Undergoing any sort of medical procedure can be stressful, particularly when it involves a delicate area of the body, such as the brain. By educating yourself about your condition and your treatment options, you can develop a better understanding of what to expect during this time. The information below will help you learn more about your condition, the significance of tumor grade and meningioma tumor removal treatment options.
About Meningioma Tumors
The meninges are a delicate, specialized covering of your central nervous system, including the brain and spinal cord. These connective tissues are separate from the brain and help form part of the network that provides nourishment and support to the central nervous system.
A meningioma is an abnormal growth of the meninges, which means it does not arise from brain cells. The majority of meningiomas are benign, which means they are non-cancerous, noninvasive and do not metastasize. However, any meningioma can potentially put pressure on the brain, leading to the symptoms you may be experiencing and necessitating meningioma tumor removal.
Different Grades of Meningioma Tumors
Assigning grades to tumors is a classification system based on what the cells of the tumor look like under a microscope. Your doctor will recommend treatment options based on multiple factors and tumor grade is one of the main aspects he or she will take into consideration.
Meningioma (Grade I)
Approximately 90 percent of all meningiomas are Grade I and they are benign. They are not invading the surrounding tissues and they have not spread to other areas of the body. These tumors are often small and asymptomatic and will not grow larger in 60–70 percent of patients. Grade I meningiomas are often discovered incidentally, following a CT that has been ordered for an unrelated condition.
The recommended treatment is for the surgeon to remove as much of the tumor as he or she safely can, monitoring any remaining tumor that cannot be removed. The location of your tumor will be a key factor in whether or not surgical removal is an option. Most meningioma tumors occur in operable areas, but they are sometimes located in delicate areas, such as near the optic or cranial nerves or the base of the skull, where complete removal is difficult.
For small tumors or remaining sections that are difficult to remove, your doctor may recommend stereotactic radiosurgery. However, for large or symptomatic tumors, surgery is typically the first line of treatment.
Atypical Meningioma (Grade II)
Grade II meningiomas are far less common than Grade I, making up 7–8 percent of all meningioma tumors. These tumors are made up of cells that appear abnormal under a microscope, but they are not spreading and not considered cancerous. These tumors are more aggressive than Grade I and tend to grow larger and more quickly.
The treatment protocol for Grade II meningioma is similar to Grade I except that these tumors carry a greater chance of recurring. This means they need to be treated more aggressively, removing as much as possible surgically, followed by stereotactic radiosurgery. Monitoring alone is not typically an option for Grade II tumors.
Anaplastic Meningioma (Grade III)
Grade III tumors are the rarest form of meningioma, occurring in only 2–3 percent of patients. These tumors are considered cancerous and are malignant, which means they can spread locally. These tumors do not typically metastasize or spread to distant sites in the body.
The primary goal of treatment is to remove as much of the tumor as possible, aiming for complete removal, including the dura. These tumors are the most aggressive and most likely to return with a 9 percent recurrence rate. As with Grade II, surgical removal of these tumors must be followed by radiation therapy.
Procedure Overview
There are two meningioma tumor removal treatment options: surgery and stereotactic radiosurgery. Despite the name, stereotactic radiosurgery does not involve an incision, but instead a focused delivery of radiation, targeted specifically at your tumor. Your doctor may recommend one treatment or a combination approach, depending on factors such as your tumor location, grade, size and your overall health condition.
Surgery
Surgical meningioma tumor removal takes place in a hospital and will require a stay of a few days. During the procedure, the surgeon performs a craniotomy, removing a small section of skull to provide access to the tumor. The surgeon carefully removes as much of the tumor as possible, then secures the section of bone using a plate or screws and finally, closes the incision site.
Stereotactic Radiosurgery
Stereotactic radiosurgery is often used following surgery to treat any remaining tumor and will always be used in the treatment of Grade II or III meningiomas. It may also be used alone to treat small, growing tumors or in patients who cannot tolerate surgery.
The treatment uses a focused beam of radiation to target your tumor directly, shrinking the tumor cells while sparing the surrounding tissue. Stereotactic radiosurgery is an outpatient treatment and the number of visits required depends on your individual tumor. Some patients may require only a single visit.
Understanding for Peace of Mind
It is great that you are taking the extra time before your meningioma tumor removal procedure to learn more about the process. This active role you are taking can help you develop confidence about your choices and give you peace of mind, reducing any anxiety you may be feeling. It is important that you are able to relax and focus on healing and your decision to increase your knowledge will benefit you and your recovery.
