Meningioma treatment

Meningioma treatment can include active monitoring, surgery, radiotherapy, chemotherapy, or a combination of these. But, the type of treatment depends on the grade of tumour, its size, where it is in the brain, and the symptoms of the person affected.

On this page, we’ll cover:

• About meningioma treatment
• Grade 1 meningioma treatment
• Grade 2 or 3 meningioma treatment
• Getting a second opinion

About meningioma treatment

Your medical team will consider a range of factors about your meningioma when deciding the most appropriate treatment.

Meningiomas are normally treated according to their grade. But their size, location and the symptoms you’re experiencing will also affect the treatment you’re offered. 

However, treatment for more than one meningioma may be different as the tumours may be of different grades and have different growth rates. If this is the case, some treatments, such as active monitoring may not be suitable.

Surgeons prefer not to perform repeat surgery, as any surgery carries some risk. But if your tumour comes back or you have more than one tumour, surgery may be considered depending on your general health and the growth rate of your tumours

With multiple meningiomas, there’s also the possibility of stereotactic radiosurgery. 

It’s important to note that your healthcare team should discuss these options with you and you should feel comfortable asking any questions you may have.

Grade 1 meningioma treatment

Active monitoring

Active monitoring (also known as watch and wait) is frequently the treatment approach used for grade 1 meningiomas.

If you’re on active monitoring, you’ll see your specialist for regular check-ups and MRI scans. This will usually be every 3, 6 or 12 months.

You may only begin treatment if:

• there’s a marked increase in tumour size
• you develop symptoms (or they become much worse) that badly affect your quality of life. For example, uncontrollable seizures. 
• the tumour starts growing more quickly and becomes a higher grade.

Surgery

Neurosurgery may be offered after a period of active monitoring or it can be offered straight away after diagnosis. It’s generally offered if the tumour is causing, or likely to cause, problems or symptoms that affect your day-to-day living. This will partly depend on its size and location within the brain.

It may be the only treatment needed, especially if all of your tumour can be removed.

Radiotherapy

Radiotherapy may be used in the following circumstances:

• if all of your tumour can’t be removed, then radiotherapy may be used after surgery
• if the tumour is in part of the brain which means it’s not possible to operate on (known as a non-operable tumour)
• if your tumour has come back (also known as a recurrent tumour).

If your tumour can’t be operated on, a type of radiotherapy called stereotactic radiosurgery (SRS) or stereotactic radiotherapy (SRT) may be used instead of conventional radiotherapy.

SRS and SRT allow high doses of radiation to be given to a very focussed, precise area. It’s only suitable for small tumours (less than 3cm at the widest part) but it can be used instead of surgery to avoid risking damage to crucial parts of the brain. 

Grade 2 or 3 meningioma treatment

Surgery and radiotherapy

The treatment for grade 2 and 3 meningiomas is usually surgery (where possible), followed by radiotherapy.

Chemotherapy

Chemotherapy is rarely used in the treatment of meningiomas, as they are very resistant to currently available chemotherapies. It may still be used in some circumstances, such as a high grade meningioma (grade 3) recurring after surgery or radiotherapy.

Make the right choices for you

Our Step by Step interactive guide outlines what happens following a diagnosis, to answer your questions and help you to understand what to expect.

Read our guide

Getting a second opinion

If you’re uncertain about the decision to put you on active monitoring (or any other decision about your care and treatment), even after talking to your healthcare team, you can ask for a second or further opinion, either on the NHS or privately.

Under the NHS Constitution, you have a right to ask your GP or another healthcare professional for a second or further opinion from a different doctor. That does not mean you have a legal right to get one, but a healthcare professional will rarely refuse. Healthcare professionals are used to being asked about second opinions, so they won’t be offended by the request, nor will your care be affected. 

The Patient Advice and Liaison Service (PALS) in your hospital or your local citizens’ advice service (CAB) may be able to offer advice if you’re having difficulty getting referred for a second opinion. You could also contact our Support team.

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Download our meningioma factsheet

Meningioma factsheet – PDF

Find out more about meningiomas, including symptoms, treatments and risk factors in our new meningioma factsheet.

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