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Stage 4 Pleural Mesothelioma

Stage 4 is the final and most advanced stage of pleural mesothelioma. Cancer cells and secondary tumors have spread to the opposite side of the chest or to distant sites of the body. Median life expectancy for stage 4 is about one year with treatment.

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Stage 4 pleural mesothelioma is considered unresectable — unable to be removed by surgery —because of advanced tumor spread.

Primary treatments at this stage include chemotherapy and radiation therapy. Emerging therapies such as immunotherapy are also used to control cancer growth, relieve symptoms and improve quality of life.

Life expectancy for stage 4 pleural mesothelioma depends on the patient’s response to treatment and how fast tumors continue to spread. Patients who decide against treatment live an average of six months, while those who undergo treatment survive about 12 months.

Stage 4, or end-stage mesothelioma, is considered terminal. However, treatment breakthroughs have helped some advanced-stage patients outlive their prognosis by years.

Symptoms

Pleural mesothelioma symptoms are most advanced at stage 4 because the cancer has spread well beyond the point of origin. Tumors are no longer isolated to the chest cavity.

Common stage 4 symptoms include:

Symptoms at stage 4 are more intense and typically occur more frequently compared to the earlier stages. Some patients may experience blood problems such as a low red blood cell count (anemia) and high platelet count (thrombocytosis).

Treatment

Tumor-removing surgery is typically not part of the treatment plan for stage 4 pleural mesothelioma. This is because the cancer has spread throughout the chest cavity and possibly to distant sites of the body.

Most patients at this stage are also not healthy enough to undergo aggressive surgical procedures. Oncologists who specialize in treating mesothelioma usually take a palliative approach with stage 4 patients.

Common stage 4 treatment options include:

The goal of these treatments is to slow tumor growth, reduce tumor size and improve a patient’s quality of life.

Some stage 4 pleural mesothelioma patients may qualify for clinical trials testing the latest cancer treatments. These research studies are a great opportunity for patients to get access to promising immunotherapy drugs such as Keytruda (pembrolizumab) and Opdivo (nivolumab) as well as other emerging treatments like gene therapy.

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Stage 4 Pleural Mesothelioma Survivor Stories

A stage 4 pleural mesothelioma diagnosis and the survival statistics that come with it can be devastating. But many survivors have beaten the odds and far outlived their initial prognosis.

Andy Ashcraft

Andy Ashcraft survived for seven years after his stage 4 diagnosis. He enrolled in a clinical trial where he saw positive results taking the immunotherapy drug Amatuximab (MORab-009). He later turned to cannabis oil, which he credited for controlling his tumor growth and managing symptoms.

George Schottl

This Swedish mesothelioma survivor was given just 3 to 6 months to live after his stage 4 diagnosis. Schottl went on to survive nine years thanks to surgery, chemotherapy and a positive outlook.

Lannie Chitwood

Doctors gave Lannie Chitwood a death sentence. He didn’t let that stop him. Chitwood is a rare example of a stage 4 patient being eligible for and finding success with an aggressive surgery. He underwent an extrapleural pneumonectomy, followed by radiation and chemotherapy.

Chitwood survived 10 years after his 2007 diagnosis, spending much of that time fishing, traveling and cherishing moments with his five grandchildren.


Dr. Snehal Smart

Snehal Smart

Snehal Smart is the Pleural Mesothelioma Center’s in-house medical doctor, serving as both an experienced Patient Advocate and an expert medical writer for the website. When she is not providing one-on-one assistance to patients, Dr. Snehal stays current on the latest medical research, reading peer-reviewed studies and interviewing oncologists to learn about advancements in diagnostic tools and cancer treatments.

Medically Reviewed By Dr. Joanne Getsy
Last Modified January 8, 2019

4 Cited Article Sources

  1. Stage 4 Pleural Mesothelioma Survivor Stories

    A stage 4 pleural mesothelioma diagnosis and the survival statistics that come with it can be devastating. But many survivors have beaten the odds and far outlived their initial prognosis.

    Andy Ashcraft

    Andy Ashcraft survived for seven years after his stage 4 diagnosis. He enrolled in a clinical trial where he saw positive results taking the immunotherapy drug Amatuximab (MORab-009). He later turned to cannabis oil, which he credited for controlling his tumor growth and managing symptoms.

    George Schottl

    This Swedish mesothelioma survivor was given just 3 to 6 months to live after his stage 4 diagnosis. Schottl went on to survive nine years thanks to surgery, chemotherapy and a positive outlook.

    Lannie Chitwood

    Doctors gave Lannie Chitwood a death sentence. He didn’t let that stop him. Chitwood is a rare example of a stage 4 patient being eligible for and finding success with an aggressive surgery. He underwent an extrapleural pneumonectomy, followed by radiation and chemotherapy.

    Chitwood survived 10 years after his 2007 diagnosis, spending much of that time fishing, traveling and cherishing moments with his five grandchildren.

    http://www.cancer.org/cancer/malignantmesothelioma/detailedguide/malignant-mesothelioma-staging
  2. Bonomi, M. (2017, August 18). Clinical staging of malignant pleural mesothelioma: current perspectives. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5571821/
  3. UMN Comprehensive Cancer Center. (n.d.). Stage IV/Recurrent Malignant Pleural Mesothelioma. Retrieved from http://cancer.unm.edu/cancer/cancer-info/types-of-cancer/mesothelioma/stage-iv-recurrent-malignant-pleural-mesothelioma/
  4. American Cancer Society. (2016, February 17). Palliative Procedures for Malignant Mesothelioma. Retrieved from http://www.cancer.org/cancer/malignantmesothelioma/detailedguide/malignant-mesothelioma-treating-palliative-procedures

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