Stage 4 Mesothelioma

Mesothelioma Stage 4 Symptoms

Patients have the most advanced symptoms during the final stage of malignant pleural mesothelioma.

Common symptoms of stage 4 pleural mesothelioma include:

• Difficulty breathing
• Chest pain
• Coughing up blood
• Fever
• Lack of appetite
• Loss of mobility
• Night sweats
• Pain when breathing
• Shortness of breath
• Significant weight loss

Patients may have suffered some of these symptoms in the cancer’s earlier stages. When mesothelioma reaches its fourth stage, existing symptoms will have worsened.

If you are suffering from any of these symptoms and were exposed to asbestos years ago, see a cancer specialist immediately. Mesothelioma is highly aggressive at any stage. The sooner you are formally diagnosed, the sooner you can start treatment to potentially improve life expectancy and/or ease symptoms.

Stage 4 Mesothelioma Types

Only pleural mesothelioma has its own formal staging system and is broken up into four stages. All other types do not officially have staging systems. Doctors can look to see how far a patient’s cancer has spread if they have one of these other types.

Stage 4 Pleural Mesothelioma

Pleural mesothelioma tumors first form in the lining of the lungs. By stage 4, the cancer may have invaded the lungs, lymph nodes, and other major organs like the liver.

While stage 4 pleural mesothelioma often has a poor outlook, there is hope. Veterans can get low-cost or free treatment from pleural mesothelioma specialists with decades of experience through the VA.

Specialists can offer treatments to ease symptoms of mesothelioma and potentially help patients live longer in some cases.

Staging Systems for Pleural Mesothelioma

Doctors classify cases of pleural mesothelioma into different stages using the Tumor Node Metastasis (TNM) staging system. The TNM staging system looks at how big a tumor is, if it has spread to lymph nodes, and if it has metastasized throughout the body.

Other mesothelioma staging systems include the Brigham and Butchart systems. However, these are rarely used today in the United States.

Stage 4 Peritoneal Mesothelioma

Peritoneal mesothelioma, which forms in the abdominal cavity, is not usually classified in stages. Instead, doctors will see if cancerous tumors have spread throughout the abdomen to determine the extent of the disease. Though it rarely spreads outside of the abdomen, peritoneal mesothelioma can still be fatal.

In cases of advanced peritoneal mesothelioma, patients often suffer from symptoms like swelling in the abdomen, fever, and weight loss.

Stage 4 Pericardial Mesothelioma

Pericardial mesothelioma, which forms in the heart lining, cannot be broken down into different stages since it is so rare. Instead, doctors will use the diagnostic process to see how far the cancer has spread.

Cases of advanced or late-stage pericardial mesothelioma can spread into lymph nodes and organs like the kidneys or lungs. Sadly, 80-90% of all pericardial mesothelioma cases are diagnosed only after patients have died as the cancer advances rapidly in a short span of time.

Stage 4 Testicular Mesothelioma

Doctors do not use an official staging system for testicular mesothelioma. This cancer, which develops in the lining of the testicles, is extremely rare — there have only been a few hundred reported cases in total.

In advanced cases of testicular mesothelioma, tumors may appear in lymph nodes and organs like the lungs.

Stage 4 Mesothelioma Diagnosis

Doctors can see if a patient has mesothelioma — and if so, what stage the cancer is in — with several diagnostic tests.

Doctors typically start with imaging tests such as CT (computed tomography) scans, MRI (magnetic resonance imaging) scans, and PET (positron emission tomography) scans. These tests can locate possibly cancerous tumors based on how far they have spread throughout the body.

For example, PET scans use radioactive sugar to identify cancer tumors. Cancer cells absorb these substances faster than healthy cells and will show up as highlighted areas on the PET scan.

Amy FairRegistered Nurse
20+ years helping mesothelioma victims

“…I can see what other parts and major organs this disease is in, I can really have an honest discussion with them. I can say, ‘Look, this is a stage four. It’s not operable, you’re not going to be a surgical candidate. So let’s talk about another therapy.”

Chat now with our trusted advocates to learn more about what therapies may be available for you or your loved one.

If doctors think a patient has mesothelioma after conducting imaging scans, they’ll perform a biopsy. A biopsy is the only way to confirm a patient has mesothelioma. Doctors take a sample of the possibly cancerous tumor and look at it under a microscope to see if cancerous cells are present.

Once a stage 4 mesothelioma diagnosis has been confirmed, doctors can develop a cancer treatment plan to help the patient live with less pain.

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Stage 4 Mesothelioma Prognosis

Patients with stage 4 mesothelioma often have the worst prognosis because the cancer has already spread throughout the body. The average life expectancy of stage 4 mesothelioma patients is just 12 months.

However, it’s important to know that some patients may defy the odds and live longer. The key to outliving an initially poor prognosis is by getting treatments from top doctors.

Mesothelioma Stage 4 Treatments

While stage 4 mesothelioma is highly advanced, treatments are still available to help patients. Most of these treatments are considered pain-relieving (palliative) and may help some patients live longer.

Stage 4 Mesothelioma Surgery

Patients with stage 4 mesothelioma may not be able to undergo major surgeries used to extend the life of early-stage patients. By this point, the cancer is so widespread that the risks of the surgery may outweigh the benefits.

However, minor palliative mesothelioma surgeries may still be an option.

“Palliative surgery may be an option if the tumor has already spread beyond where it started and would be hard to remove completely. It may also be used if you’re too ill for a more extensive operation. The goal of this surgery is to ease or prevent symptoms, not to cure the cancer.”

– American Cancer Society

For example, doctors can remove the lining of the lungs in patients with stage 4 pleural mesothelioma to help them breathe easier. Doctors can also use debulking surgeries to reduce the size of cancerous tumors, but not remove them altogether.

Stage 4 Chemotherapy

Chemotherapy (cancer-killing medication) is often the main treatment method used for stage 4 mesothelioma cases.

Your doctor probably won’t use an aggressive dose of chemotherapy, meaning you can avoid serious side effects from the treatment. Instead, your doctor will want to lessen the size of tumors and prevent them from spreading if possible. This will help you to stay comfortable for a longer amount of time.

Chemotherapy drugs can be used to treat stage 4 pleural mesothelioma and advanced cases of all other mesothelioma types.

Mesothelioma Stage 4 Radiation Therapy

The Texas Oncology health care system notes that radiation therapy is not frequently used to help stage IV mesothelioma patients, although it can relieve some symptoms like chest pain.

For example, radiation therapy can shrink larger cancerous tumors without the need for surgery. The ACS also notes that radiation treatment can help clear buildups in a patient’s breathing tube.

Other Palliative Care Options

Doctors can explore additional palliative treatment options besides chemotherapy, surgery, and radiation therapy to help stage 4 mesothelioma patients live with less pain.

Other palliative mesothelioma treatments include:

• Chest fluid drainFluid buildup in the lining of the lungs are called pleural effusions. Doctors can insert a needle to draw out the fluid in the lungs to expand freely. It also reduces pain when breathing and makes it easier to get deep breaths.
• MedicationsMedications can help patients suffer from less nausea, pain, fatigue, or other symptoms caused by their cancer. The ACS notes that mesothelioma patients can receive pain-relieving drugs like morphine without major side effects in many cases.
• PleurodesisThis procedure helps prevent pleural effusions that keep coming back. Doctors inject talc between the inner and outer linings of your affected lung. The talc fills the space where fluid would gather.

Clinical Trials

Clinical trials allow doctors to test new and potentially effective treatments for mesothelioma with the hopes of improving patient lifespans or even finding a cure.

Some stage 4 pleural mesothelioma patients lived for months or years past their initial prognosis thanks to clinical trials.

For example, some stage 4 mesothelioma patients who had Surgery for Mesothelioma After Radiation Therapy (SMART) lived longer than 3 years in a recent clinical trial.

This trial combined radiation therapy with a lung-removal surgery called an extrapleural pneumonectomy (EPP), which is normally not available to stage 4 patients.

Over the course of the trial, 10 stage 3 patients and 13 stage 4 mesothelioma patients had this treatment combination. The overall 3-year survival rate of the patients was 84%. The stage 4 patients in this study effectively tripled their survival times.

Get a free veterans packet to learn how clinical trials and other mesothelioma treatments can help you.

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• Top Treatment
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• Improving Prognosis

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Next Steps for Veterans With Stage 4 Mesothelioma

If you or a loved one has stage 4 mesothelioma, every second counts. Thankfully, whether you were diagnosed at stage 4 or your disease has recently progressed to this stage, you have options.

• Get treatment

  Skilled mesothelioma doctors can ease your symptoms and possibly help you live longer with different treatments. Veterans with stage 4 mesothelioma can seek treatment from civilian doctors and those partnered with the VA.

• Get VA benefits & compensation

  Veterans with mesothelioma may qualify for monthly financial payouts from the VA, as well as legal compensation from the makers of asbestos-based products. The average mesothelioma legal claim awards $1 million.

• Receive end-of-life support

  End-stage cancer support options like hospice care can be very helpful. On-staff caregivers at hospice facilities focus on relieving pain and making the patient feel as comfortable as possible.

Get a free veterans packet now to learn more about your options after a stage 4 mesothelioma diagnosis.