Singer Jesy Nelson recently shared an emotional update regarding the complications she is experiencing in her pregnancy with twin babies. Former Little Mix singer Jesy, who is having twins with partner Zion Foster, announced that she has been diagnosed with pre-twin-to-twin transfusion syndrome (pre-TTTS). The condition, which is present in pregnancies involving twins with a shared placenta, has serious risks involved and needs intense medical supervision. As Nelson embarks on this difficult journey, her story enlightens us about a rare but dangerous condition many expectant parents may not know much about.
Twin-to-twin transfusion syndrome is a rare but dangerous condition that arises in monochorionic twin pregnancies, in which identical twins share a single placenta. The placenta supplies the developing babies with oxygen, nutrients, and blood flow, but in TTTS, there is an imbalance of blood vessels that interconnect the twins, and thus the vital resources are not evenly distributed. One twin, or the donor twin, shares excess blood with the other, referred to as the recipient twin. This leads to one baby becoming malnourished and possibly anemic, and the other in danger of heart problems due to too much blood.
Nelson described her diagnosis in a heartfelt Instagram video, explaining that she is currently in the pre-stage of TTTS and undergoing frequent monitoring. "I am being scanned twice a week, and each time, things have gotten a little worse," she shared, expressing her fears and hopes for the health of her babies.
If left untreated, TTTS can have devastating consequences. Medical research indicates that:
TTTS usually advances in stages, beginning with minimal changes in fluid levels and worsening as one twin continues to get an unequal share of blood. In extreme cases, fetal laser surgery, referred to as the Solomon technique, can be employed to divide the blood vessels and balance the twins.
Identical twins may develop differently, and their own unique form of placental sharing can have a dramatic effect on pregnancy risk. Jesy Nelson's twins are considered monochorionic diamniotic (mono/di), which means they share a placenta but have two amniotic sacs. This is the type of pregnancy in about 70% of identical twin pregnancies and carries an increased risk of complications like TTTS, umbilical cord entanglement, and growth restriction.
Conversely, dichorionic diamniotic (di/di) twins both have a separate placenta and amniotic sac, which greatly diminishes the threat of TTTS. Twin pregnancy type is normally identified by early ultrasound, with physicians being able to track future complications from inception.
Twin pregnancies, even without the presence of TTTS, entail a variety of health risks to the mother as well as infants:
Over 60% of twin pregnancies end in premature delivery, with birth usually taking place before 37 weeks. Premature infants can have immature organs and need neonatal intensive care (NICU) assistance to assist with breathing, feeding, and infection fighting.
Pregnant women with multiples are at increased risk of having high blood pressure during pregnancy. This, if left untreated, can result in preeclampsia, a serious complication of pregnancy that can result in damage to organs, preterm labor, and in some cases, maternal or fetal death.
Pregnant women carrying multiples are twice as likely to experience anemia, a condition where the body does not produce enough healthy red blood cells. This can lead to fatigue, dizziness, and complications during delivery.
According to John Hopkins Medicine, multiple birth babies are twice as likely to have congenital abnormalities compared to single births. These can include heart defects, neural tube defects, and gastrointestinal issues.
When twins have to share a placenta, they are more likely to have polyhydramnios (excess amniotic fluid) or oligohydramnios (not enough amniotic fluid). Both result in distress to the babies during fetal development and can result in premature labor.
Twins are at increased risk of excessive postpartum hemorrhage because their uterus is larger and there are greater blood supply needs.
Jesy Nelson's openness about her challenging experience is raising awareness for TTTS, a condition that few individuals—let alone expectant mothers and fathers—might be aware of. Through her tearful video, Nelson stressed the significance of knowing about twin pregnancies aside from the thrill of having multiples. "We had no idea that this type of thing occurs when you're having twins. We just desperately want to make people aware of this because there are so many people who aren't aware."
Her case reminds us of the intricacies involved in twin pregnancy and the significance of early identification and medical management. For mothers carrying twins, frequent ultrasounds and vigilance can become a life-and-death issue for early detection and better outcomes of both babies.
Through constant medical attention and care, she and her partner Zion Foster remain positive and get ready for their babies to be born. In other parents whose situations are no different, the story of Nelson highlights awareness, medical progress, and emotional encouragement in handling complicated pregnancies.
The expecting parents of twin siblings are advised to discuss TTTS screening and possible interventions with their physicians to give their babies the best chance.
The sooner REDMOD is implemented, the better for pancreatic cancer patients.
Pancreatic cancer is one of the most painful forms of tumour and is also likely to become the second-leading cause of cancer-related deaths in the US by 2030. This could be because 85 per cent of cancer cases in the US are not diagnosed until the disease has spread. Pancreatic cancer is a disease that is usually diagnosed at an advanced stage because there are no prominent early signs. However, a newly developed AI model from the Mayo Clinic and the University of Texas MD Anderson Cancer Center could change that—a new CT scan-based system can help with the timely diagnosis of pancreatic cancer.
REDMOD (radiomics-based early detection model) was tested on CT scans of patients who were later diagnosed with pancreatic cancer. Researchers found that in nearly three out of four cases, REDMOD successfully identified the most common form of pancreatic cancer 16 months before diagnosis. It nearly doubled the detection rate of specialists reviewing scans without AI assistance. In some cases, REDMOD recognised suspicious tissue patterns more than two years before diagnosis. Researchers said that the AI system can detect cancer up to three years in advance.
Experts found that the greatest barrier to saving lives from pancreatic cancer was the inability to detect the tumour when it was still curable. AI can identify cancer signs from a normal-looking pancreas, and it can do so reliably across clinical settings. Researchers used 969 CT scans of the pancreas as training data for REDMOD to help it detect early-stage cancer signs.
Instead of looking for a prominent tumour, the model analysed radiomic patterns that disrupt tissue structure and texture—changes that are too subtle for the human eye to detect. Many cancers begin when normal cells acquire DNA mutations, which affect how cells divide and grow. However, it can take years before these changes develop into a tumour that produces symptoms or becomes clearly visible on a scan.
REDMOD was tested on a varied set of CT scans after training — 63 from patients who later developed cancer but were scanned before diagnosis, and 430 from healthy individuals. Out of the 63 cases, REDMOD flagged 46 as suspicious, resulting in a 73 per cent success rate. All these scans had previously been given the all-clear by radiologists who evaluated them at the same time as REDMOD.
Out of the 430 healthy individuals, 81 were identified as suspicious cases by REDMOD. This means that if AI were deployed in a real-world scenario, some individuals might be recommended for additional tests before receiving a final all-clear. A similar performance was observed in two other datasets from different hospitals using different equipment. For patients who had multiple scans available, AI produced consistent results, even when the scans were taken months apart.
The sooner REDMOD is implemented in clinical practice, the earlier it can detect pancreatic cancer. It could identify tumours at a stage when treatment is still possible. This could significantly improve survival rates and reduce cancer-related mortality. However, researchers now aim to test the effectiveness of AI in larger and more diverse populations.
The research has been published in the Gut.
Quitting smoking is one of the best ways to reduce cancer risk. (Photo credit: AI generated)
Eleven forms of cancer are becoming increasingly common among young people in England. Experts at the Institute of Cancer Research and Imperial College London stressed that cancer among younger people is still rare, and that everyone can reduce their risk by simply switching to a healthier lifestyle. However, why tumours have started to develop in people in their late teens, or in their 20s, 30s and 40s, remains unclear. The study further shows that the reasons behind rising cancer cases are elusive. However, this research does indicate a decade-long pattern of people becoming overweight.
A team of scientists worked towards understanding why a person develops cancer. They examined national trends in lifestyle and cancer to identify patterns. Researchers found that cases of the following types of cancer were rising:
Researchers found that breast and bowel cancers are common among younger adults, with 11,500 cases in a year, while gallbladder and pancreatic cancers were much rarer. It was also noted that ovarian and bowel cancers were exclusively being reported in young people, whereas the other nine were increasing in adults as well. The study by the Institute of Cancer Research and Imperial College London also analysed behavioural patterns known to raise cancer risk.
Researchers also found patterns related to alcohol intake, smoking levels, red and processed meat consumption, and diets low in fibre. These factors play a role in cancer development, but do not conclusively explain why cancer rates are increasing. Century-old tumour patterns, however, may explain why younger people are getting bowel cancer.
The report suggested that the only factors that align with an increased risk of cancer are obesity and being overweight, both of which have been on the rise since the 1990s. Extra fat tissue can alter hormones such as insulin, which can increase cancer risk. For instance, in the case of bowel cancer, for every 100 extra cases, 20 could be attributed to excess weight, while 80 remain unexplained. Researchers also note that it is important to prevent all cancers, not just the additional cases. It is estimated that nearly 40 per cent of cancers worldwide can be prevented through appropriate lifestyle choices, such as quitting smoking.
Quitting smoking and avoiding alcohol are among the simplest and most well-known ways of reducing cancer risk. However, experts say that other measures can also help. Maintaining a healthy body weight and staying physically active are simple ways to reduce cancer risk. Researchers also emphasise that while cancer rates are rising among younger people, the risk of tumours remains significantly higher in older age groups.
Researchers found that one in 1,000 people aged 20, 30 and 40 are diagnosed with cancer every year, compared to one in 100 among older age groups aged 50, 60 and 70. The search for other risk factors continues. Inflammation, sweetened drinks, gut bacteria, and air pollution must be addressed in time to reduce cancer risk. It is also being investigated whether improvements in cancer detection are contributing to earlier diagnoses in younger individuals.
The study’s findings are published in the BMJ Oncology.
Administering the HPV vaccine can help prevent cervical cancer. (Photo credit: AI generated)
Cervical cancer is a slow-developing cancer that occurs in the lower part of the uterus. It is caused by a persistent HPV infection, which usually occurs in women in their prime. Some of the symptoms of cervical cancer include pelvic pain and abnormal bleeding. Experts say that timely detection through a Pap smear or prevention with an HPV vaccine can make a difference. However, according to a study published in The Lancet, high-income countries are on the right track to eliminate cervical cancer.
The study published in The Lancet notes that high-income countries are on the right track towards cervical cancer prevention through vaccination and screening. By 2048, low- and middle-income countries will see only slight reductions over the next century. As a result, the gap between regions will likely widen dramatically. Experts have found that 99 per cent of cervical cancer cases are linked to infection with human papillomaviruses (HPV), a virus that is transmitted through sexual contact.
Cervical cancer, according to experts, can be prevented through the HPV vaccine and regular screenings. The elimination target set by the World Health Organization is fewer than four cases per one lakh women. Every country, as per the WHO, must meet the ‘90-70-90’ targets by 2030. This means 90 per cent HPV vaccine coverage among girls by the age of 15, 70 per cent of women screened between the ages of 35 and 45, and 90 per cent of women with pre-cancer and cancer treated. This would be considered being on track for cervical cancer elimination in the coming century.
Researchers note that reaching the WHO targets for screening and vaccination, for HPV elimination, or for introducing universal vaccination with high coverage, is essential for the elimination of cervical cancer. This could help bridge global inequalities in disease management. Achieving the 90-70-90 goal can avert 37 million cancer cases by the next century, thereby accelerating progress in eliminating the disease. The model, however, suggests that most countries are unlikely to reach the target without increasing investments in this direction.
Researchers proposed five HPV-centric prevention strategies. Under a status quo model, cervical cancer incidence could decline by 23 per cent, consequently leading to inequalities in disease management. Experts found that achieving 90 per cent vaccination coverage in low- and middle-income countries would reduce inequalities and help eliminate cancer. Research authors also noted that recent advancements, such as single-dose vaccines at a lower cost, could accelerate cervical cancer elimination worldwide.
Global efforts from international agencies and governments are also important. A September 2022 study published in The Lancet Oncology found that a single-dose cervical cancer vaccine with lasting protection and 90 per cent coverage could prevent 78 per cent of cancer cases in India.
© 2024 Bennett, Coleman & Company Limited