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Meningioma - Introduction (http://www.cancer.net/cancer-
types/meningioma/introduction)
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ON THIS PAGE: You will find some basic information about this disease and the parts of the body it
may affect. This is the first page of Cancer.Net’s Guide to Meningioma. Use the menu to see other
pages. Think of that menu as a roadmap for this complete guide.

About the central nervous system


The brain and spinal column make up the central nervous system (CNS), which controls many of the
vital functions of the body. When a tumor forms in the CNS (http://www.cancer.net/node/31327) , it can be
especially problematic and challenging to treat because a person’s thought processes, movements,
and senses can be affected.

About meningioma
A tumor begins when healthy cells change and grow out of control, often forming a mass. A tumor
can be cancerous or benign. In general, a cancerous tumor is malignant, meaning it can spread or
grown into to other parts of the body. A benign tumor can grow but will not spread.

This guide focuses on meningioma. Meningioma is usually a slow-growing tumor that forms on the
surface of the brain. It may cause significant symptoms if it grows and presses on the brain or spinal
cord. Meningioma starts in the meningeal tissues, which are thin membranes that surround the brain
and spinal cord. There are 3 meningeal layers: the dura mater, arachnoid, and pia mater. The
meninges protect the brain and spinal cord and help the cerebrospinal fluid (CSF) circulate between
the arachnoid and pia layers.

Approximately 80% of meningiomas are benign. The remaining 20% are either called atypical
because they have an increased risk of returning after treatment or, rarely, malignant. Malignant
meningioma may be called anaplastic.

Subtypes of meningioma
Meningioma is often classified based on where it starts in the CNS.

Falx and parasagittal meningioma. The falx is a membrane that sits in a groove between
the left and right sides of the brain. It contains a large blood vessel and protects the brain.
Parasagittal meningioma occurs at the top of the falx just on the inside of the skull. These are

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the most common types of meningioma and make up about 25% of all meningiomas.

Convexity meningioma. This type of meningioma occurs on the outer surface of the brain. It
makes up about 20% of meningiomas.

Sphenoid meningioma. The sphenoidal ridge is located behind the eyes. This type of
meningioma makes up 20% of all meningiomas.

Olfactory groove meningioma. This type of meningioma occurs near the nerves that
connect the brain to the nose. This type makes up 10% of meningiomas.

Posterior fossa meningioma. Posterior fossa meningioma develops at the back of the
brain. It makes up 10% of all meningiomas.

Suprasellar meningioma. Suprasellar meningioma occurs next to the sella turcica. This is
an area at the base of the skull in the center of the skull where the pituitary gland sits. This
type makes up 10% of all meningiomas.

Spinal meningioma. Spinal meningioma usually occurs in the spine at chest level and may
push against the spinal cord. It can cause pain radiating around the chest wall, bladder
trouble, or weakness or numbness in the legs. This type makes up less than 10% of all
meningiomas.

Intraorbital meningioma. This type of meningioma develops in or around the eye sockets. It
accounts for less than 10% of meningiomas.

Intraventricular meningioma. Intraventricular meningioma occurs in the chambers that


carry fluid throughout the brain. This type makes up about 2% of all meningiomas.

Looking for More of an Introduction?


If you would like more of an introduction, explore this related item. Please note that this link will take
you to another section on Cancer.Net:

Cancer.Net Patient Education Video: View a short video (http://www.cancer.net/node/27391) on


brain tumors led by an ASCO expert that provides basic information and areas of research.

The next section in this guide is Statistics (http://www.cancer.net/node/19267) . It helps explain the
number of people who are diagnosed with this disease and general survival rates. You may use the
menu to choose a different section to read in this guide.
Meningioma - Statistics (http://www.cancer.net/cancer-types/meningioma
/statistics)
Approved by the Cancer.Net Editorial Board (http://www.cancer.net/about-us) , 07/2017

ON THIS PAGE: You will find information about the number of people who are diagnosed with
meningioma each year. You will also read general information on surviving the disease. Remember,
survival rates depend on several factors. Use the menu to see other pages.

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A primary brain tumor is a tumor that begins in the brain. In the United States, meningioma accounts
for almost 37% of primary brain tumors. An estimated 29,320 people will be diagnosed with
meningioma this year. Incidence rates increase with age, with a dramatic increase in adults age 65
and older. It is rarely found in children. Women are diagnosed with meningioma more often than
men, and black men and women are at a much higher risk for the disease than white men and
women.

Most meningiomas are noncancerous. Cancerous meningiomas make up a little more than 1% of all
primary brain tumors.

The 10-year survival rate tells you what percent of people live at least 10 years after the tumor is
found. Percent means how many out of 100. The 10-year survival rate for malignant meningioma is
around 57%.

Survival rates for meningioma depend on several factors, including whether the tumor is cancerous
and the patient’s age. The 10-year survival for malignant meningioma is almost 78% for people age
20 to 44 and about 40% for people 75 and older.

It is important to remember that statistics on the survival rates for people with meningioma are an
estimate. The estimate comes from annual data based on the number of people with meningioma in
the United States. Also, experts measure the survival statistics every 10 years. So the estimate may
not show the results of better diagnosis or treatment available for less than 10 years. People should
talk with their doctor if they have any questions about this information. Learn more
about understanding statistics (http://www.cancer.net/node/24961) .

Source: Central Brain Tumor Registry of the United States.

The next section in this guide is Medical Illustrations (http://www.cancer.net/node/19268) . It offers


drawings of body parts often affected by meningioma. Use the menu to choose a different section to
read in this guide.
Meningioma - Medical Illustrations (http://www.cancer.net/cancer-
types/meningioma/medical-illustrations)
Approved by the Cancer.Net Editorial Board (http://www.cancer.net/about-us) , 07/2017

ON THIS PAGE: You will find a drawing about the main body parts affected by this disease. Use the
menu to see other pages.

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The next section in this guide is Risk Factors (http://www.cancer.net/node/19269) . It explains what factors
may increase the chance of developing this disease. You may use the menu to choose a different
section to read in this guide.
Meningioma - Risk Factors (http://www.cancer.net/cancer-
types/meningioma/risk-factors)
Approved by the Cancer.Net Editorial Board (http://www.cancer.net/about-us) , 07/2017

ON THIS PAGE: You will find out more about the factors that increase the chance of developing
meningioma. Use the menu to see other pages.

A risk factor is anything that increases a person’s chance of developing a tumor. Although risk
factors often influence the development of a tumor, most do not directly cause a tumor. Some
people with several risk factors never develop a tumor, while others with no known risk factors do.
Knowing your risk factors and talking about them with your doctor can help you make more informed
lifestyle and health care choices.

The risk factors for meningioma include:

Age. Meningioma is most common in adults age 65 or older, but it can occur at any age.
Meningioma is rare in children (http://www.cancer.net/node/31323) .

Gender. Women are about twice as likely as men to develop noncancerous meningioma.
However, men and women are equally likely to be diagnosed with cancerous meningioma.

Radiation exposure. Radiation to the head may increase a person’s risk of developing
meningioma. Common sources of radiation that can cause meningioma include accidental
exposure to radiation and radiation therapy as a treatment for ringworm on the scalp, called
tinea capitis.

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Genetic disorders. People with neurofibromatosis type 2 (http://www.cancer.net/node/19451) (NF2)


have a higher risk of developing meningioma. People with NF2 are also more likely to
develop cancerous meningioma or more than 1 meningioma.

Race/Ethnicity. In the United States, black people have higher rates of meningioma than
white people. Meningioma is more common in Africa than in North America or Europe.

The next section in this guide is Symptoms and Signs (http://www.cancer.net/node/19270) . It explains
what body changes or medical problems this disease can cause. You may use the menu to choose
a different section to read in this guide.
Meningioma - Symptoms and Signs (http://www.cancer.net/cancer-
types/meningioma/symptoms-and-signs)
Approved by the Cancer.Net Editorial Board (http://www.cancer.net/about-us) , 07/2017

ON THIS PAGE: You will find out more about body changes and other things that can signal a
problem that may need medical care. Use the menu to see other pages.

People with meningioma may experience the following symptoms or signs. Sometimes, people with
meningioma do not have any of these changes. Or, the cause of a symptom may be a different
medical condition that is not a tumor.

Symptoms of meningioma can be caused by the tumor pressing on the brain or spinal cord,
stopping the normal functioning of a specific part of the brain, or pressing on nearby nerves or blood
vessels. If the meningioma involves nearby bone, it may cause the bone to expand. Generally,
meningioma is not diagnosed until symptoms begin.

General symptoms
General symptoms from the tumor pressing on the brain or spinal cord:

Seizures. Motor seizures, also called convulsions, are sudden involuntary movements of a
person’s muscles. People may experience different types of seizures, including myoclonic,
tonic-clonic (grand mal), sensory, and complex partial. Certain drugs can help prevent or
control them. The differences between these types of seizures are explained below:
Myclonic
Single or multiple muscle twitches, jerks, and/or spasms

Tonic-Clonic (Grand Mal)


Loss of consciousness and body tone, followed by twitching and relaxing
muscle contractions
Loss of control of body functions
May be a short 30-second period of no breathing and the person may turn a
shade of blue
After this type of seizure a person may be sleepy and experience a headache,
confusion, weakness, numbness, and sore muscles.

Sensory
Change in sensation, vision, smell, and/or hearing without losing consciousness

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Complex partial
May cause a loss of awareness or a partial or total loss of consciousness
May be associated with repetitive, unintentional movements, such as twitching

Headaches, which may be severe and may worsen with activity or in the early morning
Personality or memory changes
Nausea or vomiting
Blurred vision

Symptoms specific to the tumor’s location:

Symptoms of falx and parasagittal meningioma


Leg weakness

Headaches

Seizures

Symptoms of convexity meningioma


Seizures

Headaches

Focal neurological deficits. These are nerve problems that affect either a specific location or a
small area. These problems may affect one side of the face or an arm or leg. They may also
affect a smaller area like the tongue. The tumor can also affect a specific function. For
example, speech may be affected, but not the ability to write. It also may cause a loss of
movement or feeling.

Personality or memory changes

Symptoms of sphenoid meningioma


Loss of feeling or numbness in the face

Loss of patches of sight within field of vision, blindness, double vision

Headaches

Symptoms of olfactory groove meningioma


Loss of smell

Loss of patches of sight within field of vision, blindness, double vision

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Headaches

Symptoms of posterior fossa meningioma


Sharp pains in the face, facial numbness, and spasms of the facial muscles

Loss of hearing

Difficulty swallowing

Trouble walking

Symptoms of suprasellar meningioma


Swelling of the optic disk, which is in the retina of the eye where nerve fibers come together
to form part of the optic nerve.

Loss of patches of sight within field of vision, blindness, double vision

Symptoms of spinal meningioma


Back pain

Pain in the limbs or chest

Numbness and weakness or the arms and/or legs

Difficulties with bodily functions of the bowel or bladder

Symptoms of intraorbital meningioma


Bulging of the eye

Loss of vision

Symptoms of intraventricular meningioma


Personality or memory changes

Headaches

Dizziness

If you are concerned about any changes you experience, please talk with your doctor. Your doctor
will ask how long and how often you’ve been experiencing the symptom(s), in addition to other
questions. This is to help figure out the cause of the problem, called a diagnosis (http://www.cancer.net

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/node/19271) .

If a brain tumor is diagnosed, relieving symptoms remains an important part of care and treatment.
This may also be called symptom management, palliative care, or supportive care. Be sure to talk
with your health care team about the symptoms you experience, including any new symptoms or a
change in symptoms.

The next section in this guide is Diagnosis (http://www.cancer.net/node/19271) . It explains what tests
may be needed to learn more about the cause of the symptoms. You may use the menu to choose a
different section to read in this guide.
Meningioma - Diagnosis (http://www.cancer.net/cancer-
types/meningioma/diagnosis)
Approved by the Cancer.Net Editorial Board (http://www.cancer.net/about-us) , 07/2017

ON THIS PAGE: You will find a list of common tests, procedures, and scans that doctors use to find
the cause of a medical problem. Use the menu to see other pages.

Doctors use many tests to find, or diagnose, a tumor and learn if it is cancerous. They may also do
tests to learn which treatments could work best.

For most tumor types, a biopsy or the removal of a tumor with surgery are the only sure ways for the
doctor to know whether an area of the body has a tumor. In a biopsy, the doctor takes a small
sample of tissue for testing in a laboratory. If a biopsy is not possible, the doctor may suggest other
tests that will help make a diagnosis.

This list describes options for diagnosing meningioma. Not all tests listed below will be used for
every person. Your doctor may consider these factors when choosing a diagnostic test:

The type of tumor suspected


Your signs and symptoms
Your age and medical condition
The results of earlier medical tests

Sometimes, meningioma is found accidentally while having a procedure for another reason. More
commonly, meningioma is often not diagnosed until a person starts having symptoms. A neuro-
oncologist is a doctor who specializes in diagnosing and treating brain and nervous system tumors.
The neuro-oncologist uses a patient’s symptoms as clues to the location of the tumor. In addition to
a detailed medical history and physical examination, the following tests may help the doctor find and
diagnose meningioma:

Neurological, vision, and hearing tests. These tests help find out how a possible tumor is
affecting the brain. An eye examination can find changes to the optic nerve caused by
pressure from a meningioma.

Stereotactic neurosurgery/biopsy. A biopsy (http://www.cancer.net/node/24406) can be performed


during a procedure called a stereotactic technique. This technique uses a needle guided to
the tumor with computers and imaging tests. A biopsy can also be done during surgery when
the surgeon can look at the tumor directly. However, meningioma is usually removed rather
than doing a separate biopsy. This means that surgery for meningioma is usually done by an
open craniotomy instead of with stereotactic techniques. An open craniotomy is surgery

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where part of the skull is removed to provide access to the brain. The portion of skull
removed during surgery is replaced after the tumor is removed.

Imaging tests. Sometimes, meningioma is diagnosed using only the imaging tests below
because the location of the tumor may make a biopsy risky. Imaging tests are most useful
when the results are combined with the patient’s medical history, physical examination, and
neurological tests. This combination helps to more accurately find out where the tumor began
and whether or where it has grown. The most common imaging tests used for diagnosing
meningioma include:

Magnetic resonance imaging (MRI). An MRI (http://www.cancer.net/node/24578) uses magnetic


fields, not x-rays, to produce detailed images of the body. A special dye is injected into a
patient’s vein before the scan to create a clearer picture. MRIs may create more detailed
pictures than CT scans (see below) and often show changes in the brain caused by the
tumor, such as swelling or areas where the tumor has grown. MRI is the preferred way to
diagnose meningioma.

Computed tomography (CT or CAT) scan. A CT scan (http://www.cancer.net/node/24486) creates a


3-dimensional picture of the brain by using x-rays of the head from many different angles. A
computer combines these images into a detailed, cross-sectional view that shows any
abnormalities or tumors. A CT scan can be used to measure the tumor’s size. Sometimes, a
special dye called a contrast medium is injected into a patient’s vein before the scan to
provide better detail on the image. A CT scan is best for finding changes in the skull that can
be caused by meningioma. These changes may include the hardening of the area near the
tumor, which can mean that the tumor has been there for a long time.

X-ray. A general x-ray is a way to create a picture of the structures inside of the body using a
small amount of radiation. An x-ray of the head can sometimes help doctors find out where a
tumor is, but is not enough to diagnose meningioma.

Cerebral angiogram. A cerebral angiogram is a type of x-ray, or series of x-rays, of the head
that shows the arteries and veins in the brain. X-rays are taken after a contrast medium is
injected into the main arteries of the head. Because a meningioma can block important veins
that drain blood from the brain, it is sometimes important to get an angiogram to plan surgery.
In addition, there may be abnormal blood vessels that feed the tumor and these can be seen
with the angiogram. Sometimes, material is injected into the tumor before surgery to reduce
bleeding during surgery.

After diagnostic tests are done, your doctor will review all of the results with you. If the diagnosis is
meningioma, these results also help the doctor describe the tumor. This is called staging and
grading.

The next section in this guide is Stages and Grades (http://www.cancer.net/node/19272) . It explains the
system doctors use to describe the extent of the disease. You may use the menu to choose a
different section to read in this guide.
Meningioma - Stages and Grades (http://www.cancer.net/cancer-
types/meningioma/stages-and-grades)
Approved by the Cancer.Net Editorial Board (http://www.cancer.net/about-us) , 07/2017

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ON THIS PAGE: You will learn about how doctors describe meningioma and factors that help decide
treatment options. This is called the stage and grade. Use the menu to see other pages.

Staging is a way of describing where the tumor is located, if it is cancerous, if or where it has
spread, and whether it is affecting other parts of the body. Doctors use diagnostic tests to find out
the tumor’s stage, so staging may not be complete until all of the tests are finished. Knowing the
stage helps the doctor to decide what kind of treatment is best and can help predict a patient's
prognosis, which is the chance of recovery. There are different stage descriptions for different types
of tumors.

After meningioma has been diagnosed, additional tests will be done to learn more about the tumor.
As outlined in the Risk Factors (http://www.cancer.net/node/19269) section, people with neurofibromatosis
type 2 (http://www.cancer.net/node/19451) are more likely to have more than 1 meningioma. In this situation,
a patient will have a variety of tests, including an MRI, to find out how much the tumor has spread
within the brain and spine.

There is no formal staging system for meningioma because CNS tumors cannot be staged the same
way as other types of tumors. For meningioma, doctors use the 6 factors listed below to determine
the treatment options and prognosis:

Tumor histology. As outlined in the Diagnosis (http://www.cancer.net/node/19271) section, a sample


of the tumor is removed for analysis.Tumor histology includes the type of tumor, the grade,
and additional molecular features that predict how quickly the tumor can grow. Together,
these factors will help your doctor understand how the tumor will behave. These factors may
also help determine a patient’s treatment options.

Grade describes specific features in the tumor that are linked with specific outcomes. For
example, doctors may consider whether the tumor cells are growing out of control or if there
are a lot of dead cells. Tumors with features generally linked with growing more quickly are
given a higher grade. For most tumors, the lower the grade, the better the prognosis.

In general, a meningioma is classified into 1 of 3 grades:

A grade I tumor grows slowly.


A grade II tumor grows more quickly and is often called atypical meningioma.
A grade III tumor grows and spreads very quickly and is often called anaplastic or
malignant meningioma.
Age of patient. In adults, the age that a person is diagnosed with meningioma is one of the
best ways to predict prognosis. In general, the younger the adult, the better the prognosis.
Extent of tumor residual. Resection is surgery to remove a tumor. Residual refers to how
much of the tumor remains in the body after surgery. A patient’s prognosis is better when all
of the tumor can be surgically removed. It includes 3 classifications:

Gross total. The entire tumor was removed, although microscopic cells may remain.
Subtotal. Large portions of the tumor were removed.
Biopsy only. Only a small portion, used for a biopsy, was removed.
The prognosis is better when all of the tumor can be surgically removed.
Tumor location. Tumors can form in any part of the CNS. A tumor can cause more damage
to some areas than others. Some tumors are harder to completely remove than others
because of where they are located.
Functional neurologic status. The doctor will test how well a patient’s CNS is working by

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using an assessment called the Karnofsky Performance Scale. A higher score indicates a
better prognosis.
Metastatic spread. Meningioma very rarely spreads to other parts of the body.

Recurrent meningioma
A recurrent tumor is one that has come back after treatment. If the tumor does return, there will be
another round of tests to learn about the extent of the recurrence. These tests and scans are often
similar to those done at the time of the original diagnosis (http://www.cancer.net/node/19271) .

Biogenetic markers
The factors listed above are the best ways to determine the prognosis for a person with
meningioma. Researchers are currently looking for tumor markers that could make meningioma
easier to diagnose and allow the staging of adult CNS tumors. These tools may someday make it
possible for doctors to determine how quickly a brain tumor will grow and spread, develop more
effective treatments, and more accurately predict prognosis.

Used with permission of the American College of Surgeons, Chicago, Illinois. The original and
primary source for this information is the AJCC Cancer Staging Manual, Eighth Edition (2017)
published by Springer International Publishing.

Information about the tumor will help the doctor recommend a specific treatment plan. The next
section in this guide is Treatment Options (http://www.cancer.net/node/19273) . You may use the menu to
choose a different section to read in this guide.
Meningioma - Treatment Options (http://www.cancer.net/cancer-
types/meningioma/treatment-options)
Approved by the Cancer.Net Editorial Board (http://www.cancer.net/about-us) , 07/2017

ON THIS PAGE: You will learn about the different treatments doctors use for people with
meningioma. Use the menu to see other pages.

This section tells you the treatments that are the standard of care for this type of tumor. “Standard of
care” means the best treatments known. When making treatment plan decisions, patients are
encouraged to consider clinical trials as an option. A clinical trial is a research study that tests a new
approach to treatment. Doctors want to learn whether the new treatment is safe, effective, and
possibly better than the standard treatment. Clinical trials can test a new drug, a new combination of
standard treatments, or new doses of standard drugs or other treatments. Your doctor can help you
consider all your treatment options. To learn more about clinical trials, see the About Clinical Trials
(http://www.cancer.net/node/19274) and Latest Research (http://www.cancer.net/node/19277) sections.

Treatment overview
Different types of doctors often work together to create a patient’s overall treatment plan that
combines different types of treatments. This is called a multidisciplinary team (http://www.cancer.net
/node/24957) . For meningioma, this team may include neuro-oncologists, medical oncologists,
radiation oncologists, and surgeons. Cancer care teams include a variety of other health care
professionals, such as physician assistants, oncology nurses, social workers, pharmacists,
counselors, dietitians, and others.

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Meningioma is typically a slow-growing tumor. However, because a growing CNS tumor can cause
severe symptoms, people diagnosed with a CNS tumor should seek treatment as soon as possible.
The pressure caused by a growing CNS tumor can cause serious symptoms that can damage
delicate nerves and block cells from getting important nutrients.

Descriptions of the most common treatment options for meningioma are listed below, including
surgery, radiation therapy, and very rarely, chemotherapy. Treatment options and recommendations
depend on several factors, including the type and grade of the tumor, possible side effects, and the
patient’s preferences and overall health. Your care plan may also include treatment for symptoms
and side effects, an important part of care for meningioma.

Treating brain and spinal cord tumors can be challenging. Surgery is the most common type of
treatment, but it can be difficult if the tumor is near a delicate part of the brain or spinal cord. The
blood-brain barrier, which normally serves to protect the brain and spinal cord from damaging
chemicals, also keeps out many types of chemotherapy. Meningioma grows outside the blood-brain
barrier, so some drugs do reach these tumors. However, the currently available chemotherapy
options do not work very well for meningioma.

More refined surgeries, a better understanding of the tumors that can be treated with chemotherapy,
and precise delivery of radiation therapy have helped more patients with CNS tumors live longer and
have a better quality of life. Take time to learn about your treatment options and be sure to ask
questions about things that are unclear. Talk with your doctor about the goals of each treatment and
what you can expect while receiving the treatment.

Learn more about making treatment decisions (http://www.cancer.net/node/24582) .

Active surveillance
Because a grade I meningioma grows slowly, active surveillance may be recommended for some
patients. This approach is also called watchful waiting or watch-and-wait. During active surveillance,
the tumor is monitored and treatment would begin if it started causing any symptoms or problems.
This approach may be used for much older patients or for those with a tumor that was discovered
accidentally and is not causing any symptoms. Often, patients continue to see their neurosurgeon
for ongoing monitoring for a grade I meningioma.

Surgery
Surgery is the removal of the tumor and some surrounding healthy tissue during an operation. For
meningioma, it is the most common treatment. It is often the only treatment needed for a person
with a noncancerous tumor that can be completely removed during surgery. For patients with a
cancerous tumor or a tumor that cannot be fully removed during surgery, the treatment plan often
includes radiation therapy and/or chemotherapy after surgery (see below).

Blocking the blood vessels that feed the tumor may be performed before surgery to reduce bleeding.
Surgery to the brain is done by removing part of the skull, a procedure called a craniotomy. A
neurosurgeon is a doctor who specializes in surgery of the brain and spinal cord. After the surgeon
removes the tumor, the patient’s own bone will be used to cover the opening in the skull.

In addition to removing or reducing the meningioma, surgery can be used to take a sample of tumor
for analysis under a microscope by a pathologist or neuropathologist. A neuropathologist is a doctor
who specializes in the diagnosis of diseases of the nervous system by studying tissue under a

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microscope. The results of the analysis can show if additional treatments, such as radiation therapy,
will be necessary.

There have been rapid advances in surgery for brain tumors, including cortical mapping to identify
the areas of the brain that control the senses, language, and motor skills and enhanced imaging
methods to give surgeons more tools to plan and perform the surgery. Talk with your doctors to learn
about the specific techniques that your surgery will include, including the possible side effects and
what you can expect during your recovery.

Learn more about the basics of surgery (http://www.cancer.net/node/30689) .

Radiation therapy
Radiation therapy is the use of high-energy x-rays or other particles to destroy tumor cells. A doctor
who specializes in giving radiation therapy to treat tumor is called a radiation oncologist. Doctors
may recommend radiation therapy along with surgery to slow the growth of an aggressive tumor. A
radiation therapy regimen, or schedule, usually consists of a specific number of treatments given
over a set period of time. Radiation therapy can be given in several ways.

Internal radiation therapy or brachytherapy is the use of tiny pellets or rods containing radioactive
materials that are surgically implanted in or near the tumor. This approach is very rarely used for
meningioma.

External-beam radiation therapy techniques use a machine outside the body to target the tumor.
These techniques are becoming better able to direct radiation to the tumor while avoiding healthy
tissue. For example, a linear accelerator is a special x-ray machine that moves around the body to
direct pencil-thin beams of radiation to the brain tumor at different angles and intensities. This helps
to reduce the amount of healthy tissue exposed to the radiation therapy.

The following external-beam radiation therapy techniques may be used:

Conventional radiation therapy. In this procedure, the direction of radiation is determined


by features of the brain and skull and by x-rays. When a person’s entire brain needs to
receive radiation therapy, this technique is appropriate. For more precise targeting, different
techniques are needed.

Intensity modulated radiation therapy (IMRT). IMRT is a type of external-beam radiation


therapy that can more directly target a tumor, further sparing healthy tissue from radiation
therapy. In IMRT, the radiation beams are broken up into smaller beams and the intensity of
each of these smaller beams can be changed. This means that the more intense beams, or
the beams giving more radiation, can be directed only at the tumor. It is most useful to treat a
tumor that is near critical parts of the brain, such as the brain stem and areas that control
sight.

3-dimensional conformal radiation therapy. Based on CT and MRI images, a


3-dimensional model of the tumor and healthy tissues is created on a computer. Beam size
and angles are determined that deliver more radiation to the tumor and less to the healthy
tissue.

Stereotactic radiosurgery. Stereotactic radiosurgery delivers a single, high dose of radiation

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therapy directly to the tumor and not healthy tissues. It works best for a tumor that is only in 1
area of the brain and some benign tumors, including most meningiomas. There are many
different types of stereotactic radiosurgery equipment, including:

A modified linear accelerator, which is a machine that creates high-energy radiation by


using electricity to form a stream of fast-moving particles that help kill tumor cells.

Gamma Knife is another form of radiation therapy that concentrates highly focused
beams of gamma radiation on the tumor. A gamma knife can only be used for
meningioma in the brain, not meningioma on the spine.

CyberKnife is a robotic device used in radiation therapy to guide radiation therapy to


the tumor. It is most often used for tumors in the brain, head, and neck.

Fractionated stereotactic radiation therapy. Radiation therapy is delivered as directly as


stereotactic radiation therapy. However, the dose is divided into small, daily doses over
several weeks using a relocatable head frame. This technique is best for tumors close to
complex or sensitive structures, such as the optic (eye) nerves or brain stem.
Proton radiation therapy. Proton therapy is a type of external-beam radiation therapy that
uses protons rather than x-rays. At high energy, protons can destroy tumor cells.

With these different techniques, doctors are trying to better target only the tumor and reduce the
dose to the surrounding healthy tissue. Depending on the size and location of the tumor, the
radiation oncologist may choose any of the above radiation therapy techniques.

Learn more about the basics of radiation therapy (http://www.cancer.net/node/30687) .

Radiation therapy side effects


Side effects from radiation therapy may include fatigue, mild skin reactions, upset stomach, and
neurologic symptoms. Most side effects go away soon after treatment is finished. Also, radiation
therapy is usually not recommended for children younger than 5 because of the high risk of
damaging their developing brains.

There are possible long-term side effects that may occur years after treatment. A person may
experience cognitive problems, including memory loss and a slow decline in intellectual
performance. If the pituitary gland received radiation, there may be changes in hormonal levels. The
pituitary gland is a small gland near the brain that releases hormones that control bodily functions. In
these situations, patients should be evaluated by an endocrinologist. An endocrinologist is a doctor
that specializes in hormones, glands and the endocrine system of the body. How severe these side
effects are depends on how much radiation therapy was given and where in the brain it was used.
These side effects have become less severe with better technology and precision in radiation
therapy. Talk with your radiation therapist before treatment begins if you have any questions or
concerns about the possible long-term side effects of radiation therapy.

Chemotherapy
Chemotherapy is the use of drugs to destroy tumor cells, usually by ending the tumor cells’ ability to
grow and divide. Chemotherapy is given by a medical oncologist, a doctor who specializes in

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treating a tumor with medication. Chemotherapy is rarely used to treat meningioma for the reasons
outlined under Treatment overview (above).

Learn more about the basics of chemotherapy (http://www.cancer.net/node/30673) .

Getting care for symptoms and side effects


A brain tumor and its treatment often cause side effects. In addition to treatments intended to slow,
stop, or eliminate the tumor, an important part of care is relieving a person’s symptoms and side
effects. This approach is called palliative or supportive care, and it includes supporting the patient
with his or her physical, emotional, and social needs.

Palliative care is any treatment that focuses on reducing symptoms, improving quality of life, and
supporting patients and their families. Any person, regardless of age or tumor type and stage, may
receive palliative care. It works best when palliative care is started as early as needed in the
treatment process. People often receive treatment for the tumor at the same time that they receive
treatment to ease side effects. In fact, patients who receive both at the same time often have less
severe symptoms, better quality of life, and report they are more satisfied with treatment.

Palliative treatments vary widely and often include medication, nutritional changes, relaxation
techniques, emotional support and other therapies. You may also receive palliative treatments
similar to those meant to eliminate the tumor, such as surgery, radiation therapy, or chemotherapy.
Talk with your doctor about the goals of each treatment in your treatment plan.

Before treatment begins, talk with your health care team about the possible side effects of your
specific treatment plan and palliative care options. During and after treatment, be sure to tell your
doctor or another health care team member if you are experiencing a problem so it can be
addressed as quickly as possible. Common types of palliative care for people with a brain tumor
include:

Steroids. Steroids occur naturally in the body in tiny amounts. In larger amounts, they are
very powerful anti-inflammatories that reduce swelling. Most patients with a brain tumor will
need steroids to help relieve swelling of the brain. You will most likely receive steroids when
you are first diagnosed, before and after surgery, before and after radiation therapy, and if
you have an advanced brain tumor. Steroids may cause weight gain and water retention,
increased appetite, difficulty sleeping, changes in mood, and stomach irritation. After
successful treatment for the brain tumor, your doctor may slowly reduce the amount of
steroids you need to take over time.

Anti-seizure medication. A person with a CNS tumor may experience seizures (see
Symptoms and Signs (http://www.cancer.net/node/19270) ). This type of medication helps to control
how often a person has seizures.

Shunt. If fluid begins to build up in the brain, a surgeon may need to place a device called a
shunt to bypass or move the fluid or drain the excess fluid.

Anti-depressant medication. Depression can be common in people with a CNS tumor, but it
is often undiagnosed. But this does not mean that all people with a CNS tumor are
depressed. For those who have symptoms of depression, the health care team may decide to
prescribe an anti-depressant medication to help with the symptoms. Learn more about

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depression (http://www.cancer.net/node/30346) .

Learn more about palliative care (http://www.cancer.net/node/31921) .

Remission and chance of recurrence


A remission is when the tumor cannot be detected in the body and there are no symptoms. This
may also be called having “no evidence of disease” or NED.

A remission may be temporary or permanent. This uncertainty causes many people to worry that the
tumor will come back. While many remissions are permanent, it’s important to talk with your doctor
about the possibility of the tumor returning. Understanding your risk of recurrence and the treatment
options may help you feel more prepared if the tumor does return. Learn more about coping with
the fear of recurrence (http://www.cancer.net/node/25400) .

If the tumor does return after the original treatment, it is called a recurrent tumor. It may come back
in the same place (called a local recurrence), nearby (regional recurrence), or in another place
(distant recurrence).

When this occurs, a new cycle of testing will begin again to learn as much as possible about the
recurrence. After this testing is done, you and your doctor will talk about your treatment options.
Often the treatment plan will include the treatments described above such as surgery, radiation
therapy, and chemotherapy, but they may be used in a different combination or given at a different
pace. Your doctor may suggest clinical trials that are studying new ways to treat this type of
recurrent tumor. Whichever treatment plan you choose, palliative care will be important for relieving
symptoms and side effects.

The most common treatment for recurrent meningioma is additional surgery. If surgery cannot be
performed, radiation therapy is generally used. In addition, a patient can still receive care to manage
the symptoms caused by the tumor. Symptom management is always important since the symptoms
of meningioma can interfere with a person’s quality of life.

People with a recurrent tumor often experience emotions such as disbelief or fear. Patients are
encouraged to talk with their health care team about these feelings and ask about support services
to help them cope. Learn more about dealing with a recurrence (http://www.cancer.net/node/25042) .

If treatment doesn’t work


Recovery from meningioma is not always possible. If the tumor cannot be cured or controlled, the
disease may be called advanced or terminal.

This diagnosis is stressful, and for many people, advanced meningioma is difficult to discuss.
However, it is important to have open and honest conversations with your doctor and health care
team to express your feelings, preferences, and concerns. The health care team is there to help,
and many team members have special skills, experience, and knowledge to support patients and
their families. Making sure a person is physically comfortable and free from pain is extremely
important.

Patients who have advanced disease and who are expected to live less than 6 months may want to
consider a type of palliative care called hospice care. Hospice care is designed to provide the best
possible quality of life for people who are near the end of life. You and your family are encouraged to

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talk with the health care team about hospice care options, which include hospice care at home, a
special hospice center, or other health care locations. Nursing care and special equipment can
make staying at home a workable option for many families. Learn more about advanced cancer
care planning (http://www.cancer.net/node/25113) .

After the death of a loved one, many people need support to help them cope with the loss. Learn
more about grief and loss (http://www.cancer.net/node/25111) .

The next section in this guide is About Clinical Trials (http://www.cancer.net/node/19274) . It offers more
information about research studies that are focused on finding better ways to care for people with a
brain tumor. You may use the menu to choose a different section to read in this guide.
Meningioma - About Clinical Trials (http://www.cancer.net/cancer-
types/meningioma/about-clinical-trials)
Approved by the Cancer.Net Editorial Board (http://www.cancer.net/about-us) , 07/2017

ON THIS PAGE: You will learn more about clinical trials, which are the main way that new medical
approaches are tested to see how well they work. Use the menu to see other pages.

What are clinical trials?


Doctors and scientists are always looking for better ways to care for patients with meningioma. To
make scientific advances, doctors create research studies involving volunteers, called clinical trials.
In fact, every drug that is now approved by the U.S. Food and Drug Administration (FDA) was tested
in clinical trials.

Many clinical trials focus on new treatments. Researchers want to learn if a new treatment is safe,
effective, and possibly better than the treatment doctors use now. These types of studies evaluate
new drugs, different combinations of existing treatments, new approaches to radiation therapy or
surgery, and new methods of treatment. Patients who participate in clinical trials can be some of the
first to get a treatment before it is available to the public. However, there are some risks with a
clinical trial, including possible side effects and that the new treatment may not work. People are
encouraged to talk with their health care team about the pros and cons of joining a specific study.

Some clinical trials study new ways to relieve symptoms and side effects during treatment. Others
study ways to manage the late effects that may happen a long time after treatment. Talk with your
doctor about clinical trials for symptoms and side effects. There are also clinical trials studying ways
to prevent cancer.

Deciding to join a clinical trial


Patients decide to participate in clinical trials for many reasons. For some patients, a clinical trial is
the best treatment option available. Because standard treatments are not perfect, patients are often
willing to face the added uncertainty of a clinical trial in the hope of a better result. Other patients
volunteer for clinical trials because they know that these studies are a way to contribute to progress
in treating meningioma. Even if they do not benefit directly from the clinical trial, their participation
may benefit future patients with meningioma.

Insurance coverage of clinical trials costs differs by location and by study. In some programs, some
of the patient’s expenses from participating in the clinical trial are reimbursed. In others, they are
not. It is important to talk with the research team and your insurance company first to learn if and

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how your treatment in a clinical trial will be covered. Learn more about health insurance coverage
of clinical trials (http://www.cancer.net/node/30756) .

Sometimes people have concerns that, in a clinical trial, they may receive no treatment by being
given a placebo or a “sugar pill.” Placebos are usually combined with standard treatment in most
cancer clinical trials. When a placebo is used in a study, it is done with the full knowledge of the
participants. Find out more about placebos in cancer clinical trials. (http://www.cancer.net/node/24390)

Patient safety and informed consent


To join a clinical trial, patients must participate in a process known as informed consent. During
informed consent, the doctor should:

Describe all of the patient’s options, so that the person understands how the new treatment
differs from the standard treatment.

List all of the risks of the new treatment, which may or may not be different from the risks of
standard treatment.

Explain what will be required of each patient in order to participate in the clinical trial,
including the number of doctor visits, tests, and the schedule of treatment.

Clinical trials also have certain rules called “eligibility criteria” that help structure the research and
keep patients safe. You and the research team will carefully review these criteria together.

Patients who participate in a clinical trial may stop participating at any time for any personal or
medical reason. This may include that the new treatment is not working or there are serious side
effects. Clinical trials are also closely monitored by experts who watch for any problems with each
study. It is important that patients participating in a clinical trial talk with their doctor and researchers
about who will be providing their treatment and care during the clinical trial, after the clinical trial
ends, and/or if the patient chooses to leave the clinical trial before it ends.

Finding a clinical trial


Research through clinical trials is ongoing for all types of tumors. For specific topics being studied
for meningioma, learn more in the Latest Research (http://www.cancer.net/node/19277) section.

Cancer.Net offers a lot of information about clinical trials in other areas of the website, including a
complete section on clinical trials (http://www.cancer.net/node/24863) and places to search for clinical
trials for a specific type of tumor (http://www.cancer.net/node/24878) .

(http://www.cancer.net/pre-act)

In addition, this website offers free access to a video-based


educational program (http://www.cancer.net/pre-act) about cancer clinical trials, located outside of this
guide.

The next section in this guide is Latest Research (http://www.cancer.net/node/19277) . It explains areas of
scientific research currently going on for meningioma. You may use the menu to choose a different
section to read in this guide.

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Meningioma - Latest Research (http://www.cancer.net/cancer-


types/meningioma/latest-research)
Approved by the Cancer.Net Editorial Board (http://www.cancer.net/about-us) , 07/2017

ON THIS PAGE: You will read about the scientific research being done now to learn more about
meningioma and how to treat it. Use the menu to see other pages.

Doctors are working to learn more about meningioma, ways to prevent it, how to best treat it, and
how to provide the best care to people diagnosed with this disease. The following areas of research
may include new options for patients through clinical trials (http://www.cancer.net/node/24863) . Always talk
with your doctor about the best diagnostic and treatment options for you.

Hormonal drugs. Research has shown a possible link between meningioma and hormone
levels.
New treatments. New treatments that target the proteins that a tumor uses to grow are being
studied in clinical trials. These types of treatments include the following:

Immunotherapy boosts the body’s natural defenses to fight the tumor. It uses materials
made either by the body or in a laboratory to improve, target, or restore immune
system function. Learn more about immunotherapy (http://www.cancer.net/node/24726) .

Drugs affecting other functions inside of tumor cells, including those that help tumor
cells divide. Some of these are directed to specific pathways that may be unique or
abnormally regulated compared with healthy cells. These types of treatments are
called targeted therapy (http://www.cancer.net/node/24729) . Several studies are examining
this treatment approach.

Anti-angiogenesis therapy (http://www.cancer.net/node/24376) focuses on stopping


angiogenesis, which is the process of making new blood vessels. Because a tumor
needs the nutrients delivered by blood vessels to grow and spread, the goal of anti-
angiogenesis therapies is to starve the tumor. Anti-angiogenesis therapy is a type of
targeted therapy.

Gene therapy seeks to correct faulty genes that are causing tumor growth.

Directing electric fields through a portable device called the NovoTTF-100A (Optune)
for cancerous meningioma.

Palliative care. Clinical trials are underway to find better ways of reducing symptoms and
side effects of current meningioma treatments to improve patients’ comfort and quality of life.

Looking for More About the Latest Research?


If you would like additional information about the latest areas of research regarding brain tumors,
explore these related items that take you outside of this guide:

To find clinical trials specific to your diagnosis, talk with your doctor or search online clinical
trial databases now (http://www.cancer.net/node/24878) .

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Visit the website of the Conquer Cancer Foundation (http://www.conquer.org/grants-awards/research-


results) to find out how to help support cancer research. Please note that this link takes you to
a separate ASCO website.

The next section in this guide is Coping with Treatment (http://www.cancer.net/node/19275) . It offers
some guidance in how to cope with the physical, emotional, and social changes that meningioma
and its treatment can bring. You may use the menu to choose a different section to read in this
guide.
Meningioma - Coping with Treatment (http://www.cancer.net/cancer-
types/meningioma/coping-with-treatment)
Approved by the Cancer.Net Editorial Board (http://www.cancer.net/about-us) , 07/2017

ON THIS PAGE: You will learn more about coping with the physical, emotional, social, and financial
effects of meningioma and its treatment. This page includes several links outside of this guide to
other sections of this website. Use the menu to see other pages.

Every treatment for meningioma can cause side effects or changes to your body and how you feel.
For many reasons, people don’t experience the same side effects even when they are given the
same treatment. This can make it hard to predict how you will feel during treatment.

As you prepare to start treatment, it is normal to fear treatment-related side effects


(http://www.cancer.net/node/24492) .
It may help to know that your health care team will work to prevent and
relieve side effects. Doctors call this part of treatment “palliative care.” It is an important part of your
treatment plan, regardless of your age or the stage of disease.

Coping with physical side effects


Common physical side effects from each treatment option for meningioma are described within the
Treatment Options (http://www.cancer.net/node/19273) section. Learn more about side effects of
meningioma and its treatment, along with ways to prevent or control them (http://www.cancer.net
/node/25238) . Changes to your physical health depend on several factors, including the tumor’s grade,
the length and dose of treatment, and your general health.

Sometimes, physical side effects can last after treatment ends. Doctors call these long-term side
effects. They call side effects that occur months or years after treatment late effects
(http://www.cancer.net/node/25396) . Treating long-term side effects and late effects is an important part of
survivorship care. Learn more by reading the Follow-up Care (http://www.cancer.net/node/19276) section of
this guide or talking with your doctor.

Coping with emotional and social effects


You can have emotional and social effects as well as physical effects after a diagnosis of
meningioma. This may include dealing with difficult emotions, such as sadness, anxiety or anger, or
managing your stress level. Sometimes, patients have problems expressing how they feel to their
loved ones, or people don’t know what to say in response.

Patients and their families are encouraged to share their feelings with a member of their health care
team. You can also find coping strategies (http://www.cancer.net/node/21) for emotional and social effects
in a separate section of this website. This section includes many resources for finding support and

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information to meet your needs.

Coping with financial effects


Treatment for meningioma can be expensive. It is often a big source of stress and anxiety for people
with this diagnosis and their families. In addition to treatment costs, many people find they have
extra, unplanned expenses related to their care. For some people, the high cost stops them from
following or completing their treatment plan. This can put their health at risk and may lead to higher
costs in the future. Patients and their families are encouraged to talk about financial concerns with a
member of their health care team. Learn more about managing financial considerations
(http://www.cancer.net/node/24865) , in a separate part of this website.

Caring for a loved one with meningioma


Family members and friends often play an important role in taking care of a person with
meningioma. This is called being a caregiver. Caregivers can provide physical, practical, and
emotional support to the patient, even if they live far away.

Caregivers may have a range of responsibilities on a daily or as-needed basis. Below are some of
the responsibilities caregivers take care of:

Providing support and encouragement


Giving medications
Helping manage symptoms and side effects
Coordinating medical appointments
Providing a ride to appointments
Assisting with meals
Helping with household chores
Handling insurance and billing issues

Learn more about caregiving (http://www.cancer.net/node/25009) .

Talking with your health care team about side effects


Before starting treatment, talk with your doctor about possible side effects. Ask:

Which side effects are most likely?


When are they are likely to happen?
What can we do to prevent or relieve them?

Be sure to tell your health care team about any side effects that happen during treatment and
afterward, too. Tell them even if you don’t think the side effects are serious. This discussion should
include physical, emotional, and social effects of meningioma.

Also, ask how much care you may need at home and with daily tasks during and after treatment.
This can help you make a caregiving plan.

The next section in this guide is Follow-up Care (http://www.cancer.net/node/19276) . It explains the
importance of checkups after treatment is finished. You may use the menu to choose a different
section to read in this guide.

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Meningioma - Follow-Up Care (http://www.cancer.net/cancer-


types/meningioma/follow-care)
Approved by the Cancer.Net Editorial Board (http://www.cancer.net/about-us) , 07/2017

ON THIS PAGE: You will read about your medical care after treatment for meningioma is completed,
and why this follow-up care is important. Use the menu to see other pages.

Care for people diagnosed with meningioma doesn’t end when active treatment has finished. Your
health care team will continue to check to make sure the tumor has not returned, manage any side
effects, and monitor your overall health. This is called follow-up care.

Your follow-up care may include regular physical examinations, medical tests, or both. Doctors want
to keep track of your recovery in the months and years ahead.

People treated for benign meningioma typically have yearly follow-up visits with a neurosurgeon or
neuro-oncologist. People with a more aggressive tumor may need checkups more often and
ongoing medical care after recovery from surgery.

Learn more about the importance of follow-up care (http://www.cancer.net/node/19276) .

Watching for recurrence


One goal of follow-up care is to check for a recurrence. Meningioma recurs because small areas of
tumor cells may remain undetected in the body. Over time, these cells may increase in number until
they show up on test results or cause signs or symptoms. During follow-up care, a doctor familiar
with your medical history can give you personalized information about your risk of recurrence. Your
doctor will ask specific questions about your health.

People who were diagnosed with meningioma are routinely monitored for new symptoms with
regular MRI scans as well as physical examinations. If radiation therapy was given to the pituitary
gland, evaluations of hormone levels may be needed. The frequency of the checkups and scans
varies widely from patient to patient. Your plan will be determined by your oncologist or neuro-
oncologist.

The anticipation before having a follow-up test or waiting for test results can add stress to you or a
family member. This is sometimes called “scan-xiety.” Learn more about how to cope with this type
of stress (http://www.cancer.net/node/32191) .

Managing long-term and late side effects


Most people expect to experience side effects when receiving treatment. However, it is often
surprising to survivors that some side effects may linger beyond the treatment period. These are
called long-term side effects. Other side effects called late effects may develop months or even
years afterwards. Long-term and late effects can include both physical and emotional changes.

Meningioma and its treatments can affect the functioning of the brain as well as your daily well-
being. For this reason, it is sometimes helpful for the health care team to monitor your quality of life
and evaluate your cognitive (thought-process) abilities through specialized tests, often given by a
neuropsychologist. A neuropsychologist is a psychologist who studies causes of brain disorders and
specializes in diagnosing and treating these disorders using mostly a medical approach. These

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evaluations could identify certain problems that may benefit from specific therapies, such as speech
or occupational therapy (http://www.cancer.net/node/25397) , counseling with a social worker, or
prescription medications that can help to reduce fatigue or improve memory.

Talk with your doctor about your risk of developing such side effects based on the type of tumor,
your individual treatment plan, and your overall health. If you had a treatment known to cause
specific late effects, you may have certain physical examinations, scans, or blood tests to help find
and manage them.

Keeping personal health records


You and your doctor should work together to develop a personalized follow-up care plan. Be sure to
discuss any concerns you have about your future physical or emotional health. ASCO offers forms
to help create a treatment summary to keep track of the treatment you received and develop
a survivorship care plan (http://www.cancer.net/node/25394) when treatment is completed.

This is also a good time to decide who will lead your follow-up care. Some survivors continue to see
their oncologist, while others transition back to the care of their family doctor or another health care
professional. This decision depends on several factors, including the type and grade of meningioma,
side effects, health insurance rules, and your personal preferences.

If a doctor who was not directly involved in your care for meningioma will lead your follow-up care,
be sure to share your treatment summary and survivorship care plan forms with him or her and with
all future health care providers. Details about your treatment are very valuable to the health care
professionals who will care for you throughout your lifetime.

The next section in this guide is Survivorship (http://www.cancer.net/node/34026) . It describes how to


cope with challenges in everyday life after a diagnosis of meningioma. You may use the menu to
choose a different section to read in this guide.
Meningioma - Survivorship (http://www.cancer.net/cancer-
types/meningioma/survivorship)
Approved by the Cancer.Net Editorial Board (http://www.cancer.net/about-us) , 07/2017

ON THIS PAGE: You will read about how to with challenges in everyday life after a diagnosis of
meningioma. Use the menu to see other pages.

What is survivorship?
The word “survivorship” means different things to different people. Common definitions include:

Having no signs of the tumor after finishing treatment.


Living with, through, and beyond the diagnosis. According to this definition, survivorship
begins at diagnosis and includes people who continue to have treatment over the long term,
to either reduce the risk of recurrence or to manage chronic disease.

Survivorship is complicated because it is different for everyone.

Survivors may experience a mixture of strong feelings, including joy, concern, relief, guilt, and fear.
Some people say they appreciate life more after the diagnosis and have gained a greater
acceptance of themselves. Others become very anxious about their health and uncertain about

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coping with everyday life.

Survivors may feel some stress when their frequent visits to the health care team end after
completing treatment. Often, relationships built with the health care team provide a sense of security
during treatment, and people miss this source of support. This may be especially true when new
worries and challenges surface over time, such as any late effects of treatment, emotional
challenges including fear of recurrence, sexuality and fertility concerns, and financial and workplace
issues.

Every survivor has individual concerns and challenges. With any challenge, a good first step is
being able to recognize your fears and talk about them. Effective coping requires:

Understanding the challenge you are facing


Thinking through solutions
Asking for and allowing the support of others
Feeling comfortable with the course of action you choose

Many survivors find it helpful to join an in-person support group or an online community of survivors.
This allows you to talk with people who have had similar first-hand experiences. People with
meningioma may find it more helpful to reach out to groups that provide support specifically for
those with meningioma, rather than for all brain tumors.

Other options for finding support include talking with a friend or member of your health care team,
individual counseling, or asking for assistance at the learning resource center of the place where
you received treatment.

Changing role of caregivers


Family members and friends may also go through periods of transition. A caregiver plays a very
important role in supporting a person diagnosed with meningioma, providing physical, emotional,
and practical care on a daily or as-needed basis. Many caregivers become focused on providing this
support, especially if the treatment period lasts for many months or longer.

However, as treatment is completed, the caregiver's role often changes. Eventually, the need for
caregiving related to the diagnosis will become much less or come to an end. Caregivers can learn
more about adjusting to life after caregiving in this article (http://www.cancer.net/node/36396) .

A new perspective on your health


For many people, survivorship serves as a strong motivator to make positive lifestyle changes.

People recovering from meningioma are encouraged to follow established guidelines for good
health, such as not smoking, limiting alcohol, eating well, and managing stress. Regular physical
activity can help rebuild your strength and energy level. Your health care team can help you create
an appropriate exercise plan based upon your needs, physical abilities, and fitness level. Learn
more about making healthy lifestyle choices (http://www.cancer.net/node/24554) .

It is important to have recommended medical checkups and tests (see Follow-up Care
(http://www.cancer.net/node/19276) )
to take care of your health. Rehabilitation may be recommended, and
this could mean any of a wide range of services such as physical therapy, career counseling, pain
management, nutritional planning, and/or emotional counseling. The goal of rehabilitation is to help

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people regain control over many aspects of their lives and remain as independent and productive as
possible.

Talk with your doctor to develop a survivorship care plan that is best for your needs.

Looking for More Survivorship Resources?


For more information about survivorship, explore these related items. Please note that these links
will take you to other sections of Cancer.Net:

ASCO Answers Cancer Survivorship Guide: Get this 44-page booklet (http://www.cancer.net
/sites/cancer.net/files/cancer_survivorship.pdf) that helps people transition into life after treatment. It
includes blank treatment summary and survivorship care plan forms. This booklet is available
as a PDF, so it is easy to print out.
Cancer.Net Patient Education Video: View a short video (http://www.cancer.net/node/27371) led by
an ASCO expert that provides information about what comes next after finishing treatment.
Survivorship Resources: Cancer.Net offers an entire area of this website (http://www.cancer.net
/node/22) with resources to help survivors, including those in different age groups.

The next section offers Questions to Ask the Health Care Team (http://www.cancer.net/node/19278) to help
start conversations with your health care team. You may use the menu to choose a different section
to read in this guide.
Meningioma - Questions to Ask the Health Care Team
(http://www.cancer.net/cancer-types/meningioma/questions-ask-health-care-
team)
Approved by the Cancer.Net Editorial Board (http://www.cancer.net/about-us) , 07/2017

ON THIS PAGE: You will find some questions to ask your doctor or other members of your health
care team, to help you better understand your diagnosis, treatment plan, and overall care. Use the
menu to see other pages.

Talking often with your health care team is important (http://www.cancer.net/navigating-cancer-


care/diagnosing-cancer/questions-ask-doctor) to make informed decisions about your health care. These
suggested questions are a starting point to help you learn more about your care and treatment. You
are also encouraged to ask additional questions that are important to you. You may want to print this
list and bring it to your next appointment, or download Cancer.Net’s free mobile app
(http://www.cancer.net/navigating-cancer-care/managing-your-care/mobile-applications) for a digital list and other
interactive tools to manage your care.

Questions to ask after getting a diagnosis


What type of meningioma do I have? Is it benign or cancerous?

What is the grade of the tumor? What does this mean?

How many patients with this type of tumor do you treat each year?

Do you attend expert meetings to discuss complicated tumor cases? What kinds of

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specialists attend such meetings?

Can you explain my pathology report (laboratory test results) to me?

Will an experienced neuropathologist review my pathology slides?

Is any special genetic testing needed? If so, can you describe this testing to me?

Do my family members have a higher risk of developing meningioma?

Do you have reading material that would help me understand this disease?

Questions to ask about choosing a treatment and managing side


effects
What are my treatment options?

What clinical trials are available for me? Where are they located, and how do I find out more
about them?

What treatment plan do you recommend? Why?

What is the goal of each treatment? Is it to eliminate the tumor, help me feel better, or both?

When should I start treatment?

Should I get a second opinion?

Where will my treatment take place? Are there CNS tumor centers of excellence that you
recommend?

Who will be part of my health care team, and what role does each person have?

Who will be leading my overall treatment?

What are the possible side effects of this treatment, both in the short term and the long term?

How will this treatment affect my daily life? Will I be able to work, exercise, drive, and perform
my usual activities?

Could this treatment affect my sex life? If so, how and for how long?

Could this treatment affect my ability to become pregnant or have children? If so, should I talk
with a fertility specialist before treatment begins?

If I’m worried about managing the costs of medical care, who can help me?

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What support services are available to me? To my family?

Do you work with a social worker that assists patients with a CNS tumor?

Do you know of a support group for patients with meningioma?

Who answers patient questions when you are unavailable?


Whom should I call with questions or problems?
Is there anything else I should be asking?

Questions to ask about having surgery


What type of surgery will I have?
How long will the operation take?
How long will I be in the hospital?
Can you describe what my recovery from surgery will be like?
What are the possible long-term effects of having this surgery?

Questions to ask about having radiation therapy or chemotherapy


What type of treatment is recommended?
What is the goal of this treatment?
How long will it take to give this treatment?
What side effects can I expect during treatment?
What are the possible long-term effects of having this treatment?
What can be done to relieve the side effects?

Questions to ask about planning follow-up care


What is the chance that the tumor will come back? Should I watch for specific signs or
symptoms?

What long-term side effects or late effects are possible based on the treatment I received?

What follow-up tests will I need, and how often will I need them?

How do I get a treatment summary and survivorship care plan to keep in my personal
records?
Who will be leading my follow-up care?

What survivorship support services are available to me? To my family?

The next section in this guide is Additional Resources (http://www.cancer.net/node/19279) . It offers


some more resources on this website beyond this guide that may be helpful to you. You may use
the menu to choose a different section to read in this guide.
Meningioma - Additional Resources (http://www.cancer.net/cancer-

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types/meningioma/additional-resources)
Approved by the Cancer.Net Editorial Board (http://www.cancer.net/about-us) , 07/2017

ON THIS PAGE: You will find some helpful links to other areas of Cancer.Net that provide
information about cancer care and treatment. This is the final page of Cancer.Net’s Guide to
Meningioma. Use the menu to go back and see other pages.

Cancer.Net includes many other sections about the medical and emotional aspects of a brain tumor
for the person diagnosed and their family members and friends. This website is meant to be a
resource for you and your loved ones from the time of diagnosis, through treatment, and beyond.

Beyond this guide, here are a few links to help you explore other parts of Cancer.Net:

Search for a specialist in your local area (http://www.cancer.net/find-cancer-doctor) using this free
database of doctors from the American Society of Clinical Oncology.

Review dictionary articles to help understand phrases and terms used in medical care and
treatment (http://www.cancer.net/node/30662) .

Read more about the first steps to take when you are diagnosed with meningioma
(http://www.cancer.net/node/25270) .
Find out more about clinical trials (http://www.cancer.net/node/24863) as a treatment option.

Get information about managing the financial costs (http://www.cancer.net/node/24865) of medical


care.

Learn more about coping with the emotions (http://www.cancer.net/node/21) that a diagnosis of
meningioma can bring, including those within a family or a relationship.

Find a national, not-for-profit advocacy organization (http://www.cancer.net/coping-and-emotions


/managing-emotions/finding-support-and-information/cancer-specific-resources) that may offer additional
information, services, and support for people with meningioma.
Explore what to do when you finish active treatment (http://www.cancer.net/node/25400) .

To find a range of information and insights from different voices on timely topics, visit the
Cancer.Net Blog (http://www.cancer.net/blog).

This is the end of the Cancer.Net’s Guide to Meningioma. You may use the menu to choose a
different section to read in this guide.

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