David Walker

 

UK

 

Biography

Dr. David A. Walker is a Professor of Paediatric Oncology, Co-director of the Children’s Brain Tumour Research Centre at the University of Nottingham UK and a Consultant paediatric oncologist at NUH NHS Trust, Nottingham, UK

Since his appointment in the 1990s, Dr. Walker has led the UK and Europe Brain Tumour Clinical Trials Committees for the Children’s Cancer and Leukaemia Group (CCLG) and International Paediatric oncoloigie Society in Europe (SIOPe).

His current research is focused on “Halving the Harm of Brain Tumours” and includes projects concerned with:

  • Cerebellar Mutism Syndrome seeking to develop a predictive scoring system for this risk.
  • HeadSmart Early Diagnosis of Brain tumour (www.headsmart.org.uk), seeking to accelerate diagnosis of brain tumours in children and young people. 
  • Children’s Brain Tumour Drug Delivery Consortium seeking to promote research priority for drug delivery system development for children’s brain tumours www.cbtddc.org, and 
  • SIOPe Low Grade Glioma in NF1 group which is seeking to contribute to clinical trial’s design for new sight saving therapy for NF1 associated visual pathway glioma

He was an elected member of the Societe Internationale d’Oncologie Pediatrique Europe (SIOPe) Board (2010-2014) and worked to influence the revision of EU Clinical Trials Legislation in 2014 to meet the needs of children and young people with cancer.

He has participated in the UK All Party Parliamentary Group concerned with brain tumours since its inception, which supported the petitions committee report and the subsequent Parliamenary Debate in April 2016. https://www.parliament.uk/business/committees/committees-a-z/commons-select/petitions-committee/inquiries/parliament-2015/funding-for-research-into-brain-tumours/

He is married to Gill with two grown up daughters, Emma and Kate and has a lifelong ambition to climb all mountains in Scotland over 3000 feet in height (914.4m), listed on Munros Tables (201 of 282 climbed so far). He has cycled the length of Scotland and England twice.

 

Conference Presentation

Keynote Lecture: Brain Injury Due to Childhood Brain Tumours:  What Are the Causes, The Effects and How Can It Be Rehabilitated but More Importantly, Prevented?

 

Children’s brain tumours affect 1 in 2400 children aged under 16 years of age, every neurosurgical centre sees many children each year.  Improved approaches to treatment have resulted in improving survival outcomes (<70% 5-year survival), in developed countries.  Survivors experience life-long moderate to severe disability (~60%), due to a variety of focal and generalized brain injuries linked to the tumour, its clinical presentation at different ages, and surgical and adjuvant treatments.

The commonest anatomical location for brain tumours in children is the posterior fossa (~55%), the majority arising within the cerebellum, which if damaged, with its central role in brain processing, can result in serious lifelong global disability. Cerebellar mutism syndrome (CMS) is an extreme form of cerebellar injury arising in the days after surgery and is characterized by loss of speech and additional brain stem dysfunction with subsequent incomplete recovery.

The patient and family experience of CMS will be illustrated in a brief film https://jtvcancersupport.com/2016/06/cerebellar-mutism/, and a description of two cases where rehabilitation has been described 1.  The results of a detailed study of a clinical cohort where linguistic function of survivors have been studied with cortical mapping will be presented, to highlight the brain’s adaptation to the injury2,3,4.

I will conclude by proposing that serious brain injuries due to such tumours can only be reduced in their frequency and severity by accelerating diagnosis, predicting neurological risks and making adjustments to surgical and adjuvant therapy programmes and by population monitoring of relevant outcomes.  This approach is proposed as a complementary strategy to the existing clinical trials programmes.  Such is the potential scope for paediatric neuro-oncology translational research in 2017, going forward.

 

Objectives:

  1. To inform the audience of the clinical challenge of childhood brain tumours and the associated risk of brain injury, focusing upon the cerebellar brain injury as the commonest anatomical location for tumours in the age group. 
  2. To illustrate the impact on the child and family affected by cerebellar tumours by describing rehabilitation after cerebellar mutism and a cohort study correlating neurocognitive and linguistic function with anatomical studies.
  3. To identify population strategies that are in early use to reduce these risks of brain injury through accelerating diagnosis of brain tumours, and their potential to reduce visual impairment and improve brain performance for survivors.

 

References:

  1. David Walker, S.A. Thomas, E.J. Talbot, E.J. Bennett, A. Starza-Smith and Stephanie L. Da Silva.  Cerebellar Mutism: The rehabilitation challenge in pediatric neuro-oncology: Case studies.
  2. Davis EE, Pitchford NJ, Jaspan T, Macarthur D and Walker D. (2010) Development of cognitive and motor function following cerebellar tumour injury sustained in early childhood Cortex. 46(7), 919-932
  3. Davis EE, Pitchford NJ, Jaspan T, McArthur DC, Walker DA.  Effects of hydrocephalus after cerebellar tumor: a case-by-case approach Pediatr Neurol. 2011 Mar;44(3):193-201. doi: 10.1016/j.pediatrneurol.2010.09.010.
  4. Olha Hodgson Nicola Pitchford Denis Schluppeck Rob Dineen David Walker. Impaired linguistic abilities and cortical re-mapping of the language processing in long-term posterior fossa tumour survivors.  Neuro Oncol (2016) 18 (suppl_3): iii156-iii56. DOI: https://doi.org/10.1093/neuonc/now081.49  Published: 30 May 2016.

 

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