Stage 4 pleural mesothelioma is the most advanced stage and is very aggressive. Mesothelioma tumors have spread to other organs far from where the cancer started. Treatments like chemotherapy, immunotherapy, and pain-relieving care may help stage 4 patients. Our team can help veterans and civilians get the care they need for mesothelioma stage 4.
What Is Stage 4 Mesothelioma?
Stage 4 mesothelioma is the final stage of this cancer. Mesothelioma starts in the linings of major organs, but by stage 4, distant metastasis (spread) has occurred. This means mesothelioma cells can be found far from where they first formed.
Stage 4 mesothelioma cancer may reach the:
- Bones
- Diaphragm (muscle that helps with breathing)
- Liver and other distant organs
- Lymph nodes
- Opposite lung or chest wall
- Peritoneum (abdominal cavity)
While it is considered the last and most aggressive stage of mesothelioma, long-term survival may be possible for some patients with treatment.
Stage 4 Mesothelioma Quick Facts
- Over 37% of pleural mesothelioma cases are diagnosed at stage 4.
- Surgery is not usually possible, but other treatments like chemotherapy may help.
- The mesothelioma stage 4 prognosis is poor, with patients living for 13.1 months on average.
- The 5-year survival rate is 4.9% for mesothelioma stage 4.
U.S. veterans are at a higher risk of mesothelioma due to military asbestos exposure — and many are diagnosed at stage 4.
Get a Free Veterans Kit to learn how we can help veterans with stage 4 mesothelioma access military benefits, treatments, and compensation.
Stage 4 Pleural Mesothelioma
Malignant pleural mesothelioma forms in the lining of the lungs (pleura). It is the only type of mesothelioma classified into four stages using the tumor node metastasis (TNM) staging system.
In stage 4 pleural mesothelioma, the cancer has spread far from the lung lining, reaching the liver, kidneys, bones, spinal column, and adrenal glands.
Patients with stage 4 pleural mesothelioma may experience significant difficulty breathing due to pleural effusions (fluid buildup in the lung lining), weight loss, pain, and fatigue.
Stage 4 Peritoneal Mesothelioma
Doctors may unofficially consider peritoneal mesothelioma to be in stage 4 if the tumors have spread into major organs within the abdomen. These include the liver, spleen, uterus, and ovaries.
Patients with stage 4 peritoneal mesothelioma may experience significant weight and appetite loss, abdominal swelling, and pain.
Pericardial and Testicular Mesothelioma Stage 4
Pericardial mesothelioma and testicular mesothelioma affect the linings of the heart (pericardium) and testicles (tunica vaginalis), respectively. They are very rare and only informally diagnosed as stage 4.
Stage 4 pericardial mesothelioma can spread past the heart lining and into the chest cavity, causing severe pain and heart-related symptoms. Stage 4 testicular mesothelioma patients may experience swelling and fluid buildup in the scrotum.
Stage 4 Mesothelioma Symptoms
Civilians and veterans with mesothelioma are often not diagnosed until stage 3 or stage 4, as symptoms are vague at first and may not become noticeable until these stages.
Stage 4 mesothelioma symptoms can be severe as a result of the cancer’s spread to other areas of the body.
Common symptoms of stage 4 mesothelioma include:
- Chest pain
- Fatigue
- Fluid buildup in the lung or the abdominal lining
- Night sweats
- Recurring cough and coughing up blood
- Shortness of breath
- Weight loss
These symptoms can make living with stage 4 mesothelioma very difficult — but doctors can recommend ways to manage them and improve quality of life.
Mesothelioma Stage 4 Prognosis
Stage 4 mesothelioma has the least favorable prognosis (health outlook). This stage is hard to treat since the cancer has spread through the body, so patients typically live for a little more than 1 year.
With that said, it may be possible to live outlive the stage 4 mesothelioma prognosis in your case.
Survival Rate of Stage 4 Mesothelioma
Stage 4 mesothelioma cancer survival rates show that only a small percentage of patients are still alive 5 years after a diagnosis.
| Years | Survival Rates |
|---|---|
| 1 year | 36.9% |
| 2 years | 31% |
| 5 years | 4.9% |
Sources: Journal of Clinical Oncology (2024) and National Cancer Database (2022)
Mesothelioma Life Expectancy for Stage 4
The average life expectancy for stage 4 mesothelioma patients is 13.1 months, according to a 2022 review of the National Cancer Database (NCDB). This is the lowest mesothelioma life expectancy of any stage.
However, it may still be possible for you to improve your survival time with end-stage mesothelioma if you get prompt treatment.
Get a Free Veterans Kit to explore cancer treatment options that may help you or a loved one live longer with stage 4 mesothelioma.
Stage 4 Mesothelioma Treatment
Doctors typically treat stage 4 mesothelioma using therapies that shrink or remove cancer tumors. Another important aspect of treatment is palliative care, which are therapies that are designed to relieve pain.
Explore different treatments of stage 4 mesothelioma below to find out how they can help you or a veteran you love.
Stage 4 Mesothelioma Surgery
Most doctors will not perform major mesothelioma surgeries to remove tumors when a patient has reached stage 4, according to the American Cancer Society (ACS).
This is because they won’t be able to safely remove all of the mesothelioma tumors due to the spread of the cancer. However, minor surgeries could help relieve symptoms and other treatments may improve survival time.
Stage 4 Mesothelioma Chemotherapy
Chemotherapy is cancer-killing medication that circulates through the body. It is the main treatment for stage 4 pleural mesothelioma, according to Texas Oncology.
With stage 4 mesothelioma chemotherapy, doctors hope to shrink cancer tumors and destroy cells so patients can live longer and have a better quality of life. Commonly used chemotherapy drugs for mesothelioma include pemetrexed and cisplatin.
“The first treatment was with chemotherapy. I went every two weeks. It didn’t take long, maybe an hour or so, but it took maybe 7-10 days to recover.”
– John Stahl, stage 4 pleural mesothelioma survivor
Call (877) 450-8973 now for help finding the best treatments that may allow you or a loved one to live longer with stage 4 mesothelioma.
Stage 4 Mesothelioma Radiation Therapy
Radiation therapy allows mesothelioma specialists to use beams of energy (like X-rays) to shrink tumors and destroy cancer cells. Radiation therapy may be used alongside chemotherapy in cases of stage 4 mesothelioma to improve survival.
Immunotherapy for Stage 4 Mesothelioma
Immunotherapy is a newer treatment for stage 4 mesothelioma. Medications help boost the body’s immune system response so more of the cancer can be destroyed.
Mesothelioma immunotherapy can be used along with other treatments like chemotherapy to improve patient survival times.
Clinical Trials for Stage 4 Mesothelioma
Stage 4 mesothelioma patients can join clinical trials that safely offer new treatments not available to the general public.
Notable stage 4 mesothelioma clinical trials include:
- Boron Neutron Capture Therapy (BNCT): Doctors will treat late-stage pleural mesothelioma and other advanced cancers with BNCT, which collects boron in tumors before exposing them to neutron radiation.
- CT-95 in Advanced Cancers: This trial is studying the use of a new drug, CT-95, in treating advanced mesothelioma and other cancer tumors.
- Sintilimab for Peritoneal Mesothelioma: Peritoneal mesothelioma patients with advanced cancer will receive a new immunotherapy, sintilimab, along with bevacizumab (Avastin®) and chemotherapy.
Veterans or civilians facing stage 4 mesothelioma can ask their cancer doctors about any clinical trials they may qualify to join.
Palliative Care for Stage 4 Mesothelioma
Doctors can recommend palliative treatments to specifically ease symptoms, allowing stage 4 mesothelioma patients to live more comfortably in the time they have left.
Notable stage 4 palliative mesothelioma treatments include:
- Catheters to ease repeated buildups of fluid that cause pain
- Medications to relieve pain, nausea, and more
- Minor surgeries to reduce tumors
- Thoracentesis or paracentesis to drain fluid buildup
Stage 4 mesothelioma patients may also benefit from hospice care, where professional caregivers are available around the clock to make the end of life as painless as possible.
Stage 4 Mesothelioma Without Treatment
If you have stage 4 mesothelioma, it’s crucial to explore your treatment options. Suffering from stage 4 mesothelioma without treatment can be incredibly painful, both physically and emotionally, and patients may pass away in months.
Choosing to undergo major treatment is a personal decision. If you decide to focus on preserving your quality of life rather than living longer, specialists can recommend a palliative care plan to ensure your symptoms are minimized.
Get a Free Veterans Kit to learn more about benefits, treatments, and compensation that could help you following a stage 4 mesothelioma diagnosis.
Can You Survive Stage 4 Mesothelioma?
It may be possible for you or a loved one to survive for many years with stage 4 mesothelioma despite the cancer’s poor prognosis.
Notable stage 4 mesothelioma survivors include:
- John Stahl, 6+ year survivor: Diagnosed with stage 4 pleural mesothelioma in 2019 after dealing with symptoms like fatigue and severe fluid buildup, John decided to fight the cancer with chemotherapy. The treatments were a success, and John describes himself as “pretty well back to normal” today.
- Quincy Jones, 10+ year survivor: Comedian Quincy Jones received a stage 4 peritoneal mesothelioma diagnosis in 2015. Told to put his affairs in order, he’s still alive today. He receives regular chemotherapy infusions to manage his illness.
These stage 4 mesothelioma survivors show that every patient’s cancer journey is unique — and it may be possible to beat the odds.
“It’s gonna end my life eventually, but I’m gonna live it as well as I can.”
– John Stahl, stage 4 mesothelioma survivor
Get Help for a Stage 4 Mesothelioma
Veterans, civilians, and loved ones don’t need to face a stage 4 mesothelioma diagnosis alone.
The Mesothelioma Veterans Center has assisted thousands of other families affected by this cancer, making life much easier and carrying some of the burden.
We may be able to help you:
- Connect with top doctors and treatments
- File for or increase your VA benefits
- Pursue financial compensation for treatment expenses
Don’t wait: Get a Free Veterans Kit or call (877) 450-8973 now to connect with our team after a stage 4 mesothelioma diagnosis.
Stage 4 Pleural Mesothelioma FAQs
What is the final stage of mesothelioma?
Stage 4 is considered the last stage of mesothelioma. By this point, metastasis (spread to distant parts of the body) has occurred, limiting prognosis and treatment options.
With that said, it still may be possible for some stage 4 mesothelioma patients to live longer if they get care from top doctors.
How long do you live with stage 4 mesothelioma?
The average stage 4 mesothelioma life expectancy is 13.1 months, according to a 2022 review of patient records in the National Cancer Database.
While stage 4 mesothelioma is very aggressive, patients may outlive the average survival time in rare cases. For example, John Stahl is still alive over 6 years after his stage 4 mesothelioma diagnosis, thanks to chemotherapy treatments.
Get a Free Veterans Kit now to explore mesothelioma treatment options and financial compensation for health care expenses.
What is stage 4 peritoneal mesothelioma?
Stage 4 peritoneal mesothelioma is an informal term given to advanced cases. Peritoneal mesothelioma tumors have spread beyond the abdominal lining and affected organs like the liver, spleen, and ovaries.
Mesothelioma doctors can recommend a treatment plan to help shrink stage 4 peritoneal tumors and relieve painful symptoms.
Who is the longest survivor of pleural mesothelioma?
Sissy Hoffman is one of the longest-lived survivors of pleural mesothelioma. Given 6 months to live after her diagnosis in 1996, she survived for nearly 30 years before her passing in 2025.
Paul Kraus is another notable mesothelioma survivor. He developed peritoneal mesothelioma in 1997 but is still alive today.
Finally, Quincy Jones shows that even stage 4 mesothelioma patients can achieve long-term survival. Diagnosed with final-stage mesothelioma in 2015, he has survived for more than a decade thanks to chemotherapy.
What’s the difference between stage 4 mesothelioma and lung cancer?
Stage 4 mesothelioma and stage 4 lung cancer are two very different diseases.
Malignant mesothelioma stage 4 first starts in the linings of the lungs, abdomen, or other areas. Fewer than 5% of patients live for 5 years.
Stage 4 lung cancer affects the lungs directly before spreading. Cases of stage 4 lung cancer have 5-year survival rates ranging from 3-9%, depending on the specific type and other factors.
How can veterans get help after a stage 4 mesothelioma diagnosis?
Contact the Mesothelioma Veterans Center if you or a veteran you love has stage 4 mesothelioma.
Our team can help you and your family explore treatment options, find top doctors, file for VA benefits, and pursue compensation to cover medical expenses if eligible.
A stage 4 mesothelioma diagnosis can be scary, but we will walk with you through each step of the journey.
Can stage 4 mesothelioma be cured?
There’s currently no cure for final-stage mesothelioma or any other type of this cancer. With that said, some stage 4 mesothelioma patients have lived for 10 years or more, depending on how their body responds to treatments.
Doctors can recommend different treatments to improve your overall health and ease symptoms.
