It’s obviously alarming to hear you’ve got a tumor in your brain. But if that tumor is a meningioma, the good news is that they’re almost always benign.
“Meningiomas are slow-growing and unlikely to cause symptoms,” says UNC Health neurosurgeon Sivakumar Jaikumar, MD. “You can have this tumor and not need treatment.”
Your brain and spinal cord are protected by three layers of membranes called the meninges. Along with cerebrospinal fluid, which is located between two of these layers, the meninges cushion your brain and allow blood flow to the brain.
Meningiomas, the most common brain tumors—accounting for about 37 percent of all tumors diagnosed in the brain and spinal cord—originate in these layers.
Many people don’t even know they have one, but because they’re generally not cancerous, that’s OK. If you have found out you have a meningioma, here’s what you need to know.
Risk Factors for a Meningioma
Your risk for a meningioma increases as you age; they are extremely rare in children.
“It’s the lesion we find the most as you get older, age 65 and up,” Dr. Jaikumar says.
Meningiomas are more common in women, suggesting that female hormones may play a role in tumor growth. Additionally, certain ethnic groups, predominately those of African descent, have been observed to have higher rates of meningiomas.
The exact cause of meningiomas is unknown. Some rare genetic conditions, including neurofibromatosis type 2, Cowden syndrome and Werner syndrome, put people at higher risk for a meningioma, Dr. Jaikumar says. Radiation exposure to the head may also increase risk.
Meningioma Symptoms
Meningiomas don’t always cause symptoms, and they might be discovered when your doctor is looking for something else.
“Maybe you were in a fender bender and are having a scan, or your ear, nose and throat doctor orders a scan—it might be found then,” Dr. Jaikumar says. “You might have this tumor for 5, 10, 15 years with no symptoms.”
Meningiomas can cause symptoms as they grow and press into the brain; even small tumors can cause symptoms depending on where they’re located in the brain.
“If they’re in the front of the brain, they can cause loss of smell,” Dr. Jaikumar says. “If they’re at the anterior skull base, they might push on the eye and affect vision. If they’re close to the hearing apparatus, they affect hearing.”
They can also cause muscle weakness, headache, dizziness, nausea, personality changes and seizures.
Many conditions can cause these symptoms, but if you notice that they happen persistently, talk to your doctor. Meningiomas can be diagnosed via CT scan or MRI.
Meningioma Treatment Options
You may not require any treatment for a meningioma.
“If you’re newly diagnosed, the first step is observation,” Dr. Jaikumar says. “You repeat scans, maybe at three, six or 12 months, to gather data about growth.”
Most meningiomas—about 80 percent—grow very slowly and are not cancerous; about 18 percent are considered atypical because they grow more quickly or unpredictably; and 1 to 2 percent are found to be malignant, or cancerous. They grow more quickly and show signs of spread that most meningiomas do not.
Even though the risk of malignancy is very low with a meningioma, Dr. Jaikumar acknowledges that it can be hard to hear that you have a tumor but immediate treatment isn’t recommended.
“It’s important to talk through how follow-up will happen, so that you can get some reassurance that you’re being watched closely,” he says. “We can also discuss where the tumor is so that you know what symptoms to watch for.”
Your doctor may recommend some additional tests so they’ll have data on how the meningioma could affect you. For example, if the tumor could cause sight or hearing issues, you may see an optometrist or an audiologist for baseline exams, and these could be repeated periodically to check for changes in function.
If you’re a woman, talk to your doctor about any precautions you should take in regard to hormonal medications, including oral contraceptives and menopause hormone therapy, since these hormones might cause tumor growth.
Your doctor may recommend surgical removal of the tumor, depending on your symptoms, your overall health, its size and growth, and its location in the brain. When meningiomas are located in areas where critical brain functions occur, there is a higher risk for complications.
The specifics of the surgery will depend on the size and location of the tumor, so talk to your doctor about what to expect from surgery and recovery.
“Depending on the location, we might be able to do a small incision, but the goal is to completely excise the tumor, so the surgery will be reasonably aggressive,” Dr. Jaikumar says.
Radiation therapy is sometimes recommended to reduce symptoms when tumors can’t be removed or following surgery.
After surgery, there is a chance that meningiomas can recur, and that risk is higher if the meningioma showed atypical growth or was malignant, so you’ll continue to get regular scans. For the majority of patients who have surgery to remove a typical meningioma, the prognosis is reassuring, with a five-year survival rate of 96 percent.
Struggling with unexplained symptoms? Talk to your doctor. If you need a doctor, find one near you.