Pleural Mesothelioma Stage 4

Quick Summary

Stage 4 pleural mesothelioma is the most advanced disease stage with metastasis (spreading) to distant sites. The tumor is no longer contained to one side of the body and is now invading other distant organs and lymph nodes. Usually, treatments for stage 4 pleural mesothelioma patients are no longer focused on stopping the cancer from spreading. Instead, doctors administer palliative treatments to help relieve symptoms and improve quality of life.

Pleural Mesothelioma Stage 4 Overview

Most cases of pleural mesothelioma are diagnosed at end stages with many of being diagnosed at stage 4 of the disease. In stage 3, it’s possible for patients to have received a misdiagnosis of bronchitis, pneumonia or even another type of lung cancer. By the time doctors identify the type of cancer, it’s often already advanced to a point of being incurable.

If you’ve been diagnosed with stage 4 pleural mesothelioma, here’s what you need to know about this disease stage:

  • Stage 4 pleural mesothelioma is the most advanced stage
  • In stage 4, there is significant metastasis to distant sites, including throughout the chest cavity and into the abdomen
  • The median life expectancy of stage 4 pleural mesothelioma patients is 12 months
  • Treatments for stage 4 pleural mesothelioma include chemotherapy, radiation therapy and palliative surgeries
  • Stage 4 patients are often excellent candidates for clinical trials
  • All stage 4 pleural mesothelioma patients should seek a second opinion from a mesothelioma specialist with a history of treating late stage patients

What is Stage 4 Pleural Mesothelioma?

A stage 4 pleural mesothelioma diagnosis means that the mesothelioma is in its most advanced state and has spread distantly beyond the tumor’s primary location. Once mesothelioma has reached this advanced stage, it’s extremely difficult to treat. Though patients are no longer good candidates for resectable surgeries, they still have important treatments that can possibly extend life.

Stage 4 pleural mesothelioma is the most advanced form of the disease. The tumors now spread to the other side of the body, into the lymphatic system and to other distant sites.

To stage mesothelioma progression, doctors use three different systems which each look at different criteria. In general, a stage 4 pleural mesothelioma diagnosis means that the tumor has spread far beyond the primary location, cancer cells are now found in the bloodstream, and the tumor is no longer resectable (removable by surgery).

Stage 4 pleural mesothelioma symptoms cause the patient severe discomfort and pain. A patient with stage 4 pleural mesothelioma will notice a dramatic decrease in quality of life and will gradually become weaker due to how distantly cancer has spread.

What are the Symptoms of Stage 4 Pleural Mesothelioma?

Stage 4 Symptoms Update

It takes between 10 and 50 years after asbestos exposure for pleural mesothelioma to develop to the point of being diagnosable. Because of this long latency period, pleural mesothelioma patients often suffer from severe and worsening symptoms before they receive an accurate diagnosis. That’s why so many patients aren’t diagnosed with mesothelioma until stage 4.


Stage 4 pleural mesothelioma patients suffer from chronic, painful and debilitating symptoms. By the end stages, the chest cavity fills with fluid around the tumors, which causes swelling and pressure that compromises breathing and swallowing.

If you’ve been exposed to asbestos in your past and you are suffering signs of severe illness, then there are some stage 4 pleural mesothelioma symptoms to be aware of:

  • Difficulty breathing
  • Difficulty swallowing
  • Coughing up blood
  • Chronic night sweating
  • Chest pain
  • Severe weight loss

Many stage 4 pleural mesothelioma patients become very weak and frail because it becomes so difficult to eat. Additionally, even when patients can consume food, the body is no longer fully absorbing nutrients and converting food to energy because the immune system is fighting so hard to keep the patient alive.

Stage 4 Pleural Mesothelioma Prognosis

Stage 4 pleural mesothelioma has the worst prognosis of all the stages. Though some treatments and novel therapies may possibly help extend life, the condition is very difficult to treat once it has advanced this far.

The median life expectancy of stage 4 pleural mesothelioma patients is 12 months.

It’s important for patients to be aware of how many different factors influence a person’s prognosis and ultimately, their life expectancy. Mesothelioma cell type and patient age and health all play an important role in how doctors treat the condition. A prognosis is not a fact, and it can be improved with the right approach. Stage 4 pleural mesothelioma patients often undergo clinical trials which can provide a renewed hope for additional treatment options. In some cases, these novel therapies have contributed to an increased life expectancy.

Experts encourage everyone with a stage 4 pleural mesothelioma to get a second opinion from another mesothelioma specialist. Getting a second opinion can either confirm or change your original diagnosis and possibly present you with new information about your condition. Each doctor has a different philosophy they apply when approaching each case. Some doctors may not recommend aggressive treatment on a stage 4 mesothelioma patient, while others might. Regardless of what comes out of getting a second opinion, at least you can rest assured you’ve done all you can to pursue treatment options.

Stage 4 Pleural Mesothelioma Treatment Options

In general, stage 4 pleural mesothelioma patients have limited treatment options. In almost every case, the patient is no longer healthy or strong enough to undergo aggressive surgeries. However, there have been cases where doctors have performed extrapleural pneumonectomies (removing the lung and pleura) of stage 4 patients for symptom relief and also to help slow the cancer spread.

If you’ve been diagnosed with stage 4 pleural mesothelioma, the following are your standard treatment options:

  • Chemotherapy: Chemotherapy is an anticancer drug that’s given orally or intravenously. You take it over the course of several weeks to help slow disease progression, which can help to eliminate or ease painful symptoms.
  • Radiation Therapy: Radiation is a targeted and non-invasive treatment that shrinks tumors in size. By shrinking tumors, patients can feel relief from reduced pressure and controlled metastasis.
  • Palliative Surgery: Surgical procedures are extremely important for stage 4 pleural mesothelioma patients in order to improve quality of life. Surgeons will perform different palliative procedures that drain fluid from the chest cavity to help improve breathing and reduce pain.
  • Clinical Trials: Clinical trials are taking place at cancer centers across the country. Stage 4 pleural mesothelioma patients have access to new and novel therapies that can possibly extend life. Immunotherapy and gene therapy are two new treatment methods being tested in clinical trials that show promising results.

Compensation for Stage 4 Pleural Mesothelioma Treatments

Stage 4 pleural mesothelioma patients have important treatment options that can not only improve quality of life but possibly extend life expectancy as well. Though treatments are limited in stage 4, patients can still benefit from multimodal therapies and new and novel treatments being tested in clinical trials.

As a victim of asbestos exposure on the part of negligent asbestos companies, mesothelioma patients are usually eligible for legal compensation through claims and lawsuits. If you’re a veteran, you may be eligible for VA benefits. To find out more about your legal rights, contact our Patient Advocates today. We will connect you with top mesothelioma lawyers who will review your case and fight to get you compensation for your treatment costs and other damages. Don’t delay in getting the treatments you deserve that can extend your life.

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Sources
  1. Annals of Translational Medicine, “Perspective on malignant pleural mesothelioma diagnosis and treatment.” Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4828731/. Accessed on December 18, 2017.
  2. “Stage IV/Recurrent Malignant Pleural Mesothelioma” Retrieved from: http://cancer.unm.edu/cancer/cancer-info/types-of-cancer/mesothelioma/stage-iv-recurrent-malignant-pleural-mesothelioma/. Accessed on December 18, 2017.

Last modified: May 7, 2018