Stage 4 Mesothelioma
Stage 4 mesothelioma is the final and most advanced stage. By this point, metastasis (cancer spread) has occurred, and tumors have reached distant organs like the brain. Stage 4 mesothelioma often has a poor health outlook, but we can help you pursue treatments so you can hopefully live longer.
What Is Stage 4 Mesothelioma?
Stage 4 malignant mesothelioma is the last and most aggressive stage. By this point, mesothelioma cancer tumors have spread through the body.
Stage 4 Mesothelioma Quick Facts
- The cancer has metastasized to organs like the bones, liver, or brain
- The 5-year survival rate for stage 4 mesothelioma is 4.9%
- Stage 4 mesothelioma patients live for 9 months on average
- Treatments include chemotherapy and immunotherapy, with radiation and surgery
While there are fewer treatment options available for late-stage mesothelioma due to cancer spread, some patients could live longer than expected.
“Sometimes you may feel alone, but I know for a fact that I’ve never truly been alone through this. And I’ve been blessed in that regard.”
— Quincy, 9-year stage 4 mesothelioma survivor
If you or a loved one has stage 4 mesothelioma cancer, Lung Cancer Group may be able to assist you. Speak with our mesothelioma nurses for help finding the best treatments and doctors after a diagnosis.
- Find Top Doctors and Treatments
- Connect You With Clinical Trials
- Answer Medical Questions
Amy Fair
20+ Years Helping
Mesothelioma Patients
Types of Stage 4 Mesothelioma
There are four types of mesothelioma, with only pleural mesothelioma classified into four stages.
The other three types are assigned localized or advanced stages depending on how far the cancer has spread. The advanced stage is the equivalent of a stage 4 diagnosis. Learn about the types of stage 4 mesothelioma below.
Stage 4 Pleural Mesothelioma
Malignant pleural mesothelioma forms in the lining of the lungs (pleura). Doctors classify it into one of four stages with the Tumor-Node-Metastasis (TNM) staging system. If the cancer has metastasized, the patient has stage 4 mesothelioma.
Pleural mesothelioma cancer stage 4 may have spread to:
- Adrenal glands
- Bones
- Diaphragm (muscle at the bottom of the chest)
- Linings of the heart or abdomen
- Lungs
- Lymph nodes on both sides of the body
- Spinal column
Stage 4 pleural mesothelioma is not usually treated with surgery. Instead, thoracic oncologists (doctors who treat chest-related cancers) may use chemotherapy, immunotherapy, and pain-relieving treatments.
Stage 4 Peritoneal Mesothelioma
Peritoneal mesothelioma forms in the lining of the abdominal cavity (peritoneum).
In late-stage peritoneal mesothelioma, the cancer may reach the:
- Female reproductive organs (ovaries and uterus)
- Liver
- Spleen
Treatment plans for advanced peritoneal mesothelioma depend on the patient’s overall health.
Call (877) 446-5767 to speak with a registered nurse about the best treatment options for your stage 4 mesothelioma diagnosis.
Stage 4 Pericardial Mesothelioma
Pericardial mesothelioma forms in the heart lining (pericardium).
Late-stage pericardial mesothelioma can spread to the:
- Kidneys
- Liver
- Lungs
- Lymph nodes
Between 80% and 90% of pericardial patients are only diagnosed after they’ve died. Doctors can recommend treatments to help early and late-stage patients diagnosed while they’re living.
Stage 4 Testicular Mesothelioma
Testicular mesothelioma develops in the testicle lining and can spread to the lungs, lymph nodes, and other parts of the body. Doctors can use multiple treatments to help patients with advanced testicular mesothelioma live longer.
Mesothelioma Stage 4 Symptoms
The symptoms of stage 4 mesothelioma can vary depending on where the cancer developed in the body.
Stage 4 mesothelioma symptoms may include:
- Ascites (fluid buildup in abdominal lining)
- Changes in bowel movements
- Coughing up blood
- Fatigue
- Fever
- Nausea
- Night sweats
- Pleural effusions (fluid buildup in lung lining)
- Rib, shoulder, upper back, or chest pain
- Shortness of breath
- Vomiting
- Weight loss
Symptoms of mesothelioma take 10-50 years to develop after asbestos exposure. By the time most patients develop symptoms, however, the cancer is in either stage 3 or stage 4.
Diagnosing Stage 4 Mesothelioma
Doctors typically follow a series of steps to diagnose mesothelioma and determine the stage.
Here’s how doctors test for stage 4 mesothelioma:
- Check symptoms and assess the patient’s asbestos exposure history
- Perform imaging tests to detect signs of cancer
- Order a biopsy (removal of fluid/tissue to look for cancer cells under a microscope)
Nearly 40% of pleural mesothelioma cases are diagnosed in stage 4, according to a study from the American Cancer Society Journals. If you’ve received a stage 4 diagnosis, speak to our mesothelioma nurses to find top doctors and treatments.
- Find Top Doctors and Treatments
- Connect You With Clinical Trials
- Answer Medical Questions
Amy Fair
20+ Years Helping
Mesothelioma Patients
Diagnosing Stage 4 Mesothelioma Cell Type
If doctors find mesothelioma cells in a biopsy and see that tumors have spread through your body on imaging scans, you could be diagnosed with stage 4 cancer.
There are different types of cells doctors can see, and which type you have may impact your overall survival.
There are 3 types of mesothelioma cells:
- Epithelioid (epithelial): Stage 4 epithelial mesothelioma responds the best to treatment since these cells don’t spread as quickly as the other types.
- Sarcomatoid: Sarcomatoid mesothelioma stage 4 is the hardest to treat because the cells spread easily to other parts of the body.
- Biphasic: These tumors contain both epithelioid and sarcomatoid cells. Biphasic mesothelioma is easier to treat if more epithelioid cells are present.
Doctors can recommend a treatment plan for your stage 4 mesothelioma in part based on your cell type.
Stage 4 Mesothelioma Prognosis
Stage 4 mesothelioma has the least favorable prognosis (health outlook) of all stages, but some patients may live longer depending on how their cancer responds to treatments.
View stage 4 mesothelioma prognosis statistics below.
Mesothelioma Stage 4 Life Expectancy
The average mesothelioma stage 4 life expectancy is 9 months, according to a 2024 report from The Journal of Clinical Oncology.
That said, your stage 4 mesothelioma life expectancy could be longer. Your overall health, treatment plan, cancer cell type, and what type of mesothelioma you have all impact your survival time.
Stage 4 Mesothelioma Survival Rates
Survival rate is the percentage of people still alive after a set period of time. Stage 4 mesothelioma has the lowest survival rates of any stage.
Stage 4 pleural mesothelioma survival rates include:
- 1-year survival rate: 36.9%
- 2-year survival rate: 26%
- 5-year survival rate: 4.9%
It’s important to remember, though, that survival rates are averages and that you could outlive them.
Contact our team to learn about treatments that could help you live longer with stage 4 mesothelioma.
Stage 4 Mesothelioma Treatment
Most stage 4 mesothelioma cancer treatments are palliative (pain-relieving). Some patients may qualify for treatments that could help them live longer.
Learn about treatment options for stage 4 mesothelioma below.
Chemotherapy
Chemotherapy is the main treatment for stage 4 pleural mesothelioma, according to the health network Texas Oncology. Chemotherapy drugs like pemetrexed and cisplatin can destroy cancer cells and reduce the size of tumors.
Peritoneal mesothelioma may resist chemotherapy, but it’s sometimes used for late-stage patients who don’t qualify for surgery, as noted by Translational Lung Cancer Research.
Immunotherapy
Immunotherapy medications improve the body’s immune response so it can destroy cancer cells. It’s currently used with chemotherapy to treat pleural mesothelioma patients.
Other studies are looking at how immunotherapy could help late-stage cases of other mesothelioma types.
Radiation
Radiation therapy uses concentrated X-rays or other energy beams to shrink tumors. Stage 4 mesothelioma doctors can use it alone to ease cancer symptoms or with chemotherapy to hopefully help patients live longer.
Surgery
Doctors can sometimes treat cases of stage 4 mesothelioma with minor surgeries that can reduce tumors and ease symptoms.
Major surgeries typically aren’t used for stage 4 mesothelioma as the cancer will have spread far, so doctors can’t remove all the tumors.
Clinical Trials
Doctors study new and possibly more effective ways to treat stage 4 mesothelioma through clinical trials.
A 2024 review of clinical trials for advanced mesothelioma from Critical Reviews in Oncology/Hematology found that the immunotherapy drugs ramucirumab (Cyramza®), nivolumab (Opdivo®) and ipilimumab (Yervoy®), along with chemotherapy, were the most effective treatments.
Speak with our mesothelioma nurses to learn about clinical trials that you could join for stage 4 cancer.
- Find Top Doctors and Treatments
- Connect You With Clinical Trials
- Answer Medical Questions
Amy Fair
20+ Years Helping
Mesothelioma Patients
Palliative Care
Doctors can use palliative treatments to help stage 4 mesothelioma patients live with less pain.
Palliative care options for stage 4 mesothelioma include:
- Catheters: These can drain pleural effusions or ascites.
- Mental health treatments: Cancer is stressful and scary. Speaking with a counselor, trying yoga or meditation, or joining a support group can help patients cope.
- Pleurodesis: Doctors flush medical-grade talcum powder into the lung lining to seal it and prevent pleural effusions.
- Thoracentesis: A small needle drains pleural effusions so patients can breathe better. A similar treatment, paracentesis, treats ascites.
Palliative treatments may be the main ones for stage 4 patients reaching the end of life. Doctors can also use them alongside life-extending treatments to help relieve symptoms.
Stage 4 Mesothelioma Without Treatment
Patients who don’t get any stage 4 mesothelioma treatments typically live just a few months.
For this reason, it’s in your best interest to understand all available treatment options after a stage 4 mesothelioma diagnosis.
If you decide that you don’t want to undergo aggressive, potentially life-extending treatments, palliative care can help make you more comfortable and ease symptoms.
Speak with a mesothelioma nurse now for help finding the best cancer treatments for you.
Are There Any Survivors of Stage 4 Mesothelioma?
Yes, some patients live much longer than expected, becoming stage 4 mesothelioma survivors.
Notable stage 4 mesothelioma survivors include:
- John (5-year survivor): Diagnosed with stage 4 pleural mesothelioma in 2019, John’s cancer was successfully treated with chemotherapy. “I’m pretty well back to normal,” he says today.
- Quincy (9-year survivor): When Quincy received his peritoneal mesothelioma stage 4 diagnosis in 2015, doctors gave him just 1 year to live. However, chemotherapy beat the cancer back, and he’s now coming up on a decade of survivorship.
While stage 4 mesothelioma is aggressive, these survivors prove it’s not a death sentence.
“I didn’t choose to accept this prognosis and I still don’t. I’m going to keep fighting, I’m going to keep living my life.”
— Quincy, 9-year stage 4 mesothelioma survivor
We Can Help Stage 4 Mesothelioma Patients
You don’t have to face a stage 4 mesothelioma diagnosis alone. If you or someone you love is dealing with this cancer, contact Lung Cancer Group.
Our registered nurses and patient advocates may be able to:
- Connect you with top doctors and treatments
- Locate nearby support groups and other resources
- Help you explore financial compensation options for cancer expenses
Our team has assisted thousands of families facing a mesothelioma or lung cancer diagnosis. We’re ready to help you and your family, too.
Call (877) 446-5767 now or connect with our mesothelioma nurses to get started.
Mesothelioma Stage 4 FAQs
What is the difference between stage 4 mesothelioma and lung cancer?
Stage 4 mesothelioma and stage 4 lung cancer are two different types of cancers, and each requires unique treatments.
Mesothelioma forms in the lining of the lungs and other organs, while lung cancer develops in the lung itself. When either of these cancers reach stage 4, they can spread throughout the body to the brain, spinal cord, and other areas.
Contact us to get help if you or a loved one has been diagnosed with either mesothelioma or lung cancer stage 4. We can help you understand available treatment and compensation options.
How long can you live with stage 4 mesothelioma?
The average life expectancy for most stage 4 mesothelioma patients is 12 months. That said, it’s sometimes possible to live for many years with stage 4 mesothelioma, depending on how your body responds to treatments.
Working with cancer specialists offers you the best chance at living longer with stage 4 mesothelioma.
Can I get immunotherapy for stage 4 mesothelioma?
Yes, you may be able to get immunotherapy to treat stage 4 mesothelioma. This type of treatment helps your immune system better target and destroy cancer cells.
Speak with a registered nurse to learn if immunotherapy could be a helpful treatment for your stage 4 mesothelioma.
Can stage 4 mesothelioma go into remission?
Possibly, yes. In rare cases, patients with stage 4 mesothelioma might achieve remission (where the cancer shrinks or disappears).
A 76-year-old man with stage 4 mesothelioma went into remission after having a thoracocentesis (fluid drain) and using alternative therapies. This was a unique case, as remission is more common when aggressive treatments like surgery are used.
What happens in the final stages of mesothelioma?
In the final stages of mesothelioma, cancer tumors have spread past where they first formed, reaching major organs like the brain, liver, or bones.
Patients may experience painful symptoms, such as difficulty breathing, coughing up blood, and severe weight loss due to cancer spread.
Doctors can recommend treatments to ease pain and, in some cases, help end-stage mesothelioma patients live longer.
