The words “brain tumor” sound scary to anyone. After all, we are talking about the most complex organ in the human body.
But what you might not know is that some brain tumors can be treated — or even just monitored — quite successfully with very positive outcomes.
And this is exactly the case with a specific type of brain tumor called a meningioma, which is a common tumor that forms within the outer three thin layers of tissue that cover the brain and spinal cord, called meninges.
Dr. Ravi Gandhi, neurosurgeon at Florida Hospital Orlando who specializes in brain tumors and minimally invasive brain surgery, explains more about meningiomas, and how many patients go on to live healthy, fulfilling lives under the care of a qualified neurosurgeon.
Meningiomas account for about 36 percent of all primary brain tumors and 20 percent of all brain tumors
“Meningiomas are common types of tumors within the head,” says Dr. Gandhi. In fact, this skilled neurosurgeon performs an average of two brain tumor surgeries per week, and about one meningioma-specific surgery per month.
Dr. Gandhi further explains that meningiomas can affect anyone, but 40 percent occur in adults over age 60.
“Certain genetic mutations can cause people to have multiple meningiomas, or have these types of brain tumors run in their families,” explains Dr. Gandhi.
Meningiomas are usually benign
The good news is that most meningiomas are usually benign and slow-growing, meaning they do not have cancerous cells that can spread to other parts of the body.
“All tumors are evaluated and given a specific “stage,” from grade 1 being the least aggressive to grade 4 being most aggressive; 90 percent of meningiomas are grade 1 (or completely benign), a handful are grade 2, and a grade of 3 to 4 meningioma is very rare,” confirms Dr. Gandhi.
Meningiomas are often found inadvertently
“70 to 80 percent of meningiomas are found incidentally, meaning patients have no symptoms and they are identified through a CAT scan or MRI for an unrelated reason,” says Dr. Gandhi.
He adds, “For the remaining 20 to 30 percent of patients, meningiomas cause symptoms that bring them in to see a doctor for evaluation and more specific diagnostic testing.”
Meningioma symptoms depend on its location in the brain
“Meningiomas are often asymptomatic until they get to a certain size or affect a specific location — in the brain, location is everything,” points out Dr. Gandhi.
Meningiomas tend to grow inward, which can eventually can cause pressure on the brain or spinal cord.
When the tumor begins to put pressure on the brain, symptoms might begin.
Dr. Gandhi explains that common meningioma symptoms can include chronic:
- Neurologic difficulties
- Problems with speech
- Difficulty hearing
- Facial weakness and/or pain
- Disturbances in vision
Not all meningiomas need surgery
Meningiomas most commonly occur in specific locations and are classified as convexity (over the surface of the brain) or skull-based.
“Every patient is unique, presenting with different tumor sizes and locations, symptoms, growth rate, age, medical history, etc., so the treatments that we recommend consider many factors,” explains Dr. Gandhi.
Dr. Gandhi explains that treatment generally falls into three options: observation, surgery to remove the meningioma, and/or radiation.
Dr. Gandhi notes, “Many patients with meningiomas just need observation, where depending on the size and location, we check the meningioma through an MRI in one year’s time to see if it is changing.”
If it’s found that the meningioma reaches a specific size or the patient is experiencing symptoms, surgery is often the first line of treatment.
Surgery often brings positive outcomes for patients with meningiomas
“If you’ve been diagnosed with a meningioma and you’re being told that you need surgery, it becomes important to have surgery from neurosurgeon that specializes in these types of tumors,” Dr. Gandhi thoughtfully explains.
He adds, “When your neurosurgeon has adequate experience, the risk of complications and difficulties after surgery to remove a meningioma are relatively low, but just like any surgery, there are always risks, which rise as a tumor gets larger or is located in a more challenging part of the brain.”
After surgery, according to Dr. Gandhi, patients can expect to spend about one day in the ICU for close monitoring, and then another one to two days in the hospital before returning home. Once home, patients are advised to take it easy, and are able to do most daily activities with restrictions on vigorous activity for a few weeks.
“We see patients for frequent follow-ups after surgery to make sure they are healing, and once we confirm that they are doing well, patients generally come for check-ups only once a year,” says Dr. Gandhi.
Meningiomas can reoccur
Just like any tumor, meningiomas can reoccur after surgery. Dr. Gandhi clarifies, “The rate of reoccurrence depends on how much of the tumor tissue and surrounding cells are removed during surgery — if the entire tumor has been taken out with all affected tissue, reoccurrence is much less likely.”
Gandhi adds, “Sometimes, due to the location and position of the tumor (if it is too close to an artery or particular nerves), part of the tumor or affected tissue can’t always be removed, and the chance of reoccurrence is higher, but since meningiomas are usually slow-growing tumors, we can often control their growth with radiation.”
There is no proven cause of meningiomas
There is no proven cause of meningiomas, but there are two important risk factors to consider: radiation exposure and a genetic condition called neurofibromatosis type 2.
“We’ve also identified that some meningiomas have estrogen and progesterone receptors, so they can grow faster in stages of hormone changes that occur throughout pregnancy, or during certain treatments for breast cancer. This is a correlation and does not mean that these things are a cause of meningiomas.,” notes Dr. Gandhi.
Dr. Gandhi adds, “It’s also important to point out that there is no proven association between meningiomas — or any type of brain tumor — and cell phone usage.”
Extending hope for all
From helping patients with meningiomas to those with many other neurological conditions and traumas, Dr. Gandhi shares his love for what he does as a neurosurgeon.
Dr. Gandhi reflects:
“When I wake up every day, I feel lucky that I get to help people as a neurosurgeon — being a neurosurgeon is something that I dreamt about since childhood. I decided I wanted to be a neurosurgeon in fourth grade, and after having a grandfather experience a stroke and learning more about how someone who can treat diseases of the brain can change a person/family’s lives, my commitment to making this dream come true was even more solidified.”
“The reality of my childhood dream is just how I always imagined it would be – I talk to patients and their families, sometimes at their worst, and provide some hope and comfort. And I get to work within a hospital that has some of the most advanced technology available in the field that supports me in providing safer and better surgery for my patients. It’s what I was meant to do.”
Learn more about the Florida Hospital Neuroscience Institute.