What is a Meningioma?
Meningioma is the tumor of the meninges which are the covering of the brain and the spinal cord. Meninges actually comprise of three layers namely; dura mater, arachnoid mater and pia mater. These coverings are there to protect the Central Nervous System and are present around the brain and the spinal cord.
Meningioma in itself is usually benign and rarely causes problems but when it puts pressure or squeezes the adjoining brain parts or nerves; that is when problems arise. They are very slow growing and are usually left undetected for long periods of time. Meningiomas are the most common type of brain tumors.
Meningioma though benign; are sometimes classified as atypical which basically means that they are neither benign nor malignant but have the potential to turn malignant. Though some types of meningiomas are cancerous and can spread to not only other parts of the brain but also to the other parts of the body, most often to the lungs.
Who is Most Susceptible to Meningioma?
Women seem to be more susceptible to meningioma than men though they occur in both. The reason for that still remains unexplained but hormones are suspected to cause this. Most meningioma cases occur between the age group of 30 to 70 years. Meningiomas rarely occur in children.
What are the Symptoms of Meningioma?
Most of the cases of meningiomas exist without any evident symptoms and are usually incidentally found at autopsies but if the tumor is large in size and/or at a crucial location, there might be some symptoms. If you have one or more of these symptoms suddenly and they persist over time, then you should consult your doctor. Some of these are:
- Focal seizures occur especially if the meningioma is very close to cerebrum.
- Diplopia also known as double vision can occur if the meningiomas result in nerve palsy. Uneven pupil size can also occur due to meningiomas.
- Headaches also occur due to meningiomas and they keep on getting worse with passage of time.
- Blurred vision can also happen due to meningiomas.
- Meningiomas can cause ringing in the ears, loss of hearing, loss of smell and speech problems if they affect the nerves or parts of the brain which control all these things.
- Meningioma can also result in numbness in the body especially the limbs. It can also lead to weakness of the arms and legs.
- If the meningioma is large enough, it can also lead to memory loss.
What are the Causes & Risk Factors of Meningioma?
We do not yet know the basic cause of meningiomas. It has been found out that it can be caused by a number of things such as radiation, genetics and obesity etc. but what exactly causes meningioma is still unknown. It appears randomly, sometimes suddenly and sometimes in families who have had a history of meningioma cases and it also occurs in all kinds of people, so it is difficult to say what causes meningioma.
There are some risk factors though, which can lead to meningioma. Some of these are as follows:
Exposure to Radiation
It has been found that Hiroshima atomic bomb survivors develop meningioma more frequently. Out of these, those who were nearest to the site of the bombing are most susceptible than those who were farther away. It is surmised that this is due to their exposure to radiation and therefore, it is considered a risk factor. People who have frequent dental X-rays also have higher risk of developing meningiomas. Other kinds of exposure to different types of radiation or radiation therapy can also increase the risk of meningioma.
Effect of Hormones
Hormones are also believed to be a risk factor and that it causes meningiomas especially female hormones as meningiomas occur more frequently in females than in males. Some studies suggest that meningioma is linked to breast cancer. This is most probably due to the role of certain hormones.
Even though there is no established link or proof of obesity playing a role in causing meningiomas, it has been found that it is a risk factor and people who have body fat in excess are more susceptible to meningiomas.
Brain injuries are also a risk factor of meningioma. It has been studied that in many cases meningiomas occur at the site of skull fractures or where the surrounding membrane is scarred as a result of some brain injury.
A Specific Genetic Disorder
A specific genetic disorder called neurofibromatosis type-2 can also be risk factor. People with this nervous system disorder have 50% chance of developing meningiomas.
How are Meningiomas Diagnosed?
Meningiomas are difficult to diagnose due to lack of specific symptoms. Even if the symptoms do occur, they are more often than not mistaken for ordinary sickness or as a sign of aging. If a doctor suspects the presence of meningioma, he will refer the patient to a neurologist who will perform a basic exam. If the presence of a meningioma is suspected, one of the following techniques is used to detect their location:
Computerized Tomography (CT) Scan
CT scan produces a cross sectional image of the brain obtained by combining various X-ray images taken on different angles. This CT scan gives the location as well size of the meningioma.
Magnetic Resonance Imaging (MRI)
If a more detailed picture is required, MRI technique is used to obtain an image of the meningioma. This technique uses radio waves and magnetic field to obtain the images of the different organs of the body.
Biopsy is a process in which the surgeon removes a part of the tumor and then performs various tests to determine the presence and extent of a disease. In the case of meningiomas, a piece or the whole tumor is removed to determine whether it is malignant or not. It is also used to confirm the presence of meningiomas and the extent to which it has progressed.
What are the Treatments to Cure Meningioma?
There are many approaches to treating meningiomas. It depends on the location of the meningioma and the extent to which the tumor has progressed. Whether the meningioma is benign or malignant also affects the treatment approach and so does your age and health. Basically the following approaches are used for the treatment of meningiomas:
Observation of Tumor
This is not exactly a treatment but more of a "wait and see" kind of thing. If the tumor is small, benign and asymptomatic or if the symptoms do not cause any serious problems to the patients, then doctors recommend not doing any treatment except for periodic scans and evaluations. If it is seen that your tumor is growing or causing any problem, then you can choose any of the following treatment options depending on the state of your meningioma.
Doctors recommend surgery if the meningioma is causing serious symptoms or if it is growing at a rapid rate or if it is malignant. During surgery, surgeons strive to remove the whole meningioma but sometimes some of it is left behind. This is due to the fact that sometimes meningiomas are present at crucial locations and removing them completely will cause damage to the brain or the spinal cord. If such is the case then the patient may need further treatment. Following are the cases that you may encounter:
- Whole meningioma tumor is removed and as such the patient does not need any further treatment though periodic scans are done to make sure that it is not recurring.
- If the tumor is benign, in most cases the patient does not need further treatment even if a piece of the tumor is left behind after the surgery.
- If a piece of the tumor is left behind and the tumor is malignant, then the patient is treated with radiation therapy.
- Even though surgery is effective, it can cause various complications too such as bleeding, infection, loss of vision or hearing and loss of memory.
In radiation therapy, high powered beams of energy are aimed at tumor cells with the help of a machine. This treatment is done if the whole meningioma cannot be removed by surgery. Radiation therapy destroys cancerous cells of the meningioma and prevents meningioma from recurring.
Doctors recommend radiation therapy if a piece of the tumor is left behind. With the advance in technology, there are many types of the radiation therapies to choose from depending on the size and location of the meningioma. Some of these are:
Stereotactic Radiosurgery (SRS)
This radiation therapy is usually used for people with recurring meningiomas even after treatment or meningiomas that cannot be fully removed by surgery. In this therapy, several powerful radiation beams are focused on a specific spot to destroy tumor cells. It is usually done in a few hours and in most of the cases an overnight stay at the hospital is not required.
Fractioned Stereotactic Radiotherapy (SRT)
This technique uses low intensity radiation beams for comparatively less amount of time but more frequently such as one treatment daily for a month. This is usually done if the meningioma is at a location which cannot tolerate high powered radiation beams.
Intensity Modulated Radiation Therapy (IMRT)
In this radiation therapy, meningiomas are destroyed by radiation beams whose intensity can be modified with the help of computer software. This technique is used when meningiomas are located near very sensitive or complex shaped structures.
Proton Beam Radiation
In this technique, radioactive proton beams are directed precisely at the site of the meningiomas. It is quite helpful in limiting the amount of damage done to the surrounding tissues.
Also known as drug therapy, it uses antiprogestin agents and hydroxyurea etc. to destroy meningiomas. Current chemotherapies are not very effective in treating meningiomas and are rarely used. It is only used in cases where all other treatments fail to produce a result.
What are the Complications Caused By the Treatment of Meningioma?
Even though there are many treatments available for meningioma, almost all of them have some side-effects and complications such as seizure, memory loss, personality changes, loss of hearing and smell, speech problems and difficulty in concentrating etc. So before you go through any of these procedures, make sure that you have a long chat with your doctor and discuss the possibility of all the complications that could arise as a result of the treatment procedure.
Are There Any Preventive Measures For Meningioma?
There are not very many preventive measures to reduce the risk of meningiomas, although you can do your part by maintaining a normal body weight and avoiding unnecessary exposure to radiation.
Are There Any Alternative Treatment Methods?
There are some other treatment options available which, though they do not cure the disease, can help in providing relief and coping with the stress that comes with having to go through extensive treatment procedures that happens when one has cancer. These include massages, acupuncture, music therapy, meditation, yoga, relaxation exercises and hypnosis etc.
Many people today are fighting cancer and it is important to give them support and strength because even more important and miraculous than treatment is will-power of a person. It is therefore, the responsibility of the near and dear ones to provide cancer patients with motivation and courage. Give them something worth fighting for, something that will provide them motivation to pull through because more often than not, people die when hope dies!