Meningioma Treatment Options

Treatment options for meningiomas depend on several factors, including tumor size, location, symptoms and growth rate. Doctors will consider the tumor’s grade and the patient’s health when creating a treatment plan.

While surgery is often the preferred strategy for removing meningiomas, other options like radiation or medications might be used for symptom control or if surgery is impractical. Chemotherapy is another treatment method, though it is rarely used. It’s typically reserved for cases where surgery or radiation are ineffective.

Surgery is usually the best option for treating most meningiomas. This is particularly true for large tumors that grow rapidly or cause symptoms. Your doctor may use other treatment options along with surgery.

According to UCLA Health, up to 85% of meningiomas in favorable locations are curable with surgery alone.

When Is Surgery Recommended?

Surgery is typically the best treatment for meningiomas, particularly when the tumor is resectable. This can often cure benign tumors. However, the decision to operate depends on factors like the tumor type and your health.

For older patients or tumors in sensitive areas, doctors may recommend radiation therapy instead. If a meningioma isn’t causing symptoms, doctors often suggest monitoring it rather than immediately treating it through surgery or other strategies.

Ultimately, the choice to have surgery should be made collaboratively between you and your doctor, considering your preferences and health status.

Types of Meningioma Surgery

The method for meningioma surgery depends on different factors, such as the tumor’s size, location and proximity to critical nearby structures such as nerves or parts of the brain.

Doctors may use advanced tools and technologies to help make the surgery more effective. These can include special maps showing the brain’s layout during surgery, monitoring systems that check how the nerves function in real-time and imaging techniques that provide pictures of the treated area.

Meningioma Surgery Recovery

Most people recover from meningioma surgery within three to four weeks.

After your surgery, you can expect to stay in the hospital for three to five days. Your care team — typically made up of your surgeon as well as physical and occupational therapists — will tell you when you are ready to go home safely.

Someone will have to drive you home from the hospital. Additionally, make sure someone stays with you for a few days to help with daily tasks, such as shopping or getting food.

Common temporary side effects include nausea from an anesthetic, sore throat from being intubated, headaches, dizziness, fatigue, confusion and difficulty swallowing. You might also have personality changes, speech issues, weakness and poor balance.

Radiation therapy can be vital for treating meningiomas. It damages the tumor’s DNA, causing it to shrink and reduce symptoms. Different techniques, like intensity-modulated radiation therapy, proton therapy and stereotactic radiosurgery, can be tailored based on the tumor’s size, grade and location.

How Radiation Works: Types and Effectiveness

Doctors may use radiation therapy, also known as radiotherapy, as a primary treatment for meningiomas. It can also help destroy remaining abnormal cells after surgery.

Radiation therapy uses powerful energy beams to harm the meningioma’s DNA. This stops tumor cells from growing and can cause them to die off, shrinking the tumor and easing symptoms by reducing pressure on nearby parts of the brain or spinal cord.

Various types of radiation therapy are options for meningioma treatment, each implementing a distinct delivery method.

According to a 2022 study in the Journal of Neuro-Oncology, radiotherapy is a key treatment for meningiomas. The study’s authors found it was safe and effective as the primary or secondary treatment after surgery.

As we learn more about these tumors, medical providers can better personalize treatments, helping doctors assess risks and choose the best approaches for each patient.

Stereotactic Radiosurgery: Benefits and Limitations

Stereotactic radiosurgery (SRS) has emerged as a significant treatment for meningiomas, especially for patients who can’t have traditional surgery or have tumors in challenging locations. Its precision, safety and ease of use make it increasingly popular in brain tumor care.

According to UCLA Health, 80% of meningiomas can have their growth stopped using stereotactic radiosurgery. A 2023 study in the Journal of Neurosurgery puts the tumor control rate at 92% for large perioptic meningiomas — tumors that grow near the optic pathway.

Stereotactic radiosurgery is a treatment option that avoids surgery for small meningiomas or tumors near critical brain areas.

A 2025 study in Neurosurgical Review found that a type of stereotactic radiosurgery called gamma knife radiosurgery effectively targeted larger meningiomas near the eyes while protecting vision pathways.

However, SRS results can be less accurate for some meningiomas.

Watchful waiting for meningiomas — also called surveillance or observation — involves tracking tumor growth with imaging tests.

Some small meningiomas may never cause symptoms or grow during a person’s lifetime. Older people, specifically, may never need treatment for small meningiomas. Watchful waiting allows doctors to catch if the tumor has grown or if a person develops symptoms.

When Is Watchful Waiting Appropriate?

Watchful waiting is appropriate for small, asymptomatic meningiomas. During the observation period, you may get a check-up every three to six months to check on the tumor’s size and see if it’s causing you problems.

If there are no symptoms and the tumor hasn’t grown, your doctor may move the follow-up appointments from every few months to once a year. Your medical provider will check on the tumor with imaging tests, such as an MRI or CT scan.

At What Size Should a Meningioma Tumor Be Removed?

Large meningiomas (larger than 3 cm) and giant meningiomas (larger than 5 cm) typically require surgical removal.

Smaller meningiomas won’t usually be removed unless they’re causing problems. For reference, a 2.3 cm meningioma is about the size of a gumball, while a 4.6 cm meningioma is about the size of a golf ball.

Most people with a benign (grade 1) meningioma who receive timely treatment have a near‑normal life expectancy. Higher‑grade tumors (grade 2 and 3) carry a greater risk of recurrence and complications over time.

Your individual outlook depends on tumor grade, size and location, your age and health and how completely surgeons can remove it.

Benign Meningioma Life Expectancy

Benign grade 1 meningiomas are the most common type and grow slowly. With effective surgery and treatment, many patients live for decades and lead near-normal lives.

A 2024 study in Neuro-Oncology Advances stated that about 92% of people with meningiomas are still alive five years or more after diagnosis. Because these tumors grow in the lining of the brain, they can cause serious symptoms if they press on vital areas. However, most patients do well with ongoing monitoring and follow‑up imaging.

Most benign meningiomas have a growth rate of 5.82% per year, according to a 2023 study in Frontiers in Oncology. If these tumors are in a non-critical location, they generally have a low risk of progression. Watchful waiting is the first step in management.

Rarely, a benign meningioma can transform into a more aggressive tumor over time. Regular MRI follow‑up and early treatment help doctors catch problems before they become dangerous.

Grade 2 Meningioma Life Expectancy

Grade 2 (atypical) meningiomas grow faster. They are also more likely to come back after treatment, so the prognosis is more complex. One 2021 study in Advances in Radiation Oncology reported a survival range of 0.56 to 31.6 years.

According to Mayo Clinic, about 20% to 30% of grade 2 meningiomas return within 10 years. The key to managing these tumors is regular monitoring and imaging.

According to a 2020 study in Neurochirurgie, the five-year survival rate for grade 2 meningiomas ranged from 78.4% to 89.7% across research.

Grade 3 meningiomas are rare and more aggressive, with lower survival rates and higher recurrence. However, they represent a small fraction of total cases. According to Mayo Clinic, about 58% of people are alive 5 years after diagnosis.

No matter the grade, advances in surgery, radiation and imaging have improved overall survival rates. Treatment helps many patients maintain their quality of life for years after diagnosis.

Recovery from meningiomas vary by treatment type, tumor location and the patient’s overall health. Most patients need a combination of physical and cognitive rehabilitation, along with monitoring for recurrence. Rehabilitation and observation can look different depending on your side effects and signs of recurrence.

Physical Rehabilitation and Cognitive Therapy

Meningioma treatments can cause neurological and cognitive impairments. Physical rehabilitation and cognitive therapy play critical roles in recovery and long-term management following treatment.

PHYSICAL AND OCCUPATIONAL REHABILITATION:
After treatment for a meningioma, physical therapy focuses on improving your balance, strength and ability to move around. Customized exercises that build muscle and improve coordination help achieve this.

Occupational therapy can help you regain your independence in everyday activities like getting dressed, cooking and running errands. Therapists may suggest tools to assist with walking and strategies for managing tiredness and discomfort.

These therapies are tailored to your recovery goals, making it easier to return to your usual routines and enhancing your overall quality of life. In many modern treatment plans, medical teams may now suggest “pre-habilitation,” or starting certain exercises before surgery or radiation to build strength and resilience.

COGNITIVE THERAPY:
Cognitive rehabilitation can help you recover your thinking and memory skills after treatment for a meningioma. This type of therapy uses simple techniques, like memory aids and breaking down tasks into smaller steps.

The main goal is to improve attention, memory and focus through various exercises that stimulate different parts of the brain.

Programs can be customized, focusing on enhancing everyday activities and overall quality of life. You’ll work closely with psychologists and therapists to establish personal goals, and they often use tests to assess progress and guide the rehabilitation process.

Monitoring for Recurrence

Tumors may recur after surgery and may happen months or years after the initial diagnosis. A 2024 study in the Journal of Neuro-Oncology found that 10% to 32% of intracranial meningiomas recur within 10 years.

Post-treatment monitoring is crucial. You’ll likely have scans every six months to a year in the first few years. If you remain stable, the time between scans might increase. Sometimes, doctors perform a biopsy to check for tumor recurrence and gather details to determine the best treatment options.

Avoid taking medications linked to meningiomas, like Depo-Provera. Depo users who developed a meningioma may qualify for a Depo-Provera lawsuit. To see if you qualify, fill out a free case review form. If the meningioma returns, your treatment options may be similar to the original meningioma. Please seek the advice of a medical professional before making health care decisions.