How Does Cancer Start?

Cell changes and cancer

All cancers begin in cells. Our bodies are made up of more than a hundred million million (100,000,000,000,000) cells. Cancer starts with changes in one cell or a small group of cells.

Usually we have just the right number of each type of cell. This is because cells produce signals to control how much and how often the cells divide. If any of these signals are faulty or missing, cells may start to grow and multiply too much and form a lump called a tumour. Where the cancer starts is called the primary tumour.

Some types of cancer, called leukaemia, start from blood cells. They don’t form solid tumours. Instead, the cancer cells build up in the blood and sometimes the bone marrow.

For a cancer to start, certain changes take place within the genes of a cell or a group of cells.

Genes and cell division

Different types of cells in the body do different jobs, but they are basically similar. They all have a control centre called a nucleus. Inside the nucleus are chromosomes made up of long strings of DNA (deoxyribonucleic acid). DNA contains thousands of genes, which are coded messages that tell the cell how to behave.

diagram-showing-where-genes-are-in-cells_0

Where genes are in cells

Each gene is an instruction that tells the cell to make something. This could be a protein, or a different type of molecule called RNA. Together, proteins and RNA control the cell. They decide what sort of cell it will be, what it does, when it will divide, and when it will die.

Gene changes within cells (mutations)

Normally genes make sure that cells grow and reproduce in an orderly and controlled way. They make sure that more cells are produced as they are needed to keep the body healthy.

Sometimes a change happens in the genes when a cell divides. The change is called a mutation. It means that a gene has been damaged or lost or copied twice. Mutations can happen by chance when a cell is dividing. Some mutations mean that the cell no longer understands its instructions and starts to grow out of control. There have to be about half a dozen different mutations before a normal cell turns into a cancer cell.

Mutations in particular genes may mean that too many proteins are produced that trigger a cell to divide. Or proteins that normally tell a cell to stop dividing may not be produced. Abnormal proteins may be produced that work differently to normal.

Causes of Hearing Loss in Infants

Although it is not common, some infants may have some hearing loss at birth. Hearing loss can also develop in children who had normal hearing as infants.

• The loss can occur in one or both ears. It may be mild, moderate, severe, or profound. Profound hearing loss is what most people call deafness.
• Sometimes, hearing loss gets worse over time. Other times, it stays stable and does not get worse.

Risk factors for infant hearing loss include:

• Family history of hearing loss
• Low birth weight

Hearing loss may occur when there is a problem in the outer or middle ear. These problems may slow or prevent sound waves from passing through. They include:

• Birth defects that cause changes in the structure of the ear canal or middle ear
• Buildup of ear wax
• Buildup of fluid behind the eardrum
• Injury to or rupture of the eardrum
• Objects stuck in the ear canal
• Scar on the eardrum from many infections

Another type of hearing loss is due to a problem with the inner ear. It may occur when the tiny hair cells (nerve endings) that move sound through the ear are damaged. This type of hearing loss can be caused by:

• Exposure to certain toxic chemicals or medicines while in the womb or after birth
Genetic disorders
• Infections the mother passes to her baby in the womb (such as toxoplasmosis, measles, or herpes)
• Infections that can damage the brain after birth, such as meningitis or measles
• Problems with the structure of the inner ear
• Tumors

Central hearing loss results from damage to the auditory nerve itself, or the brain pathways that lead to the nerve. Central hearing loss is rare in infants and children.

Newborn Hearing Screening | Common Misconceptions and Clinical Facts

Misconception | Parents will know if their child has a hearing loss by the time their child is 2-3 months of age.
Clinical Fact | Prior to the universal screening, the average age at which children were found to have a hearing loss is 2-3 years. Children with mild-to-moderate hearing loss were often not identified until 4 years of age.

Misconception | Parents can identify a hearing loss by clapping their hands behind the child’s head.
Clinical Fact | Children can compensate for a hearing loss. They use visual cues, such as shadows or parental expressions and reactions, or they may feel the breeze caused by the motion of the hands.

Misconception | The HRR is all that is needed to identify children with hearing loss.
Clinical Fact | The HRR misses approximately 50% of all children with hearing loss.

Misconception | Hearing loss does not occur often enough to justify the use of universal screening programs.
Clinical Fact | Hearing loss affects approximately 2-4 per 1000 live births, and it has been estimated to be one of the most common congenital anomalies.

Misconception | Tests are not reliable and cause too many infants to be referred to specialists.
Clinical Fact | Referral rates are as low as 5-7%.

Misconception | There is no rush to identify a hearing loss. The loss does not need to be identified until a child is aged 2-3 years.
Clinical Fact | Children identified when they are older than 6 months can have speech and language delays. Children identified when they are younger than 6 months do not have these delays and are equal to their hearing peers in terms of speech and language.

Misconception | Children younger than 12 months cannot be fitted with hearing aids.
Clinical Fact | Children as young as 1 month of age can be fit with and benefit from hearing aids.

Newborn Hearing Screening | Golden Hour

The newborn hearing screening test helps to identify babies who have permanent hearing loss as early as possible. This means parents can get the support and advice they need right from the start. This is what we call the ‘Golden Hour’. It means detecting any medical issues at the right time. The right time is when it can be mitigated and cured with the best and least medical intervention.

One to two babies in every 1,000 are born with permanent hearing loss in one or both ears.
This increases to about 1 in every 100 babies who have spent more than 48 hours in intensive care. Most of these babies are born into families with no history of permanent hearing loss.
Permanent hearing loss can significantly affect a baby’s development. Finding out early can give these babies a better chance of developing language, speech, and communication skills. It will also help babies make the most of relationships with their family or carers from an early age.

How is the newborn hearing test done?

The test is called the automated otoacoustic emission (AOAE) test. It takes just a few minutes. A small soft-tipped earpiece is placed in your baby’s ear and gentle clicking sounds are played. When an ear receives sound, the inner part (called the cochlea) responds. This can be picked up by the screening equipment.

It’s not always possible to get clear responses from the first test. This happens with a lot of babies, and does not always mean your baby has a permanent hearing loss. It could mean:

• your baby was unsettled when the test was done
• there was background noise
• your baby has fluid or a temporary blockage in their ear

In these cases your baby will be offered a second test. This may be the same as the first test, or another type called the automated auditory brainstem response (AABR) test.

The AABR test involves placing three small sensors on your baby’s head and neck. Soft headphones are placed over your baby’s ears and gentle clicking sounds are played. This test takes between 5 and 15 minutes.

These tests will not harm your baby in any way.

Understanding the Importance of ‘Golden Hour’

It is 2017. Technology has updated to its best levels, economies are booming and health is the one taking the toll of everything. Welcome to the new age lifestyle. Where health takes a back seat and its not the best choice.

Living a healthy life begins with preventive healthcare. Maintaining your body and a good lifestyle are the first steps towards a long healthy life. Another important cog to complete the chart is finding your medical problems early to help your doctor help you. This is what we call the ‘Golden Hour’. It means detecting any medical issues at the right time. The right time is when it can be mitigated and cured with the best and least medical intervention.

Traditionally, the concept of golden hour has been long associated with the first sixty minutes post a heart attack, to recoup the situation to increase the probability of surviving the attack. We at GenWorks Health believe that the best time to solve a health issue is before it happens, through understanding the symptoms and signs and detection of the disease(s).

Technology advancements have brought together a whole set of medical devices which help in detection of diseases and disabilities at the right time, with the least pain. The two assumptions that people hold when it comes to detection are high cost and not happening to them. Well, its better to invest when it can be cured and diseases and disabilities can happen to anyone, anytime.

So, lets resolve in 2017 to take a better care of ourselves and invest our time and energies in understanding if we or our near and dear ones might be inching towards a life threatening disease. There is some reason that the expression is, ‘Health is Wealth’.