In some cases, if a meningioma is not producing symptoms, doctors may take a “watchful waiting” monitoring approach, in which they scan the meningioma on a regular basis and have routine evaluations to check for symptoms. This may be a particularly good solution for older individuals without symptoms, for whom the risks and potential complications of surgery or radiation therapy may be greater than the symptoms of the meningioma.
Treatment options for meningioma will depend on where the tumor is located, its size and how aggressive it is perceived as being. Many times, doctors will want to remove a tumor that is growing or causing symptoms with surgery; however, for some patients this surgery is too risky, especially if the tumor is close to a vital blood vessel or brain structure.
If the surgeon cannot remove the tumor, or if he or she cannot remove the entire tumor, radiation therapy may be used to help shrink the tumor and prevent it from spreading. (Radiation therapy may also be used in cases where the surgery is successful, as meningiomas often grow back.)
Radiosurgery, a type of radiation treatment that aims powerful beams of radiation at a precise location (but is not, contrary to its name, actually surgery) is an option for individuals whose meningiomas cannot be removed or recur despite treatment. Fractionated radiation may be used to patients whose tumors are too large for radiosurgery or who cannot tolerate radiosurgery. In this technique, radiation is delivered in small fractions over time—for instance, the patient may undergo one treatment per day for 30 days.
Some doctors may also use medications for meningiomas that do not respond to radiation or surgery. Most types of chemotherapy do not work, though drugs such as hydroxyurea are sometimes used, and medications that inhibit the formation of blood vessels seems to have some potential.