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My name is Dr. Jeremy Rees.
I work as a Consultant Neurologist
at the National Hospital for Neurology
and Neurosurgery in London
and I'm going to be speaking
on the new advances
in treatment of gliomas.
And I'm going to restrict the talk
to the treatment of adult gliomas.
The format of the lecture
is that I'm going to give an overview
of the burden of disease and survival
from brain tumours in general
and then specifically talk about
according to the WHO's scheme
of brain tumours
and how we divide them up
into four distinct grades.
I'm then going to talk a little bit
about the molecular genetics
of these tumours
and how they are important
in determining prognosis,
and then I'm going to focus
the rest of the talk
on the controversies
in treatment of low-grade gliomas
followed by the advances
and limitations of current therapies
in high-grade gliomas,
and briefly finish
with a look at future directions
in the management of high-grade gliomas.
In terms of general cancer,
brain tumours occupy
a fairly small proportion
of the overall burden of cancer.
Recent data suggests that
there are approximately 4,000 cases
of brain cancer in a total of just
under 300,000 now,
so this is a relatively small proportion,
only about 2% of cancer in general.
However, brain cancer represents
the leading cause of life lost
and remains one of the most
challenging cancers to treat.
Unlike most cancers in adults,
brain cancer affects all age groups
all the way through
from very young children
to elderly adults.
As a general rule,
the incidence of cancer increases by age
and reaches a maximum in the 7th decade,
i.e. between 60 and 70 years old.
there is an almost universal agreement
that males are affected
more than females.