Stage Four of Mesothelioma

Stage 4 is the last and most advanced stage of mesothelioma. Stage 1 and 2 are termed as initial stages while Stage 3 is considered to be advanced stage. As with all cancers, the stage is determined based on how far the cancer has spread from the initial location. Stage 4 is characterised by high spread of cancer to vital organs through the lymphatic system and blood stream. For example, in case of Stage 4 of Pleural Mesothelioma apart from entire lung being affected, the cancer would have spread to other vital organs such as esophagus and lymph nodes in the neck. In case of stage 4 of Pericardial Mesothelioma the cancer spreads to chest cavity and with blood stream remote parts of the body too. For Peritoneal Mesothelioma the cancer spreads throughout the abdominal cavity and to other vital organs of the body.

Symptoms of stage 4 for Mesothelioma

Symptoms of Stage 4 depends a lot on where the cancer has spread to. Most common stage 4 symptoms include severe chest pain and problems in breathing. This is generally accompanied with local symptoms (0f where the cancer has spread) such as pain in abdomen, etc. Other common symptoms include loss of appetite and problems in swallowing.

Treatment of mesothelioma stage 4

At this stage of mesothelioma the treatments are aimed towards relieving the symptoms rather than curing the cancer, as there is little which can be done to cure it. The biggest hurdle is that the curative surgery which is possible in stage 1 and 2 is not possible as the cancer has spread to too many areas. Further, at this stage most patients cannot physically bear the strain of the surgery as they become too weak. Even if a surgery is done, the aim is to remove bulk tumors so that patients get bit of relief and drugs can become a more effective.  For example, in case of pleural mesothelioma, removal of primary tumor of lung may help in easing pressure on lung, improve breathing and help in pain. Similarly, in case of pericardial and peritoneal surgery of heart and abdomen to remove primary / large tumors will ease pain.

Radiation therapy remains an open option for treating patients of stage 4 of mesothelioma.  In some cases its combined with surgery (as mentioned above) and chemotherapy. But as already mentioned all these measures are primarily to improve quality of life of the patient and reduce the pain and suffering.

Draining excess fluid from the affected areas Thoracentesis (lungs) / Paracentesis (abdomen)  / Pericardiocentesis (heart) can help and provide temporary relief.

Palliative Care becomes more important and relevant for advanced mesothelioma stages to ensure that the patient is comfortable and pain free. Physical and emotional support play an important part in coping up with the disease and its discomfort.

Prognosis of Stage 4 of mesothelioma

Prognosis of stage 4 of mesothelioma is poor and thus not encouraging. This is because the treatment options available at this stage are very limited in nature. Unfortunately large number of patients are diagnosed with mesothelioma when the cancer has already reached Stag 4. With cancer spread to multiple vital organs the life expectancy decreases at this stage. Typical life expectancy is around six months.


Early detection of mesothelioma is key to good treatment and prognosis. It is important that if one was exposed to asbestos in past, at slightest symptoms resembling mesothelioma one should consult a doctor.