Stage IV Mesothelioma

Mesothelioma is diagnosed as one of four stages, ranging between Stage I and Stage IV. Patients who are diagnosed with Stage IV mesothelioma are in the last and most advanced stage, and consequently have less effective treatment options. By the time mesothelioma is characterized as Stage IV, tumor growth and symptoms are intensified in comparison to previous stages. This stage carries the poorest prognosis, but resources are available to help patients cope and make the best treatment decisions for their case.

Stage 4 Mesothelioma

A Stage IV diagnosis is determined by the extent of how far the cancer has spread from its original location. If mesothelioma tumors initiated in the pleura have affected the chest wall, diaphragm, lining of the heart, or other areas, a Stage IV diagnosis will be made. With this type of mesothelioma, doctors may avoid using potentially curative treatments such as surgery because the extent of the cancer and the risks involved.

Symptoms of Stage IV Mesothelioma

Because Stage IV mesothelioma affects several parts of the body, patients may experience a variety of symptoms in various locations throughout the body. Two of the most common symptoms are severe chest pain and difficulty breathing. In some cases, tumors will spread to the esophagus and stomach, leading to a loss in appetite and difficulty swallowing. Abdominal pain can also be a symptom of Stage IV mesothelioma if the cancer has spread to the lower abdomen.

Treating Stage IV Mesothelioma

Stage IV mesothelioma treatment tends to be more palliative (which aims to relieve symptoms) than curative. For example, pleural mesothelioma treatments to drain excess fluid from the pleural cavity such as a thoracentesis or paracentesis are typically used to relieve symptoms rather than attempt to cure the cancer. In most late-stage cases, patients are not eligible to undergo curative surgery, as their body is not physically able to withstand the strain of surgery. Curative surgery on a Stage IV case of mesothelioma is generally too extensive, and because of the pattern of mesothelioma tumor growth, it is not feasible to remove all of the tumors. If surgery is used on a Stage IV patient, it is likely to remove bulk tumors to reduce pressure on the lungs and alleviate symptoms.

Stage 4 Mesothelioma Treated by Radiation Therapy

Since radiation therapy presents fewer side effects than surgery or chemotherapy, it may be a preferred form of treatment for some Stage IV patients. Some doctors may utilize a mix of palliative radiation therapy and surgical removal of bulk tumors to ease symptoms and potentially extend survival. If surgery is not an option, chemotherapy may be used in conjunction with radiation therapy to shrink tumors and provide relief of symptoms. Although these treatments do not offer a cure, patients may elect to receive them in an effort to reduce pain and improve quality of life.

Prognosis for Stage IV Patients

Patients with Stage IV mesothelioma generally have a poor prognosis because the cancer has spread to other parts of the body, making treatment options limited and less effective. Described as “distant metastasis” in staging systems, mesothelioma will typically spread throughout the abdomen, into lymph nodes, and sometimes into the heart sac or other organs. Patients with Stage IV mesothelioma have an average life expectancy of six and a half months after a diagnosis is made.

Final Stage of Mesothelioma

Approximately 30 percent of patients who are diagnosed with malignant mesothelioma have Stage IV cancer. If you have been diagnosed with late-stage mesothelioma and would like to learn more about treatment options, our Doctor Match Program can help. Please call (800) 615-2270 to receive assistance from a Patient and Family Advocate, or fill out the form on this page to receive more information about your specific diagnosis.