Stage 4 Pleural Mesothelioma

This is the last stage of the disease and past the point of curative treatment. Read on about how this stage differs from the others while discovering your symptoms, treatment, and prognosis options.

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What’s Stage 4 Pleural Mesothelioma?

Of the three types of mesothelioma, malignant pleural mesothelioma (MPM) is the most common and only type with a formal staging system. With MPM, a physician will stage cancer based on a few criteria established by the American Joint Committee on Cancer (AJCC). These criteria are also called the TNM system, apply only to MPM, and rely on three pieces of information about the patient’s health.

  1. Size of the initial tumor (T).
  2. Advancement to lymph nodes (N).
  3. Spread of the tumor to distant organs (metastasis) (M).

The TNM system relays necessary details on where the cancer is in the patient’s body, coupled with numbers that doctors can use to differentiate levels of development.

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Stage 4 Progression

If the doctor establishes a diagnosis as late as stage 4, the disease has a shallow success rate for curative treatments. Most procedures will revolve around palliative care methods or improving mesothelioma symptoms and quality of life for the patient. The TNM scale puts stage 4 pleural mesothelioma into one section.

Stage 4

  • Primary tumor no longer resectable
  • Advancement to nearby lymph nodes and lymphatic system
  • Tumors spread to distant organs such as bones, liver, lung, peritoneum, or pleura

Symptoms and Treatment

Patients with stage 4 pleural mesothelioma typically experience the most developed symptoms, however, symptoms will vary depending on exactly where the cancer is located within the body. Fortunately, your oncologist can recommend medications or treatments to lessen symptoms.

Stage 4 symptoms include:

  • Body aches
  • Chest pain or tightness
  • Chronic fatigue
  • Dyspnea (shortness of breath)
  • Excessive weight-loss
  • Fluid buildup
  • Fever
  • Persistent bloody cough
  • Night sweats

Limited treatment is available for stage 4 pleural mesothelioma due to the tumor’s advancement. Resection surgery is typically not an option, and doctors may lean towards palliative care moving forward. Chemotherapy, radiation, immunotherapy, and clinical trials may still be available to stage 4 patients as a method of pain management. Seeking a second opinion after the initial diagnosis can also sometimes be helpful.

Life Expectancy and Prognosis

After the doctor has made an official diagnosis, they’ll inform the patient of their life expectancy and prognosis. Oncologists determine this information based on the data of other diagnosed patients with similar conditions. How long other patients have survived after their initial diagnosis will determine the life expectancy, while the anticipated progression of the disease is the prognosis.

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Stage 4 MPM survival rates for patients are reduced, with life expectancy at about one year. However, each patient’s case is unique and can turn out different than anticipated. Researchers are developing treatment options that may improve life expectancy through clinical trials. Patients can also make small lifestyle changes recommended by the doctor to improve their mesothelioma prognosis. Diet and exercise habits have a substantial effect on general health.


Small, dietary changes can vastly help a prognosis. When a patient makes positive changes to their diet, they are building up their body’s strength and resistance to symptoms and side-effects of mesothelioma and treatment. Patients could make strides towards eliminating oils and avoiding processed sugars while increasing the intake of vegetables, fruits, grains, fluids, and high in protein foods. Other toxic substances to avoid are cigarettes and alcohol, cigarettes have an extremely negative impact on the lungs.


A prognosis can be improved by moderate exercise that gets the heart pumping. Physical activity has been proven to reduce fatigue and stress while helping to regulate pain and promote healthy blood flow. A little over two hours of aerobic work every week with a few days of muscle activity can help, but the doctor’s recommendations coupled with the patient’s comfort levels should be what guide’s the workout regimen.

There are a few other factors that can weigh in on a person’s life expectancy and prognosis. While the stage of cancer is important, other variables that make a difference:

  • Age of the patient
  • Whether the patient is male or female
  • Mesothelioma tumor subtype
  • LDH blood levels
  • Red blood cell, white blood cell, and platelet count

Stage 4 pleural mesothelioma is the most difficult stage for a patient due to extreme symptoms, but an oncologist can develop a palliative treatment plan to aid the patient in lessening those symptoms and increasing the quality of their remaining time.