Molecular pathology of brain tumours - how will molecular and cell biology contribute to improved outcomes in patients with malignant brain tumours?

Abstract

Although in comparison to breast, lung and colon cancer, the brain is a relatively uncommon site for the development of cancer, the brain is the tenth most common site for the development of cancer in men and about the twelfth in women. This translates to about 6,000 individuals in the UK developing a primary malignant brain tumour every year. Cancer of the brain develops in two distinct age groups, although the types of tumour that develop in these two age groups differ markedly. There is a peak of incidence in the first decade of life, and brain tumours rank with leukaemia as a leading cause of cancer death in children. These tumours tend to be indolent low-grade astrocytomas or highly malignant primitive neuroectodermal tumours like medulloblastoma. However, the vast majority of brain tumours occur with increasing frequency in the sixth, seventh and eight decade of life and they are the second fastest growing cause of cancer death among those over 65. These tumours tend to be malignant astrocytomas particularly the most malignant variety, glioblastoma multiforme (GBM). Unlike lung cancer or malignant melanoma there is no strong evidence of an environmental carcinogen associated with the development of these tumours and no change in behaviour reduces risk.