Stage 4 Mesothelioma

Stage 4 mesothelioma is a rare and advanced stage of malignant cancer.

Stage 4 denotes that the cancer cells have metastasized, meaning that they have spread to other areas in the body different from where they originated.

Stage 4 is the final stage for cancer and it is considered terminal for patients with mesothelioma. The average life expectancy for patients diagnosed with stage 4 mesothelioma is under 12 months. 


Since mesothelioma has no cure, it is a terminal cancer. Many patients with mesothelioma will go into remission, but life expectancy largely depends on tumor growth and cancer stage.

Although stage 4 mesothelioma is the most advanced form, many patients continue to live years after the initial prognosis. 


Breathlessness, and coughing are the most common and severe symptoms of stage 4 mesothelioma. There may be additional symptoms since stage 4 denotes that the tumors have spread outside the lungs and chest cavity. 

Below are the most common symptoms for stage 4 mesothelioma: 

  • Abdominal pain 
  • Cachexia 
  • Coughing up blood 
  • Difficulty swallowing 
  • Fatigue 
  • Fluid buildup in chest or abdomen 
  • General discomfort 
  • High platelet counts 
  • Night sweats or fever 
  • Pain or tightness in chest 
  • Severe weight loss or anorexia 
  • Shortness of breath 


Since stage 4 mesothelioma is the most severe, some patients are unable to undergo aggressive surgeries or therapies. For this reason, chemotherapy and targeted radiation are the best treatment options for those with stage 4 mesothelioma. These treatment options will not cure the disease, but they can improve quality of life and lengthen life expectancy. 

Chemotherapy is the most common treatment for stage 4 mesothelioma.

The treatment will slow tumor growth and may be able to shrink the tumor size. This outcome alleviates the symptoms of the disease and can extend life expectancy. 

Depending on tumor growth and the overall health of the patient, doctors may prescribe targeted radiation therapy to reduce tumor size. This treatment can alleviate symptoms such as chest pressure and breathing pain. Radiation therapy is not always the best treatment option for those with stage 4 mesothelioma. 

Types of Late-Stage Mesothelioma 

Mesothelioma comes in four types, all of which have unique characteristics. 

Stage 4 Pleural Mesothelioma 

Pleural mesothelioma is the most common form of mesothelioma that affects the pleura around the lungs. Tumors can either be epithelial cells or sarcomatoid cells. Cell type will affect the cancer treatment. 

Stage 4 Peritoneal Mesothelioma 

Peritoneal mesothelioma is not officially classified as stage 4. By the point patients have excessive tumor spreading, they will often undergo heated intraperitoneal chemotherapy. This combines surgery and chemotherapy throughout the abdomen. 

Stage 4 Pericardial Mesothelioma 

Pericardial mesothelioma develops on the heart’s lining. This cancer type is normally not diagnosed until the later stages, though it may not be classified as stage 4. 

Stage 4 Testicular Mesothelioma 

The rarest form of mesothelioma is testicular mesothelioma. It will most likely be recognized as an advanced disease, though it may not be defined as stage 4. There are only around 100 cases of testicular mesothelioma documented.