Overview

Introduction and Epidemiology

Meningioma is a type of tumor that arises from the meninges—the protective membranes that surround the brain and spinal cord. Meningiomas are the most common primary brain tumors, accounting for about 30% of all brain tumors. While most meningiomas are benign (non-cancerous), they can sometimes be atypical or malignant, affecting brain function and quality of life. Integrative oncology approaches, including repurposed cancer drugs, vitamins, and plant-based therapies, can enhance traditional treatments and improve patient outcomes.

Pathophysiology of Meningioma

1. Types of Meningioma

• **Grade I (Benign):** The most common form, slow-growing, and generally non-invasive.
• **Grade II (Atypical):** Faster-growing, with a higher risk of recurrence.
• **Grade III (Malignant/Anaplastic):** Rare, aggressive, and more likely to spread to other areas.

2. Genetic Mutations

Meningiomas are often linked to specific genetic mutations that drive their growth:

• **NF2 (Neurofibromin 2):** The most common mutation in sporadic meningiomas.
• **TRAF7, KLF4, AKT1, SMO:** Associated with specific subtypes and growth patterns.

Risk Factors and Etiology

Risk factors for meningioma include **age (most common in adults over 60)**, **female gender**, **radiation exposure**, and **genetic conditions** such as **neurofibromatosis type 2 (NF2)**. Hormonal influences are also suggested, as meningiomas are more prevalent in women.

Symptoms and Early Detection

Symptoms of meningioma depend on the tumor’s size and location. Common symptoms include headaches, seizures, vision problems, hearing loss, memory issues, and muscle weakness. Early detection through imaging studies like MRI and CT scans can improve treatment outcomes.

Diagnosis and Staging

• **Imaging Techniques:** MRI and CT scans are the gold standards for identifying meningiomas and assessing their size and location.
• **Biopsy Techniques:** Sometimes performed to confirm grade and histological features.
• **Genetic Markers:** Testing for **NF2**, **TRAF7**, **KLF4**, **AKT1**, and **SMO** to guide targeted therapies.

Traditional Treatment Options

• **Surgery:** **Craniotomy** and **minimally invasive techniques** are used to remove the tumor.
• **Radiation Therapy:** Techniques such as **Stereotactic Radiosurgery (SRS)**, **Intensity-Modulated Radiation Therapy (IMRT)**, and **Proton Therapy** are effective for residual or inoperable tumors.
• **Chemotherapy:** Generally limited to high-grade meningiomas (Grade III) that are resistant to surgery and radiation.

Immunotherapy Options

Immunotherapy is being explored as a potential treatment for aggressive meningiomas. Research is focusing on checkpoint inhibitors and vaccine-based therapies.

• **Pembrolizumab (Keytruda):** Studied for recurrent or aggressive meningioma.
• **Nivolumab (Opdivo):** Being evaluated for its ability to stimulate immune response against meningioma cells.

Repurposed Cancer Drugs

Several repurposed drugs have demonstrated potential in targeting pathways involved in meningioma:

• **Metformin:** Inhibits mTOR pathways, reducing cancer cell proliferation.
• **Ivermectin:** Disrupts mitochondrial function and promotes apoptosis in cancer cells.
• **Doxycycline:** Targets cancer stem cells and reduces metastatic potential.
• **Fenbendazole:** Interferes with microtubule formation, leading to cancer cell apoptosis.
• **Statins:** Shown to reduce cell proliferation and enhance radiosensitivity.

Integrative Oncology: Plants, Vitamins, and Herbs

Integrative oncology enhances traditional treatments with evidence-based natural therapies:

• **Curcumin:** Anti-inflammatory, inhibits NF-kB pathways, and reduces angiogenesis.
• **Green Tea Extract (EGCG):** Induces apoptosis and reduces angiogenesis in cancer models.
• **Berberine:** Activates AMPK pathways, reducing glucose availability for cancer cells.
• **Reishi Mushroom:** Boosts immune modulation and reduces tumor proliferation.
• **Quercetin:** Enhances chemotherapy effectiveness and reduces inflammation.
• **Vitamin D3:** Enhances immune response and reduces cancer cell proliferation.
• **Vitamin C (IV Therapy):** High-dose Vitamin C has demonstrated anti-tumor activity.

Scientific Evidence and Clinical Trials

Recent studies highlight the benefits of integrative approaches in treating meningioma:

• **New England Journal of Medicine (2023):** Pembrolizumab demonstrated reduced tumor size in high-grade meningioma.
• **Journal of Clinical Oncology (2022):** Metformin reduced tumor growth in preclinical meningioma models.
• **Cancer Research (2024):** Curcumin enhanced the effects of radiation therapy in meningioma cells.
• **Integrative Cancer Therapies (2023):** Berberine and Green Tea Extract reduced angiogenesis in preclinical studies.

Conclusion and Call to Action for Integrative Oncology in Meningioma

Meningioma, while often benign, can significantly impact quality of life if left untreated. A comprehensive approach combining surgery, radiation, and integrative oncology strategies provides the best outcomes. Advanced therapies, repurposed cancer drugs, and botanical interventions enhance recovery and reduce recurrence. Early detection and a holistic protocol are essential for optimizing survival and well-being.