Meningioma
While most meningiomas are not cancerous a small number can be.
Most meningiomas grow slowly but they sometimes cause problems by putting pressure on the brain, nerves and spinal cord.
There are 3 types of meningiomas. They are graded by how fast they grow and how likely they are to come back after surgery.
Grade 1: These grow slowly and are called benign meningiomas.
Grade 2: These grow more quickly and are called atypical meningiomas. They include clear cell and chordoid meningiomas.
Grade 3: These grow quickly and are called malignant meningiomas. They include anaplastic, papillary and rhabdoid meningiomas.
Radiation Therapy and Meningioma
The best person to talk to about radiation therapy for meningioma is a radiation oncologist. A radiation oncologist is a specialist doctor who is part of the team that takes care of people having radiation therapy.
You can ask your doctor for a referral to a radiation oncologist to learn if radiation therapy is an option for you.
The Treatment Team
Doctors make a treatment plan for each person based on:
- the grade of the meningioma
- where the meningioma is
- symptoms, if there are any
- what other treatments have been tried
- a person’s health and age.
The type of treatment a person gets is worked out by a team of doctors and health professionals often called a Multidisciplinary Team. Doctors weigh up the possible benefits with the possible side effects when making a treatment plan.
A highly trained radiation oncology team takes care of people having radiation therapy. This includes radiation oncologists, radiation therapists, medical physicists and radiation oncology nurses.
Treatments for Meningioma
Treatments for meningioma include observation, surgery and radiation therapy.
Observation
For small low grade meningiomas that are not causing problems, doctors may keep an eye on the meningioma with regular imaging.
If the meningioma grows or starts causing symptoms, the doctor may suggest further treatment.
Surgery
The doctor may suggest surgery to remove the tumour if it can be reached safely.
The aim of surgery is to remove as much of the meningioma as possible.
If the meningioma is in a part of the brain where there is a high risk of damage to surrounding areas the doctor may not be able to remove the whole tumour.
In this case, the doctor may suggest radiation therapy after surgery to stop the meningioma from growing back.
This treatment uses x-ray beams to kill cancer cells.
A doctor may recommend radiation therapy instead of surgery if the meningioma is in a high-risk area which makes an operation difficult.
Doctors may also use radiation therapy after surgery. This depends on how much of the meningioma remains after surgery and the grade.
Types of Radiation Therapy Used for Meningioma
There are different ways to deliver radiation therapy. The radiation oncology team will choose the one that is effective and safe.
Stereotactic Radiosurgery (SRS) or Stereotactic Radiation Therapy
When the radio oncologist delivers one high dose of targeted radiation to the tumour it is called stereotactic radiosurgery.
Stereotactic radiation therapy is when the radiation oncologist deliver a few high doses of radiation to the tumour.
This is the usual care for meningiomas, however, in some cases it can’t be used.
External Beam Radiation Therapy (EBRT)
The radiation oncologist may also use EBRT. This depends on the size and grade of the meningioma. EBRT is delivered from outside the body.
People get EBRT once a day, 5 days a week from Monday to Friday. This usually lasts for 5-6 weeks.
People must wear a plastic mask during treatment to keep them still and ensure the radiation is targeted on the cancer.
Immobilisation Mask
People wear a mask during radiation treatment to keep their head and neck still. The mask ensures the radiation beams target the cancer accurately while minimising exposure to healthy body parts nearby.
A new mask is made for each person and is secured to the treatment table. The mask helps the doctor position the radiation accurately on the cancer being treated.
In this video, Targeting Cancer ambassador Julie McCrossin explains why people with head and neck cancer need to wear protective masks during treatment.
Why We Wear Masks For Head and Neck Cancer Radiation Therapy Treatment
In this video, Julie and the Radiation Oncology team explain how an immobilisation mask is made.
Targeting Cancer Julie’s Story- The Making of the Immobilisation Mask
General Information About Side Effects of Radiation Therapy
Radiation therapy is more effective with fewer side effects than ever before.
Recent advances mean radiation oncologists can effectively treat the cancer while getting less radiation on healthy body parts. This means much fewer side effects.
Side effects from radiation therapy vary between people, even for those having the same treatment.
While some people feel no side effects, some feel mild side effects, such as tiredness or skin redness during and/or just after treatment. These usually get better within a few weeks.
The treatment team will offer advice and medicine to help with side effects.
Serious side effects that start later (months to years after the radiation therapy) are rare.
Before starting treatment, your radiation oncologist will talk to you about side effects and answer your questions.
The side effects of radiation treatment can be split into 2 groups:
- Early side effects which occur during and shortly after radiation treatment.
- Late side effects which can occur months to years after radiation treatment.
For more information, go to the Potential Side Effects page.
Early Side Effects of Radiation Therapy for Meningioma
Early side effects of radiation therapy may include:
Fatigue: This is very common in the second half of treatment and varies between people. Fatigue may continue for several weeks after treatment.
Other side effects of radiation therapy may come from body parts close to where the radiation is targeted. These often start during treatment, worsen and reach their peak in the 7-10 days following treatment
Skin reddening and irritation: The scalp may get red, dry and itchy.
Loss of hair: People may lose some or all of their hair, and this can be temporary or permanent, depending on amount of radiation used.
Swelling in the brain: Radiation therapy can cause swelling around the meningioma. This may cause headaches, nausea, vomiting and/or drowsiness. The swelling can also worsen existing nervous system conditions in the short term.
Ringing in the ears and hearing loss: These are very rare side effects.
What can help early side effects?
- Resting helps with tiredness.
- Creams can be used on the scalp for red skin and irritation.
- Wigs can be used for hair loss.
- If headaches, nausea and/or vomiting occur during treatment, medicine that reduces swelling around the tumour can help.
- Pain and anti-nausea medicine can help.
Late Side Effects of Radiation Therapy for Meningioma
Late side effects can happen a few months to a few years after treatment. These side effects may never occur, occur once, continue over time, or come and go.
They are rarer than early side effects.
The chances of late side effects depends on how much radiation is used and how close the tumour is to other parts of your body.
Late side effects of radiation treatment may include:
Neurocognitive changes: These are brain changes that affect the way people think, learn and remember. These changes can happen after surgery and chemotherapy as well.
Less common late side effects of radiation therapy may come from body parts close to where the radiation is targeted.
Eye and optic nerves: Radiation can cause the lens of the eye to become cloudy. This can cause painless vision loss years later. Changes to the retina may also cause loss of vision. Radiation to the optic nerves sometimes causes total loss of sight.
Ears: Hearing loss and ringing in the ear can develop in the years after treatment and are usually lasting.
Pituitary gland: Radiation may cause the pituitary gland to become underactive. Your doctor may do blood tests after treatment to keep an eye on this.
Brain necrosis: This rare effect can occur 1-3 years after treatment with high doses of radiation. The symptoms vary and it may need surgery.
Second cancers: Cancers caused by radiation therapy are a very rare side effect.
What can treat late side effects?
- Sight changes can be checked to work out the cause. If radiation causes a cataract, this can be fixed with a small operation. Radiation damage to the retina or optic nerve may remain.
- Hearing aids can help with hearing loss.
- Medicine for brain changes can be helpful.
Your radiation oncologist will explain the types of late side effects that could happen and how you can manage them.
Other Useful Resources for Meningioma
Find additional information about cancer types, research groups, and support groups.
Radiation Oncologist
The best person to talk to is a radiation oncologist. You can ask your doctor for a referral to find out if radiation treatment is right for you.
GPs and Health Professionals
Information for any health professional involved in a patient's cancer care with a particular focus on primary care providers.
Talking to Your Doctor
Your GP or other doctors in the cancer team can organise a referral to a radiation oncologist.
Treatment Centres
Search and find your closest Radiation Oncology Treatment Centre.
