Not all meningiomas need to be treated right away. Close observation may be the best choice for those with few symptoms and little to no brain swelling in the nearby areas. Or for those who experience a significant risk with treatment. Some people may find that a second opinion about treatment helps in their decision-making.
Surgery
Your doctor will likely want to remove it with surgery if your meningioma is causing symptoms or is growing. In some cases, though, trying to remove the tumor may be too risky. For example, the tumor may be too close to vital brain structures or blood vessels.
If you do have surgery, the surgeon will try to take out as much of the tumor as possible. The surgeon may use MRI scans of your brain to help guide the surgery. The surgeon may also use a special microscope during the surgery to get a better view of the tumor and the surrounding parts of your brain.
Radiation therapy
If the surgeon can't remove the tumor—or can only remove part of it—you may need radiation therapy. Depending on the areas of the brain or spinal cord that are involved, radiation therapy may help shrink any remaining tumor and can also help prevent it from spreading to the tissues around it. Even if the tumor is completely removed during surgery, some doctors may still recommend radiation therapy to help prevent another meningioma from developing in the future. Meningiomas have a tendency to grow back after surgery. Radiation treatment is sometimes given with more precision by using a gamma knife or cyberknife.
Medicine
Your doctor may also recommend medicine to treat the tumor or some of the symptoms related to the tumor. Clinical trials are underway that are studying several different medicines to see if they are effective in treating meningiomas. You may need to take part in a study to be able to use these medicines.
You may also be prescribed other types of medicines to treat symptoms caused by the meningioma, such as seizures, excessive vomiting, weakness, and vision disturbances.