Meningiomas are tumours that begin to develop in the membranes surrounding the brain and spine, called the meninges. These tumours can develop in the dura mater, the pia mater or the arachnoid (the three different layers of membranes). The majority of meningiomas--approximately 90 per cent--are benign, although this does not mean they are harmless. Even a benign tumour can be dangerous once it begins to encroach on the brain or spine. Malignant, or cancerous, meningiomas make up the other 10 per cent, and they account for approximately 27 per cent of all brain tumours. Depending on the type of meningioma, a full recovery may require surgery or other treatment, or it may simply be impossible.
Meningiomas are usually diagnosed by their symptoms. Some are slow-growing and do not begin to cause symptoms until they are quite large. Symptoms range from loss of sight, smell or hearing, to memory loss and difficulty walking or balancing. Seizures and headaches are also common. The specific symptoms depend on the location, size and number of meningiomas. A CAT scan and MRI can help to diagnose and identify the meningioma that is causing the symptoms so that doctors can help try to treat the meningioma and facilitate recovery.
The size and location of the meningioma, and whether it is benign or malignant, are determinative of the chances for recovery.
Malignant meningiomas have the lowest recovery rate. Atypical meingiomas have a higher recovery rate than malignant meningiomas but a lower survival rate than benign meningiomas. Benign meningiomas have the highest recovery rate and the highest chance for survival, depending on other factors such as location of the tumour and age of the patient.
Tumours located in the brain generally have a poorer recovery prognosis than tumours located in the spine or less-evasive tumours. Those with brain tumours confined to the convexity, or outer surface of the brain, are more easily treatable. Patients with tumours on the convexity only have a greater chance of recovery than those with tumours on the underside of the brain or within the brain and located near other nerve centres or blood vessels. Because of its location, if a tumour is not completely removed during surgery, it is likely to grow back or reoccur.
The patient's age and general health is another significant factor. Older patients have a more difficult time achieving a full recovery after surgery to remove meningiomas.
For patients with small tumours and no symptoms, the best treatment is simply to watch and wait. As long as the tumour remains asymptomatic, treatment would be more risky than beneficial, and there is no need to operate to aid in recovery. Brigham & Women's Hospital, a teaching hospital affiliated with Harvard University, states that as many as two-thirds of patients who watch and wait will not develop symptoms at any point, and thus the meningioma will be harmless. When symptoms do develop, surgery to remove the tumour is the best method of facilitating recovery.
Types of Treatment
Non-surgical treatments include the use of steroid medication and anticonvulsant medications. Steroids help to reduce inflammation and swelling in tissue surrounding the brain or spine. If the tumour begins to cause excess fluid build-up in the brain, a shunt may be inserted to relieve the pressure. These treatments offer recovery from symptoms associated with meningiomas but do not treat the underlying tumour itself.
Surgery is usually the first approach designed to facilitate complete recovery from meningiomas. If the meningioma itself is not invasive, complete removal and a full recovery is possible. If the tumour is located too close to the blood vessels in the brain and cranial nerves, surgery may not be able to remove the whole meningioma, and a complete recovery may not be possible, although symptoms can be alleviated by a surgical procedure that removes part of the tumour.
Radiation may be a treatment option to control tumours and help minimise symptoms in situations where surgery is not an option. Mayo Clinic reports that radio therapy may have fewer complications for tumour control for some patients. Chemotherapy is not a method of treatment that offers recovery from meningioma.
Even when a tumour is successfully removed, a full recovery is not guaranteed. Over a 10-year period, the relapse rate--which signifies the recurrence of a tumour or the growth of a new tumour--is between 10 and 20 per cent, according to the Mayo Clinic. If the full tumour is not removed, this relapse/recurrence rate is higher.