You said your meningioma is small. The typical growth rate is about 1/8th inch a year. I have an 8 mm. meningioma and after putting two and two together I am pretty sure my neurosurgeon's game plan is that by the time the 8 mm meningioma grows to the point where it is causing problems I probably will have passed on from something else anyway. Personally, I think radiation to the brain is a big deal. You should scroll back and read posts from others who have gone through it. It seems to me the biggest side effect is fatigue. Are you already experiencing that with the Waldenstoms? If so, would you be willing to load on more fatigue? It seems to me the key would be the likelihood of the Waldenstroms rearing its ugly head and preventing you from dealing with the meningioma. The oncologist would have the answer to that. Also, is the pressure you say you experience in the morning something that is so uncomfortable that you need to take a pain medicine? My non-medical opinion would be if the meningioma is small, and not really causing you an all-day headache that can't be controlled with over the counter pain meds, and the oncologist thinks the Waldenstroms is stable for the long term, I'd go with watch-and-wait as your neurologist suggested.