Stage 4 Mesothelioma

Stage 4 is the final stage of mesothelioma and is the most difficult to treat. However, there are still several treatment options available. Most often, palliative treatment options are used to make the patient more comfortable.


Late Stage Mesothelioma

Mesothelioma reaches stage 4 when it has metastasized (spread) to different areas of the body, not necessarily close to the point of origin. At this point, the patient is not eligible for some of the more aggressive mesothelioma treatments, but other treatment options are still available to make the patient comfortable and to extend life.

Stage 4 Treatment Options

When a patient reaches stage 4 mesothelioma, the treatment plan is typically more palliative (pain relieving) than curative. The main goal for physicians of patients with stage 4 mesothelioma is to alleviate pain and improve quality of life by any means possible.


Chemotherapy is used to shrink tumors and slow their growth. It can be given in pill form or intravenously. Chemotherapy is rarely curative but may be able to help patients live longer. This is one of the most common treatments for late-stage mesothelioma patients


Radiation is used to shrink tumors and to kill mesothelioma cells. Depending on the location of the tumors, different types of radiation are used. For stage 4 mesothelioma patients, radiation is sometimes used to help relieve pain from tumors.

Palliative Surgery

Palliative surgeries for late stage mesothelioma patients can improve quality of life while reducing symptoms. Some studies have shown these surgeries improve life expectancy as well.

Clinical Trials

Experimental treatments potentially have stronger effects than standard treatments. Some clinical trials are even formed specifically for treating late-stage patients and patients who didn’t see results from standard treatments.

We Can Connect You with Clinical Trials

One of the best ways to improve your prognosis and the likelihood of beating mesothelioma is through clinical trials. Clinical trials are currently underway for stage 4 pleural and peritoneal mesothelioma patients.

Why Clinical Trials?
  • Exclusive access to promising new procedures
  • One-on-one care from leading mesothelioma specialists
  • Participation in trials has helped survivors triumph


In stage 4, the mesothelioma has already spread to other parts of the body, possibly some important organs. This can have serious affects on the patient’s health. It can also make surgery difficult for doctors to perform, narrowing the patient’s treatment options.

Some basic characteristics of stage 4 mesothelioma are:

  • Aggressive tumors spread from original location to other organs
  • Definite lymph node involvement
  • Palliative surgery useful to reduce symptoms

Patients with stage 4 mesothelioma usually have a poorer prognosis than earlier stage patients. The median life expectancy for patients in stage 4 is around 12 months after the diagnosis is given.

However, it is very important for patients to receive a second opinion to ensure their diagnosis is correct.

Second Opinion

A second opinion is critical in determining a patient’s staging and available treatment options. Late stage patients are often ineligible for surgery or other life-saving treatments so it is extremely important that all patients know their diagnosed stage is accurate.

The best way to check the accuracy of a diagnosis is to get a second opinion from a specialist. Doctors who specialize in treating mesothelioma are much more experienced in diagnosing and staging the disease.

Alexis Kidd was initially diagnosed with stage 4 mesothelioma because of the metastasis to her diaphragm. After getting a second opinion, it was found that the mesothelioma actually originated in her diaphragm and it had not yet metastasized. After her second opinion, her diagnosis was amended to stage 2.

She was given 6-12 months, but as of 2014, Alexis is alive and well more than 8 years later. After her experience she says, “no one can really predict how much time someone has left.” Read other survivor stories in our free Mesothelioma Survivor Guide.

Stage 4 by Different Staging Systems

Stage 4 (Buchart System)

In stage 4 mesothelioma, the mesothelioma cells have spread to the bloodstream, and this system recommends palliative treatments to keep the patient comfortable. At this point, because it has attacked the bloodstream, tumors may now be present in the liver, brain, bones or other organs.

Stage 4 (Brigham System)

According to the Brigham System, the tumor has grown and metastasized to other parts of the body and cannot be treated any further. Dr. David Sugarbaker is the developer of the Brigham System and is also one of the top pleural mesothelioma specialists.

Stage 4 (TNM System)

TNM is the most commonly used staging system. During the stage 4 progression, the TNM system states that the cancer has spread to the lymphatic system and the tumor has grown throughout the entire body.