Treatment overview
During an operation, the doctor removes tumour and some surrounding healthy tissue. It is the most common treatment for meningioma. And it is frequently the only treatment required for a person with noncancerous tumours that can be removed entirely after surgery. After surgery, radiation therapy and Chemotherapy are commonly used to treat patients who have a malignant tumour or a tumour that cannot be removed entirely after surgery (see below). The blood arteries that feed the tumour may be blocked before surgery to decrease bleeding.
A craniotomy is a treatment that removes a portion of the skull to perform brain surgery.
A neurosurgeon is a doctor who specialises in brain and spinal cord surgery. After the neurosurgeon removes the tumour, he or she utilises the patient’s bone to close the opening in the skull.
Aside from eliminating or shrinking the meningioma, the surgeon can perform surgery can to collect a tumour sample for examination under a microscope by a pathologist or neuropathologist (see Diagnosis). A neuropathologist is a doctor who specialises in diagnosing nervous system illnesses by examining the tissue under a microscope. The analysis results can indicate whether a patient requires additional treatments.
Wait-and-see approach
Everyone with meningioma does not require immediate treatment. A small, slow-growing meningioma that isn’t causing any indications or symptoms may not need a treatment. If you are not going to have treatment for your meningioma, you will most likely have brain scans regularly to review your meningioma and check for signals that it is growing. If your medical practitioner determines that your meningioma is growing and should receive a treatment, you have several alternatives.
Radiation therapy
Radiation therapy means the use of high-energy x-rays or other particles to eliminate tumour cells. A radiation oncologist is a doctor who specialises in administering radiation treatment to treat tumors. To limit the growth of an aggressive tumor, doctors may consider radiation therapy in addition to surgery. A radiation therapy regimen, or schedule, typically consists of a predetermined number of treatments administered over a predetermined period. Doctors can administer radiation therapy in a variety of methods.
Internal radiation therapy, also known as brachytherapy, involves surgically implanting tiny pellets or rods containing radioactive elements in or near the tumour. However, doctors use this metghod rarely to treat meningioma. External-beam radiation therapy employs a machine outside the body to target the tumour. These approaches improve their ability to target the tumour while avoiding healthy tissue. A linear accelerator, for example, is a piece of specialised x-ray equipment that moves around the body, directing pencil-thin beams of radiation to the brain tumour at various angles and intensities. This reduces the quantity of healthy tissue exposed to radiation.
For meningioma, one can use the following external-beam radiation treatment approaches:
Internal radiation therapy, also known as brachytherapy, involves surgically implanting tiny pellets or rods containing radioactive elements in or near the tumour. However, doctors rarely use this method to treat meningioma. Identification of the radiation path in this method becomes easy through features of the brain and skull and x- rays. This approach is appropriate when a person complete brain requires radiation therapy.
Different strategies required for more precise targeting.
IMRT is an external-beam radiation therapy that can directly target a tumour, sparing healthy tissue from radiation therapy. The radiation beams are divided into smaller beams in IMRT, and the intensity of each of these smaller beams can be adjusted. In other terms, the doctor can only direct the radiation beams towards the tumour. It is most effective in treating tumours close to critical sections of the brain, such as the brain stem and areas that govern vision.
A doctor builds a 3-dimensional model of the tumour and healthy tissues based on CT and MRI pictures on a computer. He or she chooses beam size and angles such that more he or she can deliver more radiation to the tumour while delivering less is to healthy tissue.
Stereotactic radiosurgery directs a single high dose of radiation therapy directly to the tumour rather than healthy tissue. It is most effective for tumours only in one part of the brain and some benign tumours, such as most meningiomas. Stereotactic radiosurgery equipment comes in a variety of forms, including:
A modified linear accelerator is a machine that generates high-energy radiation by using electricity to create a stream of fast-moving particles that aid in the death of tumor cells.
Another type of radiation therapy is gamma knife, which concentrates highly focused beams of gamma radiation on the tumor. A gamma knife can only treat meningioma in the brain, not the spine.
The cyberknife is a robotic device that guides radiation to the tumor during radiation therapy, and it is most commonly used to treat brain, head, and neck malignancies.
Stereotactic radiosurgery using fractionated doses is a radiation therapy comparable to stereotactic radiation therapy in that smaller doses are administered over days to weeks. The patient’s precise placement is critical, and a specific head frame is employed to aim the radiation. This method is appropriate for tumors adjacent to complicated or sensitive structures, such as the optic nerve, eye, or brain stem.
Proton treatment is a type of radiation therapy that uses protons. Proton treatment is an external beam radiation therapy in which the medical practitioners use protons instead of X-rays. Protons can destroy tumor cells at high energies.
Using these various strategies, medical practitioners attempt to target the tumour better and limit the dose to the surrounding healthy tissue. The radiation oncologist may use any of the initial radiation therapy approaches depending on the size and the location of the meningioma.
Side effects of radiation therapy
Radiation therapy can cause fatigue, moderate skin responses, stomach distress, and neurologic problems. The majority of adverse effects fade quickly after the treatment is complete. Furthermore, doctors usually do not suggest radiation therapy for children under the age of five due to the high risk of brain damage. Long term adverse effects are possible and may emerge years after the treatment. Cognitive issues, such as memory loss and a gradual deterioration in intellectual function, may occur in a person. If the patient exposes his or her pituitary gland to radiation, changes in hormone levels may occur. The pituitary gland is located near the brain, producing hormones that regulate biological processes or activities. An endocrinologist should assess patients in these scenarios. An endocrinologist is a physician who specialises in hormones, glands and the body’s endocrine system.
The severity of these adverse effects depends on the amount of radiation therapy administered and the location of the radiation in the brain. With improved technology and precision in radiation therapy, many side effects have grown less severe. If you have any questions or concerns regarding radiation therapy’s potential long-term side effects, consult and discuss with your radiation therapist before the treatment begins.
Chemotherapy
Doctors rarely use chemotherapy, also known as drug therapy, to treat meningiomas. However, they may utilise it in cases where surgery and radiation have failed. There is no common chemotherapeutic strategy for meningiomas; however, researchers invest in molecularly targeted techniques.
Chemotherapy uses medications to eliminate tumor cells, typically by preventing tumor cells from growing, dividing and proliferating. Chemotherapy is administered by a medical oncologist, a specialist who specialises in using drugs to treat tumors or a neuro-oncologist. As previously stated, rarely Chemotherapy is the solution to treat meningioma.
The chemotherapy side effects vary depending on the individual and the doses used. Still, they can include exhaustion, infection risk, nausea and vomiting, hair loss, loss of appetite, and diarrhoea. These adverse effects usually fade away once the treatment is complete.
What are the treatment options for atypical and anaplastic meningiomas?
If possible, surgery is the first line of defence against a malignant meningioma. Surgery aims to gather tissue to determine the type of tumor and remove as much tumor as feasible without exacerbating the patient’s symptoms.
The majority of people with atypical and anaplastic meningiomas need further treatment. Radiation is frequently takes place after surgery to postpone the recurrence of Grade II and Grade III meningiomas. One can also use chemotherapy and clinical trials as treatments. Clinical trials with novel Chemotherapy, targeted therapy or immunotherapy medications may also be accessible as a treatment option. It is unknown what kind of role chemotherapy or clinical trials play after radiation therapy. Treatments are determined by the patient’s healthcare team based on the patient’s age, the amount of tumor remaining after surgery, and the type of tumor.
Physical, emotional, and social effects
Meningioma and its treatment are associated with many physical symptoms and side effects and emotional, social, and economic consequences. Palliative care treats all these side effects, also known as supportive care. It is an essential aspect of your treatment, along with medicines to slow, stop, or remove the tumor.
Palliative care focuses on enhancing your quality of life throughout the treatment process by treating symptoms and assisting patients and their families with non-medical concerns. This form of care is available to everybody, regardless of age, tumor type, or stage. And it frequently works best when started immediately following a diagnosis.
People who receive palliative care and treatment for the tumor often have less severe symptoms, a better quality of life and report that they are more satisfied with their treatment.
Palliative treatments vary widely and often include medication, nutritional changes, relaxation techniques, emotional and spiritual support, and other therapies. You may also receive palliative treatments similar to those meant to get rid of the tumor, such as Chemotherapy, surgery, or radiation therapy.
In trace levels in the human body, doctors can find steroids. They are incredibly effective and potent anti-inflammatories in larger doses that reduce swelling. Most people who have a brain tumor will require steroids to decrease brain swelling. When you are first diagnosed, before and after surgery, before and after radiation therapy, and if you have an advanced brain tumor, you will certainly be given steroids. Steroids can induce weight gain and water retention and increase hunger, sleeping difficulties, mood swings, and gastrointestinal irritation. After a successful brain tumor therapy, your medical practitioner may gradually reduce the number of steroids you need to take over time.
If fluid begins to accumulate in the brain, a surgeon may need to insert a device known as a shunt to bypass, transfer, or drain the excess liquid.
Medication for depression: Depression is common in people with central nervous system tumors, yet it is frequently undiagnosed. However, not everyone who has a CNS tumor is under depression. Firstly inform your health care staff often about how you are feeling. If you have any depression symptoms, your health care provider may opt to prescribe an antidepressant prescription to help you with your symptoms.
Medication to prevent seizures – Seizures may occur in people with central nervous system tumors. This sort of drug aids in the regulation of a person’s seizure frequency.
Remission and chance of recurrence
Remission occurs when the tumour is no longer detectable in the body and no symptoms exist. In other words, NED, or “no evidence of disease.”
A remission may be temporary or permanent. Many people are concerned that the tumour will return due to this uncertainty. While many remissions are durable, it’s crucial to discuss the potential of the tumour bearing with your doctor. Knowing your recurrence risk and treatment options will help you feel better prepared if the tumour produces. Find out how to deal with the worry of recurrence.
A recurrent tumour occurs when the tumour returns after the initial treatment. It may reoccur in the exact location (called a local recurrence), in a nearby area (called a regional recurrence), or in a different place (called a regional recurrence) (distant recurrence).
When this happens, a new testing cycle will begin to understand the recurrence as much as possible. Following the testing, you and your doctor will discuss treatment choices. Doctors frequently include these treatments, like surgery, radiation therapy, and chemotherapy in treatment plans. However, the doctors perform them in a different order or at a different pace. Your doctor may refer you to clinical studies looking for novel ways to treat recurrent tumours.
Additional surgery is the most typical treatment for recurrent meningioma. Doctors commonly perform radiation therapy, when surgery is not an option. In addition, a patient can still receive treatment for the tumor’s symptoms. Because meningioma symptoms might interfere with a person’s quality of life, symptom management is always essential.
People who have a recurring tumour frequently experience feelings of scepticism or terror. Patients have to discuss their thoughts with their health care team and inquire about support options to assist you in coping. Find out how to deal with a recurrence.
If treatment does not work
Meningioma recovery is not usually possible. The sickness is progresses or remains terminal, when a tumour there is no cure or control of the tumor.
This is a traumatic diagnosis, and for many people, discussing advanced meningioma is tough. However, it is critical to communicate openly and honestly with your health care team to express your views, preferences, and concerns. The health care team has specialised skills,
expertise, and information to assist patients and their families. ensuring that a person is physically comfortable and pain-free
People who have advanced disease and are anticipated to live for less than six months may benefit from hospice care. Hospice care is intended to offer patients nearing the end of their lives the highest possible quality of life. You and your family are invited to discuss hospice care alternatives with the health care team, which may include hospice care at home, a designated hospice centre, or other healthcare venues. Staying at home with nursing care and proper equipment might be a viable choice for many families. More information about advanced cancer care planning is available here. Alternative medicine treatments cannot cure meningiomas, but they can help you cope with The stress of having a meningioma or relieve adverse therapy effects. Alternative medicine treatments that may be beneficial include:
Acupuncture, hypnosis, massage, meditation, music therapy, and relaxation exercises are options.
