Staging systems are used to determine how far a patient’s cancer has spread. Mesothelioma staging is based on whether the cancer can be surgically removed or treated and the extent to which the lymph nodes are involved. Stage 4 is the end stage.

Stage 4 mesothelioma is a very advanced form of the cancer. By the time mesothelioma reaches this stage, the cancer has generally metastasized or spread to other locations throughout the body. Instead of the cancer being primarily located at one tumor site, it is typical to find that it has spread to the brain and the abdomen as well as to other important organs in the body.

Symptoms of Stage 4 Mesothelioma

Stage 4 malignant mesothelioma will be located in one or both sides of the body and involves the lymph nodes. According to the National Institutes of Health, the cancer has spread in one or more of the following ways:

  • Through the diaphragm and into the peritoneum (the tissue lining the abdomen and its organs)
  • Into the pleura on the opposite side of the body
  • To the chest wall and possibly the rib
  • To the chest organs
  • Into the sac around the heart or into the heart muscle
  • To the brain, spine, thyroid, or prostate

Treatment Options for Stage 4

Unfortunately, patients diagnosed with Stage 4 mesothelioma have few treatment options. Surgery is not usually advised due to the health of the patient, the fact that the cancer has spread too much, or the fact that the original tumor is just too large to successfully remove. If surgery is performed, it will focus on debulking, or removing, cancerous tissue to ease symptoms of pleural mesothelioma.

Chemotherapy and radiation are also used at times to provide relief for the patient but can sometimes have side effects that may outweigh the benefits. Multimodal therapy (a combination of surgery, radiation therapy, and chemotherapy) may also be an option. Or patients may be able to sign up for clinical trials that explore promising–but untested–therapies.

Many Stage 4 mesothelioma patients will receive nonsurgical treatments instead. These palliative treatments can help relieve symptoms and attempt to make the patient more comfortable.


Mesothelioma is a fatal disease with a median survival period of about 1 year following diagnosis. Unfortunately, the overall prognosis for Stage 4 mesothelioma is poor and survival time may be months.

Since Stage 4 mesothelioma is the final stage of mesothelioma cancer, it is important for patients to have a good support system in place to help them through this difficult time. Whether or not these individuals decide to receive palliative treatment, a support system consisting of family and loved ones is paramount to their quality of life during the end stage of this disease.


Mesothelioma Symptoms was founded by a team of advocates to educate people about this aggressive form of cancer. Mesothelioma affects thousands of people each year. We help give hope to those impacted by mesothelioma.

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