage for your product, just email me at jerm@day-storms.com.
Day-Storms, LLC provides full medical writing and consultation services. For more information, check out our Services page.
Ambiguity within medical policy guidelines can be a challenging hurdle for healthcare professionals… not to mention medical writers. These guidelines, intended to provide direction for coverage decisions and appropriate patient care, can sometimes leave room for interpretation. Navigating such ambiguity requires a strategic and thoughtful approach to ensure accurate coverage decisions for the health plan as well as providing evidence-based patient care. The following key strategies can help effectively tackle ambiguity in medical policy guidelines.
Collaborative Expert Insights
When ambiguity arises, collaboration becomes a powerful tool. Engage in discussions with colleagues, subject matter experts, and even guideline creators themselves, if possible. Collaboration may seem a “no-brainer”, but I have seen issues arise when a well-meaning person has made assumptions from ambiguous guidelines.
By pooling diverse perspectives, you can gain a more comprehensive understanding of the guideline’s intent. I have had the pleasure of working with one group that proactively brought together team members from different departments and specialties to discuss these issues. Collaborative sessions can uncover nuances that might have been overlooked individually. Additionally, seeking expert opinions can provide valuable insights into potential interpretations and considerations.
Example:
Consider a scenario where a medical policy guideline provides limited guidance on the coverage of a new diagnostic tool. By gathering a team of radiologists, clinicians, and health economists, you can jointly analyze the guideline’s implications from different angles. This collaborative effort can lead to a holistic interpretation that considers the clinical, economic, and patient-centered aspects.
Evidence-Based Reasoning
In the face of ambiguity, evidence-based reasoning serves as “true North”. Thoroughly examine the available clinical studies, real-world data, and scientific literature related to the topic at hand. By aligning your interpretation with existing evidence, you can bolster the validity of your coverage decision. Analyze how the available data correlates with the guideline’s broader goals and objectives. Finally, clearly document your rationale because this can save many future headaches.
Example:
Suppose a medical policy guideline offers vague recommendations for the coverage of a novel immunotherapy drug. By conducting a systematic review of clinical trials and presenting data on the drug’s efficacy, safety, and long-term outcomes, you can craft a compelling case for coverage. Connecting the dots between the evidence and the guideline’s overarching goals can guide decision-making and may sway an indecisive P&T formulary committee member.
Contextual Analysis and Stakeholder Engagement
Understanding the broader context is essential when dealing with ambiguity in medical policy guidelines. Consider the patient population, the treatment landscape, and the healthcare system’s priorities. Engage with various stakeholders, including patient advocacy groups and healthcare administrators, to gain insights into the real-world implications of different interpretations.
Example:
Imagine a medical policy guideline that lacks clarity on the coverage of a rare disease treatment. By consulting patient advocacy groups and discussing the potential impact on patient outcomes, quality of life, and the healthcare budget, you can enrich your interpretation. Understanding the broader context enables you to make decisions that align with the healthcare ecosystem’s values.
Cracking the code of ambiguity in medical policy guidelines requires a multifaceted approach. Collaborative discussions with experts, evidence-based reasoning, and contextual analysis are powerful tools that empower healthcare professionals and medical writers to make accurate coverage decisions to help patients get appropriate care. By embracing these strategies, you can navigate the complexities of ambiguous guidelines and ensure that your decisions reflect the best interests of patients and the healthcare system.
If you need help with getting payor coverage for your product, just email me at jerm@day-storms.com.
Day-Storms, LLC provides full medical writing and consultation services. For more information, check out our Services page.
Securing favorable coverage from healthcare payors for your product demands a strategic approach. While working within the medical policy field, I have seen my share of products not covered by payors even though the manufacturer felt confident the evidence supported it.
Here are three pitfalls to evade:
Underestimating Value Demonstration
Convincing healthcare payors goes beyond highlighting product features. Neglecting to showcase how YOUR product significantly improves patient outcomes, reduces costs, or enhances overall healthcare quality can hinder success. Construct a robust case demonstrating the tangible value your product brings to the table.
Focusing on how your product is better than a competitor’s does NOT guarantee positive coverage by health plans and hospital systems. Instead, you can come across like a used car salesperson.
Disregarding Data-Driven Insights
Relying solely on anecdotes or incomplete data won’t cut it. Payors seek evidence-based solutions. Avoid the mistake of overlooking comprehensive data from well-designed clinical trials, real-world studies, and health economic analyses. Concrete data is a persuasive tool in negotiating coverage terms.
In another post, I will cover this point in greater detail–it is THAT important to securing positive payor coverage.
Overlooking Patient Access
While engaging with payors is crucial, don’t forget about the patients. Failing to address affordability, convenience, and availability can undermine coverage efforts. Develop strategies to ensure your product is accessible and beneficial for patients, enhancing its appeal to payors.
Remember, the path to positive payor coverage involves a synergy of value, evidence, and patient-centricity. Focus on those rather than delving into a diatribe against a competitor or than throwing every piece of data at the reviewer.
By steering clear of these missteps, your product can garner the attention and endorsement it deserves from healthcare payors. The ultimate goal is to provide the patient with appropriate, evidence-based care. 💼
If you need help with getting payor coverage for your product, just email me at jerm@day-storms.com.
Day-Storms, LLC provides full medical writing and consultation services. For more information, check out our Services page.
A recent neuroimaging study published in Communications Biology, a journal within the Nature portfolio, reports a possible link in individuals with Alzheimer disease between neuroinflammation in the brain and task-related activities, independent of amyloid aggregation.1 These early findings may indicate that abnormal brain activity may possibly be restored by targeting neuroinflammation; however, additional studies and clinical trials are still needed to corroborate and build upon these findings.
This study by Canário and colleagues examined the link between brain activity, neuroinflammation caused by microglia, and amyloid aggregation (A𝛃) by using duel positron emission tomography (PET) and functional magnetic resonance imaging (fMRI). Two different PET radiotracers were used to simultaneously determine neuroinflammation and A𝛃 accumulation.
PET allows for the in vivo imaging of biomarkers associated with Alzheimer disease (AD). Radiotracers, such as 11C‐labeled Pittsburgh compound B ([11C]PiB), target the amyloid protein associated with AD,2 and have even been used in studies associating amyloid protein to impaired memory.2,3 Similarly, 11C-PK11195 is a PET radiotracer that binds to the translocator protein expressed in activated microglia associated with neuroinflammation.4
Microglia are involved in the CNS immune response, yielding different effects depending on the signals received from the neurons. Typically, homeostatic signals, such as CD200, would elicit an anti-inflammatory response from microglia, but A𝛃 and pathogen-associated molecules cause an inflammatory response.5
Researchers saw a statistically significant (P = 0.013) positive correlation in the posterior cingulate cortex (PCC) between the 11C-PK11195 radiotracer measuring neuroinflammation (microglial activation) and the beta values derived from the fMRI in the AD group whereas no relationship was evident with the control group (P = 0.185). They also did not see a correlation between A𝛃 and fMRI beta values. Higher beta values indicate higher neuronal activation required for the task.1
Figure from Cánario et al., 2022. (a) The PCC cluster is shown in orange. (b). Scatter plot depicting relationship between the extent of neuroinflammation at the PCC cluster (PK BPND) and the beta value of fMRI. This figure is licensed Creative Commons Attribution 4.0.
These results imply that future studies may focus on reducing neuroinflammation to restore abnormal brain activity since neuroinflammation may have an independent role from A𝛃 in cognition in symptomatic AD patients.1
Canário N, Jorge L, Martins R, Santana I, Castelo-Branco M. Dual PET-fMRI reveals a link between neuroinflammation, amyloid binding and compensatory task-related brain activity in Alzheimer’s disease. Commun Biol. 2022;5(1):1-7. doi:10.1038/s42003-022-03761-7
Chandra A, Valkimadi P, Pagano G, Cousins O, Dervenoulas G, Politis M. Applications of amyloid, tau, and neuroinflammation PET imaging to Alzheimer’s disease and mild cognitive impairment. Hum Brain Mapp. 2019;40(18):5424-5442. doi:10.1002/hbm.24782
Frings L, Spehl TS, Weber WA, Hüll M, Meyer PT. Amyloid-β load predicts medial temporal lobe dysfunction in Alzheimer dementia. J Nucl Med Off Publ Soc Nucl Med. 2013;54(11):1909-1914. doi:10.2967/jnumed.113.120378
Rissanen E, Tuisku J, Rokka J, et al. In Vivo Detection of Diffuse Inflammation in Secondary Progressive Multiple Sclerosis Using PET Imaging and the Radioligand 11C-PK11195. J Nucl Med Off Publ Soc Nucl Med. 2014;55(6):939-944. doi:10.2967/jnumed.113.131698
Augusto-Oliveira M, Arrifano GP, Lopes-Araújo A, et al. What do microglia really do in healthy adult brain? Cells. 2019;8(10):1293. doi:10.3390/cells8101293
A recent PLOS One study of acute coronary syndrome (ACS) (1) reports on factors that impact sleep disturbance. Even though it may seem obvious that people who have a heart attack may suffer from a lack of sleep later, this study finds that some factors may have a greater impact than others, and some of these may even be actionable. By taking a few steps, could it be possible to help decrease the lack of sleep after a heart attack? While it may not revolutionize cardiac (or sleep) medicine, this study does gives us a baseline to start a discussion.
Holding chest in pain, free public domain CC0 photo
Acute Coronary Syndrome(ACS)
According to the CDC and Mayo Clinic, acute coronary syndrome is a generic term describing conditions causing a sudden reduction in blood flow to the heart. This can include myocardial infarction (“heart attack”) and unstable angina (chest pain that occurs even at rest without an apparent reason)(refs 2,3).
This was a longitudinal study, meaning that the researchers followed the participants over a given length of time. The study started with 180 patients, and the researchers assessed sleep disturbance (using the 4-item Jenkins Sleep Scale, or JSS-4) at the time of hospital admission (time zero), 3 months, and 12 months. 101 patients completed the entire 12-month study. Also, the investigators did an extensive search of other factors or variables (covariates) that may have an effect. The covariates included within the study were:
Demographic factors, such as
Age
Employment status (full-time, part-time, retired, or unemployed)
Living arrangement (living alone or with at least one other person)
Level of education
Clinical variables
Cardiac clinical variables, of course, such as the index event (STEMI vs. non-STEMI), severity of acute coronary syndrome
Pain
Fear of dying
Feeling of helplessness
Depression
Sleep apnea
Use of sleeping pills and antidepressants
Other comorbidities (meaning other diseases or conditions also present within a single patient)
Health behaviors
Body-mass index (BMI)
Smoking status (Never smoked, previous smokers, or current smokers)
Alcohol consumption
Weekly physical activity
What were the results?
Interestingly, the study did not find a statistically relevant general connection between sleep disturbance after having an ACS, such as a heart attack, and socioeconomic factors or most clinical factors. So, did they find any factors that may be tied to an in increase in sleep disturbances after cardiac events? Yes. The researchers note a statistically significant increase in sleep disturbance for three general categories:
The authors define “distress during ACS” as patients who reported a greater fear of dying or a sense of helplessness during the actual cardiac event.
Why does sleep (and this study) matter?
Anecdotally, we have been told that a good nights’ sleep is ‘good for you’. Studies have shown that many people who have had a heart attack or other sudden cardiac event (ACS) experience sleep disturbance of some degree afterward (4-6). Some studies have indicated that impaired sleep after cardiac events are associated with a worse prognosis (7-9). This current study helps define what factors may be associated with increased sleep impairment. Some of these factors are not preventable or cannot be modified, such as gender. However, other factors are “potentially modifiable” (as the authors state it) and easier to assess at time of admission during the heart attack. For example, trying to remain as calm as possible and decrease anxiety (decrease fear of dying and feelings of helplessness) may have have a greater, long-term impact on decreasing sleep disturbance in the patient’s future.
References
von Känel R, Meister-Langraf RE, Zuccarella-Hackl C, et al. Sleep disturbance after acute coronary syndrome: A longitudinal study over 12 months. Pizzi C, ed. PLoS ONE. 2022;17(6):e0269545. doi:10.1371/journal.pone.0269545
Madsen MT, Huang C, Zangger G, Zwisler ADO, Gögenur I. Sleep disturbances in patients with coronary heart disease: a systematic review. J Clin Sleep Med. 2019;15(3):489-504. doi:10.5664/jcsm.7684
Shaffer JA, Kronish IM, Burg M, Clemow L, Edmondson D. Association of acute coronary syndrome-induced posttraumatic stress disorder symptoms with self-reported sleep. Ann Behav Med. 2013;46(3):349-357. doi:10.1007/s12160-013-9512-8
Coryell VT, Ziegelstein RC, Hirt K, Quain A, Marine JE, Smith MT. Clinical correlates of insomnia in patients with acute coronary syndrome. Int Heart J. 2013;54(5):258-265. doi:10.1536/ihj.54.258
Clark A, Lange T, Hallqvist J, Jennum P, Rod NH. Sleep impairment and prognosis of acute myocardial infarction: a prospective cohort study. Sleep. 2014;37(5):851-858. doi:10.5665/sleep.3646
Zhu CY, Hu HL, Tang GM, et al. Sleep quality, sleep duration, and the risk of adverse clinical outcomes in patients with myocardial infarction with non-obstructive coronary arteries. Front Cardiovasc Med. 2022;9:834169. doi:10.3389/fcvm.2022.834169
Kim JW, Stewart R, Lee HJ, et al. Sleep problems associated with long-term mortality in acute coronary syndrome: Effects of depression comorbidity and treatment. Gen Hosp Psychiatry. 2020;66:125-132. doi:10.1016/j.genhosppsych.2020.08.004
In 2018, after many years in academia, I decided to make a career switch to a full-time medical writer. Previously, I had been doing freelance medical writing and copyediting odd jobs here and there ever since I realized that I enjoyed writing and researching in graduate school. When I first told others of my plan to switch careers, almost without fail they would ask why. I cannot claim that what works for me or is ‘right’ for me will necessarily be true for others…but I can give you my “why”.
Reasons why I switched careers to medical writing…
Before just delving in and listing reasons 1, 2, 3,… I should give a little context. I am driven. No doubt. I make goals for myself, and I work hard to achieve them. After graduate school, I sped through my post-docs with the goal in mind to get a job in academia. I loved teaching, researching, and writing, and I knew that a small, private university position would be perfect for me. I found such a position, and I worked very hard within the institution to be promoted to full professor and department chair. For the most part, I loved it. I would not trade the experience of meeting all the students I taught through the years. I also learned so much from that time.
After more than 10 years at the same university, the stress was taking its toll on me. I had married. My wife and I had been told that it would be unlikely that we could have a family due to health issues…and then we were blessed (and wonderfully surprised) to discover we were expecting. I had a health crisis and needed to reprioritize life. It was not easy to leave a rolling-contract full professor position, but I knew I had to leave for health, my sanity, and my growing family.
So, rather than scale down my duties or find a similar job, why did I change careers? I had been doing freelance medical writing work (primarily copyediting) occasionally, and I loved to learn, research, and write. Why make the career change specifically to medical writing…?
1. Flexibility
Free work from home image, public domain scrabble CC0 photo.
For me, flexibility is the main reason for the career change to medical writing. I set out looking for opportunities with flexibility in scheduling because the top priority for me was being ‘there’ or ‘around’ for my growing family. I wanted to be involved in their lives, and my previous career was unbelievably time-consuming. It was a given during the academic year that I would put in a minimum of 60+ hours each week with occasional weeks of 80 or more hours spent working. Yes, I did get a reprieve during the summer, but by that time I was spent and broken.
I entered my career switch with the goal being I needed more time with my family, and I requested flex-time in scheduling. A medical writer who is 100% full-time freelancing will have more power in scheduling; however, for those switching careers and seeking medical writing positions within industry, it is doable to find remote medical writing positions with flex-time.
Flexibility became even more a priority for me when one of our sons was diagnosed with a condition requiring frequent doctor appointments, physical therapy, occupational therapy, and so on. Plus, our time together is priceless, and I do not want to go back to being bound to long days working in a less family-friendly environment.
For freelance medical writers, there is also flexibility in the projects (or jobs) that they accept. I typically did not get veto power in the courses I had to teach at the university. Even as department chair, I usually worked beyond contract and had to pick up classes that were required to teach (but lacking professors).
For me, I felt so much relief just announcing I was leaving academia and pursuing medical writing full-time. I did not have any jobs or contracts lined up or ready. I just made the metaphorical leap. Every interview I went to did ask me ‘why’, and most interviewers would specifically ask why I wouldn’t change my mind to go back to academia. I answered honestly about needing more family time/flex-time, and I would tell them I wanted, and needed, less stress.
Medical writing projects are usually less stressful for me because I broach them using project management skills. [Don’t worry this will not devolve into a diatribe on the agile method!] I personally find it gratifying to accomplish goals–even small deliverables or milestones–so I live by checklists. My previous career did not allow for that on the macro level. I was to the point professionally where it felt more like I was working in HR while juggling countless hours between the business office, academic affairs, and the lab. Now, my life is not stress-free, but it is orders of magnitude less stressful. I actually get to enjoy my cup of coffee in the morning! I plan projects as they come along, and I get to see them accomplished. Yes, curve balls can still get lobbed at me occasionally, but I’m ready at the bat.
I loved teaching and interacting with the students; however, the aspects of my previous career I had enjoyed had grown stale and monotonous. Less time was spent with teaching and curricula development while more time was spent on all other aspects of the job. Even after I had stepped down as department chair that last year, this situation did not improve. I was being asked to teach the same materials semester after semester. Some people find comfort in the monotony; I find restlessness. I love learning new things. One of my favorite responsibilities I had (at times) was curricula development, especially writing new courses where I could learn more about new topics.
Medical writing is such a vast field. I am constantly learning. Some medical writers may choose to really focus in one particular subject-matter area while others may prefer to primarily specialize in deliverable or service (such as CME/CE development or copyediting). Before I started to actively pursue this career, I did not realize how broad medical writing was or really everything it could encompass.
Do I have my regrets?
The Day-Storms Boys (Photo by J. & D. Day-Storms)
Honestly, not at all! I have not considered returning to a career in academia. Just as I suspect with any career, I have learned more about myself, and I have encountered both ups and downs; however, I do not regret making my mid-life career change to full-time medical writing. Now, our family has grown to include two sons, so flexibility, less stress, and wise time management are all even more important. Life in our house is never boring.
For more information on medical writing, check out the American Medical Writing Association (AMWA) website. The AMWA provides many resources on medical writing, including a job directory for members. The AMWA also collaborates with the Medical Writing Certification Commission (MWCC) to develop the Medical Writer Certified (MWC®) credential, which some employers may refer to in their job postings. [Full disclosure: I am currently an office holder of the Florida chapter of the AMWA and also have my MWC certification. If you are a medical writer in Florida, we would love to have you join us.]
In 2014, as part of an initiative to encourage my biochemistry students to actively read and discuss scientific journals and publications, I read a brief IEEE Spectrum article on the proposed use of graphene-based plasmon lasers (spasers) as a possible cancer therapeutic (1). The class blog entry was a popular topic for some time (2). Since that initial post, I made the decision to become a full-time medical writer, I had a family, and years had passed. When reviewing old course materials, I came across the post, and I decided that it would be interesting to do a follow-up review of this topic…sort of a “Spasers: Where are they now?“
YouTube Video Explaining Surface Plasmon Resonance Technology (3)
Site-directed chemotherapy is highly desirable since healthy cells are also often affected by the treatment of malignant cells in systemic chemotherapeutics, resulting in general tissue destruction. The original article proposal was to develop a site-directed tumor therapy using a combination of lasers, nanotubes, antibodies, and surface plasmon technology. [For a brief tutorial on how surface plasmon resonance is used in small molecule interactions, please see the video by BiosensingUSA (3).] Spasers are similar to lasers except that surface plasmons are used in lieu of light. The original article hypothesizes that spasers could be used in the treatment of cancer. Carbon nanotubes conjugated to tumor-specific antibodies would be directed to the surface of the cancer cell where the surface plasmons are located. Then, a laser is used to excite the carbon nanotubes that then excite the surface plasmon. By exciting the surface plasmon, heat is generated. This heat then kills only the localized cancerous tissue in theory. The wavelength of light used in the laser is such that it can penetrate the skin and various layers to reach the cancerous tissues (1).
In a 2017 study by Galanzha and colleagues published in Nature Communications, the authors report developing a biocompatible spaser capable of generating stimulated emission inside either cells or animal tissues. The authors report detecting emission through approximately 1-mm-thick blood layer. This depth is more than 10-times greater than the depth typically observed using a conventional quantum dot method (4).
Figure from Harrington, 2019 (Ref. 7) depicting principle of photoswitchable spasers. Note: This figure is originally published and licensed under a Creative Commons Attribution 4.0 International License which permits use, sharing, adaptation, distribution and reproduction as long as appropriate credit is given to original author(s). To view a copy of the Creative Commons license, visit http://creativecommons.org/licenses/by/4.0/.
One limitation to the use of spasers in vivo is the weak fluorescence signal due to the background noise (autofluorescence background found within tissues)(5-7). Harrington et al., 2019 (7) published results of a proof-of-concept experiment to create a ‘multimodal photoswitchable spaser’ utilizing a spherical plasmonic gold core with a non-absorbing polymer shell containing photoswitchable fluorescent proteins (PFPs). The researchers successfully synthesized stable spaser nanoparticles capable of photoswitching between wavelengths. The importance of these findings is the possible extension in spaser applications due to multicolor capacity while retaining photothermal applications. The authors conclude that “these results suggest that multimodal photoswitchable spasers could extend the traditional applications of spasers and PFPs in laser spectroscopy, multicolor cytometry, and theranostics with the potential to track, identify, and kill abnormal cells in circulation (7).”
Yashchenok AM, Jose J, Trochet P, Sukhorukov GB, Gorin DA. Multifunctional polyelectrolyte microcapsules as a contrast agent for photoacoustic imaging in blood. J Biophotonics. 2016;9(8):792-799. doi:10.1002/jbio.201500293
Harrington WN, Novoselova MV, Bratashov DN, et al. Photoswitchable spasers with a plasmonic core and photoswitchable fluorescent proteins. Sci Rep. 2019;9(1):12439. doi:10.1038/s41598-019-48335-6
