Stage 4 Mesothelioma

Stage 4 Pleural Mesothelioma Cancer

What is Stage 4 Mesothelioma?Stage 4 Mesothelioma

Stage 4 mesothelioma is the final, most advanced stage of pleural mesothelioma. By this point, malignant mesothelioma tumors have metastasized, or spread towards other parts of the body beyond the point of origin. It is possible cancer has dispersed to the lymph nodes and several organs of the body; including the brain, lining of the heart, spine, and prostate.

In result, it has become the most difficult stage to treat for two leading reasons;

  • Lack of treatment options that have the ability to remove all tumors
  • Inability to withstand aggressive surgeries due to a patient’s decline in health

Continued advancements in palliative care could potentially help patients to live longer, as well as to have a better quality of life despite the terminality of Stage 4 mesothelioma. Living years after their initial mesothelioma prognosis, some patients have continued to defy the odds.

A patient’s outlook depends mainly on the extent of the tumor growth in addition to how well their body responds to treatments.

Symptoms of Stage 4 Mesothelioma

Symptoms of Stage 4 MesotheliomaThe symptoms of stage 4 mesothelioma are caused by the growth of metastasis and tumors. Tumor growth within the chest will cause difficulty breathing and an uncomfortable feeling in patients. New signs may emerge as mesothelioma metastasizes to new areas of the body.

If you or a loved one is displaying any of the symptoms below, it may be good to speak with a medical physician as soon as possible. Common symptoms of Stage 4 mesothelioma cancer include:

  • Weight Loss
  • Fatigue
  • Build up of fluid in the Abdomen or chest
  • Dysphagia (This term refers to the difficulty swallowing)
  • Hemoptysis (Means coughing up blood)
  • Night sweats
  • Pain in the chest area
  • Fever
  • Tightness in the chest

Few treatment options, also known as palliative treatments, options are available for Stage 4 mesothelioma. Medication for fatigue and nausea are common palliative treatments; these are provided to patients exhibiting the symptoms of Stage 4. A doctor may decide to utilize radiation to reduce tumor size and/or drain chest fluid to help with chest pain and breathing.

Late Stages by Mesothelioma Type

Late Stages by Mesothelioma TypeFor peritoneal mesothelioma, typically accounting for about 20 percent of all cases, there is no official Stage 4; instead, it is generally accepted that patients with extensive tumor spreading are classified as stage 4 for peritoneal mesothelioma.

By this point, the tumors have spread outside of the peritoneum (the protective lining of the abdomen where cancer initially develops), and the cancerous tissues are more extensive.

Similarly to pleural mesothelioma, surgery is typically not an option at this stage – including heated intraperitoneal chemotherapy (HIPEC). HIPEC is peritoneal mesothelioma treatment which combines both heated chemotherapy and surgery.

Pericardial mesothelioma develops on the lining of the heart. This form of mesothelioma may not be deemed as stage 4, but it is typically diagnosed in later stages.

Stage 4 Mesothelioma by Staging Systems

TNM System: Tumors may become visible within the esophagus, heart, lungs, and lymph nodes throughout the body due to the spreading of mesothelioma to both sides of the body.

Brigham System: Tumors have experienced excessive growth – spreading too far into additional organs – and are too large to be removed by surgical procedures in Stage 4 of the Brigham system.

Butchart System: Mesothelioma has spread to locations of the body that of which are far removed from the point of origin of the tumor in Stage 4 of the Butchart system.

Types of Mesothelioma

Pleural mesothelioma arises in the membrane which surrounds the lung, called the pleura. Pleural mesothelioma is the most common form of this deadly cancer.

Peritoneal mesothelioma develops in the lining of the abdominal cavity, called the peritoneum. Peritoneal mesothelioma is less common but is more often found in women than in men.

Pericardial mesothelioma originates in the pericardium, which lines the heart.

Stage 4 Mesothelioma Treatment Options

Treatment for Stage 4 MesotheliomaAfter being diagnosed with Mesothelioma, it is suggested that treatment choices be strongly explored with mesothelioma cancer experienced physicians. There are a number of treatment alternatives for mesothelioma through surgical treatment, radiation therapy, and certain chemotherapy. Recent studies have shown a number of natural mesothelioma healing techniques

Some of these natural mesothelioma healing techniques include: transcutaneous electrical nerve stimulation (TENS), acupuncture, acupressure, naturopathic medicine, osteopathic medicine, sufficient and well-balanced nutrition, mind-body therapies – such as yoga, qigong, and tai chi, and homeopathy, a system of medicine that relies on 2 ideologies: the principle of similarities and the concept of dilution. As well as many others which can be found on our alternative mesothelioma treatments page.

The patient’s decision of the type curing method will depend on a few circumstances:

  • The extent or stage of cancer
  • Any existing health disorders
  • Basic activeness and physical health

Stage 4 Mesothelioma Treatment Options

Treatment options that aim to extend survival become the most limited at Stage 4, as there are no curative treatments exist for any stage of mesothelioma at this point.

Typically, extensive tumor surgeries including Extra-Pleural Pneumonectomy (EPP) or Pleurotomy/Decortication (P/D), are no longer optional. Palliative treatments, such as radiation therapy and chemotherapy, can reduce the size of the tumor and slow the growth of the tumor.


A doctor’s ability to remove all growths by Stage 4 is improbable as the spread of tumors becomes too vast. Nonetheless, some patients can benefit from less extensive surgical procedures in the attempt to remove as much tumorous mass as possible. Additionally, doctors can specifically target and remove problematic tumors in the hope a patient may experience less pain and may breathe more comfortably.

Less invasive surgeries that relieve pain and reduce symptoms include:

  • Paracentesis: Drainage of fluid from the abdomen
  • Pericardiocentesis: Drainage of fluid from around the heart
  • Pleurodesis: Potential long-term solution to fluid buildup in the chest
  • Thoracentesis: Drainage of fluid from the chest


Chemotherapy is one of the most common treatment options for Stage 4 mesothelioma which utilizes chemical substances to slow tumor grown and, in some cases, shrink tumors. This can help to alleviate symptoms and extend survival.

In 2016, a study conducted by Wayne State University researchers found that chemotherapy more than doubles the life expectancy for patients with malignant mesothelioma – including those in Stage 4. Combining surgery with chemotherapy extended an even longer survival of patients.

For pleural mesothelioma, the most commonly prescribed chemotherapy regimen is cisplatin or carboplatin combined with Pemetrexed (Alimta).

Radiation Therapy

Not all doctors treat Stage 4 mesothelioma with radiation therapy – recommendation for the procedure is dependent on a patient’s tumor growth as well as their overall health. At this stage, radiation therapy might have the ability to reduce the size of tumors; this can decrease pain, improve breathing, and lessen chest pressures.

Immunotherapy and Clinical Trials

Clinical trials – including gene therapy, immunotherapy, and other emerging therapies – may be available for certain Stage 4 mesothelioma patients. The value of various treatment combinations for late-stage mesothelioma may be investigated in some clinical trials. Experimental treatments can help Stage 4 patients survive far past their prognosis in some situations.

A study conducted in 2016, published in The Annals of Thoracic Surgery”, revealed that late-stage mesothelioma survival may be improved by photodynamic therapy. In comparison to the usual one-year prognosis, a subset of patients with pleural mesothelioma who had no cancer in their lymph nodes lived an average of 7.3 years.

Supportive Care

Palliative or supportive care can to relieve symptoms and improve quality of life. At Stage 4, doctors may suggest the use of oxygen therapy, respiratory therapies, and pain medications in order to improve lung functions and control pain.

Complementary and alternative medicine therapies have been incorporated into the treatment plans of many long-term mesothelioma survivors. Certain complementary therapies may ease symptoms, enhance the quality of life, improve survival, and reduce treatment side effects. Such treatments include herbal medicines and holistic therapies, mind-body therapies (tai-chi, qigong, and yoga), and nutritional therapy.

Life Expectancy Without Treatment

A patient with mesothelioma that does not undergo treatments life expectancy is dependent on varying factors. Such factors include the stage at which the cancer is at, and how fast the tumors are experiencing growth.

Refusal of treatments for patients diagnosed in Stage 1A lives an average of two years, whereas those who are in Stage 4 live an average of 6 months.

Tumor grading was developed by researchers to estimate how fast tumors could grow. To do so, a count of how many times the cancer cell divides and analysis for abnormalities is tracked; survival is associated with these factors.

Tumor Grades and Survival is as following:

  • Grade 1 average survival: 28 months
  • Grade 2 average survival: 14 months
  • Grade 3 average survival: 5 months

Stage 4 Mesothelioma Clinical Trial

“Surgery for Mesothelioma After Radiation Therapy.” is SMART

Stage 4 Mesothelioma Clinical TrialThe objective is to thoroughly strike and weaken the mesothelioma source before undergoing surgery. Surgery for mesothelioma after radiation therapy is dependent on EPP operation to officially discard the terminal lung. Experts have prescribed more than average amounts of severe radiation aimed at the tumor.

Specialists remove the agitated tumors within the diseased lung before they allow the radiation to put the patient in danger.  A single case in the early stage of mesothelioma, 24 patients in Stage 3, and 13 patients in Stage 4 mesothelioma proceeded to undergo this procedure between 2008 and 2012. Of all these case that went through the treatment and had an outcome of only small signs of fatigue.

The survival rate for three years in its entirety was eighty-four percent. The fact of the matter is that twenty-one of indigenous cases have lived for up to three years. Patients who are in stage four of mesothelioma and have completed the procedure chances of survival have tripled since then.

Mesothelioma patients who were selected to go through with the SMART trial were chosen with care. The people who were selected for this procedure were required to meet the firm standards of eligibility.

The SMART study allows the good to outweigh the bad of going through with clinical trials.

Prognosis & Life Expectancy for Stage 4 Mesothelioma

Prognosis & Life Expectancy for Stage 4 MesotheliomaThe spreading of cancer is likely by Stage 4, which can result in heart or respiratory failure if tumors progress towards the heart. For Stage 4 mesothelioma, about 12 months (with treatment) is the median survival rate.

Survival can become extended with a positive response to treatment. Patients who exhibit good prognostic factors often live longer than average. Prognostic factors (including being in good overall health, female and having no signs of blood disorders, having the epithelioid cell type, and being younger in age) are associated with stronger survival rates.

As heterogeneous cancer, meaning no two cases are the same, survival statistics for mesothelioma cannot predict how long someone will live indefinitely. Some have particularly slow-developing mesothelioma and/or symptoms, while others respond unpredictably well to treatments.

Mesothelioma News

Stage 4 Mesothelioma Survivors

Stage 4 Mesothelioma SurvivorsThe average prognosis of Stage 4 mesothelioma has been far outlived by many patients.

For 10 years, Lannie Chitwood lived with Stage 4 pleural mesothelioma. At Duke University Medical Center in Durham, North Carolina, he received treatments including experimental chemotherapy. During those years, Lannie and his wife enjoyed traveling together and in 2015 took a second honeymoon.

For seven years, Andy Ashcraft lived with Stage 4 pleural mesothelioma. He joined a clinical trial that combined chemotherapy with an immunotherapy drug. Compared to others, Andy responded better than anyone undergoing the same trial. For more than three years he continued to take just the immunotherapy drug. When the immunotherapy drug stopped working, he utilized medicinal cannabis and lived several more years.


Steps to Take After a Stage 4 Mesothelioma Diagnosis

Patients may defy the odds and become a survivor through revolutionary clinical trials, healthy life choices, and a diverse variety of treatments. Some patients, especially those in overall good health, live far beyond their given life expectancy – despite Stage 4 being the most advanced stage of mesothelioma. Consider the following:

Steps to Consider After a Stage 4 Diagnosis

  • Consult with your doctor to determine if you are eligible to enroll in a clinical trial.
  • Receive a second opinion from a mesothelioma specialist.
  • To offset the potential financial burden, seek financial assistance available.
  • Make time for hobbies and activities that bring you joy.
  • To improve mood and quality of life, exercise and maintain a healthy diet.
  • Connect with others coping with mesothelioma, join a support group.
  • Read stories about other mesothelioma survivors for hope and inspiration.
  • Try alternative and/or complementary treatment options.

Though the diagnosis of Stage 4 mesothelioma can be shattering, it is not an immediate death sentence. A proactive approach, as well as a variety of treatments, are significant to assist in extending the life of you or a loved one.

Legal Options For Mesothelioma Patients in Stage 4

Stage 4 Mesothelioma Legal Options and LawyerLegal compensations tend to be eligible through claims and lawsuits for mesothelioma patients as a victim of asbestos exposure due to negligent asbestos companies. Additionally, veterans may have eligibility for VA benefits. Contact our Patient Advocates today to learn more about your legal rights.

Here at the Asbestos Cancer Organization, we have partnered with a top mesothelioma law firm. For over 40 years the attorneys at Goldberg, Persky & White have been fighting and winning mesothelioma cases for clients. We strongly urge that if you or a loved one has been diagnosed with mesothelioma legal consultation is sought with our partners at Goldberg, Persky & White


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