Treatment options for people with a meningioma
As with all brain tumour diagnoses, treatment depends on a variety of things. This includes:
- tumour size
- growth rate
- symptom burden
- overall health.
Meningioma treatment includes three options:
- Active surveillance. This is observation for small tumours that are not causing symptoms (asymptomatic).
- Surgery to remove the tumour. The goal here is to remove all of the tumour and the membranes from which it originates. How complex the surgery is depends on the tumour’s location and the nerves and blood vessels involved.
- Radiation may be used in combination with surgery for the more malignant meningiomas. You can find out more about the different types of radiotherapy that may be appropriate here. This includes information about stereotactic radiosurgery, a treatment option for meningiomas.
The NICE guidance states that the optimum standard of care for meningiomas should reflect:
- that management depends on signs, symptoms and the patient’s fitness, and the site and size of the tumour.
- a holistic approach to your treatment plan
- that maximum removal may be appropriate
- that radiotherapy may be considered if the tumour is:
- WHO grade II or III
- invading nearby brain tissue or extensively invading other tissue
- a second tumour or a recurring tumour
Just a note about chemotherapy. Chemotherapy is rarely used to treat meningiomas, except in atypical or malignant subtypes that cannot be adequately treated with surgery and/or radiotherapy.
You can find out more about chemotherapy here.
Whatever option is explored, there will be a need for follow-up over a period of many years. When you move into this phase, you will most likely have regular clinical reviews, which will be a scan followed by a consultation about the results.
The scanning protocol outlined by NICE gives the expected regime for meningiomas. This depends on the type of meningioma.
Grade I – scanning will be done at three months and then at 12-month intervals for three to five years. After this, scanning will be done once every two years.
Grade I – when radiotherapy is given, scanning will be done six months after radiotherapy and then at 12-month intervals for three years. After this, scanning will be done once every two years.
Grade II and III – scanning will be done at three months, six months and 12 months. After this, scanning will be done either every six months or annually, depending on the tumour.
Questions to ask about treatment options
The prospect of treatment for a meningioma can be a daunting one, and you may find that you have a lot of questions about what may be the best option for you.
Our patient guide has a selection of suggested questions that you can ask your clinical team, including treatment-specific questions.