Stage 4 mesothelioma

Stage 4 malignant mesothelioma indicates that the cancer has spread to distant parts of the body. Treatment options aim to improve survival and quality of life. Stage 4 mesothelioma patients usually have a life expectancy of about one year.

Based on the four-tier classification system used to classify mesothelioma, this is the most advanced step. The cancer has spread beyond the point of origin to distant tissues, organs and lymph nodes, causing severe symptoms.

Stage 4 mesothelioma by type

Determining the stage of mesothelioma in a patient helps doctors understand the extent of the disease and the available treatment options. Pleural mesothelioma has the most diagnosed cases, allowing specialists to establish three types of staging systems: the Butchart System, the Brigham System and the TNM System, which are the most common. The other three types of mesothelioma are less common and do not have their own staging system. Specialists therefore rely on the general characteristics of stage 4 mesothelioma to classify the disease.

Stage 4 pleural mesothelioma

According to the TNM system, stage 4 malignant pleural mesothelioma indicates that cancer cells have spread beyond the pleura to distant organs, tissues, and lymph nodes. Stage 4 mesothelioma cancer is characterized by distant metastasis.

According to the American Cancer Society, the 2-year survival rate of stage 4 pleural mesothelioma is about 17% and the 5-year survival rate is less than 1%.

Stage 4 peritoneal mesothelioma

Many mesothelioma specialists use the Peritoneal Cancer Index (PCI), a staging system for all cancers of the abdomen, to treat mesothelioma in the peritoneum. This system examines different areas of the abdomen and classifies the tumors numerically according to their size and extent. The scores are then summed to determine the stage. A score of 31 to 39 indicates stage 4 peritoneal mesothelioma.

At this point, the tumors have spread outside the immediate peritoneal region, probably to the nearby and distant lymph nodes, throughout the abdominal cavity and chest wall as well as to other distant tissues and organs. 

Stage 4 pericardial mesothelioma

As with peritoneal mesothelioma, there is no formal stage determination system for pericardial mesothelioma and physicians use general staging guidelines to determine the stage at the time of diagnosis. Because of its rarity, the disease is almost never detected before entering the final stages of mesothelioma, and this particular form of cancer is often diagnosed posthumously during an autopsy.

Stage 4 pericardial mesothelioma usually consists of the spread of tumors outside the pericardium and throughout the chest cavity, possibly to other parts of the body, such as the abdomen or esophagus.

Stage 4 Testicular Mesothelioma

Testicular mesothelioma is diagnosed in less than 1% of cases, leaving specialists with little information on the staging of the disease. Specialists rely on other tools to treat mesothelioma of the tunica vaginalis and seek spread to distant organs and tissues, as well as distant lymph node involvement.

Symptoms of Stage 4 Mesothelioma

Mesothelioma symptoms may worsen as the disease progresses and Stage 4 symptoms can be severe. New symptoms may also appear when the cancer affects other areas of the body. To address these symptoms, it is important that patients receive palliative care in addition to the treatments they are subjected to.

Common Symptoms of Stage 4 Mesothelioma

• general feeling of discomfort or fatigue

• difficulty breathing and shortness of breath (dyspnea)

• Dysphagia (difficulty swallowing)

• chest pain and tightness

•Night sweats

• Fever

• abdominal pain and discomfort

• accumulation of fluid in the chest or abdomen

• unexplained weight loss

Prognosis of stage 4 mesothelioma

Stage 4 mesothelioma has the least favorable prognosis due to the extent of disease spread and the deterioration of the patient's health. The life expectancy at stage 4 of mesothelioma is usually around one year. In addition to mesothelioma assessment, the patient's prognosis also depends on age, gender, general health status and cell type. Statistics can help patients understand the typical progression of the disease, but each diagnosis is different.

For malignant pleural mesothelioma, the most common form, the 2-year survival rate is about 17% and the 5-year survival rate is less than 1%. Although the prognosis is poor, new diagnostic tools are helping to detect the disease early, and new treatment options have been shown to prolong the life expectancy of patients, even with advanced mesothelioma.

Treatment of stage 4 mesothelioma

Treatment of patients with stage 4 mesothelioma is limited because aggressive surgery has no role to play. Depending on the case, patients may still be able to undergo minor surgeries as palliative treatments to relieve symptoms and discomfort.

• Surgery: Palliative minimally invasive surgeries such as thoracentesis, pleurodesis, and paracentesis can drain fluid accumulation and help with breathing and pain.

• Chemotherapy: Intravenous chemotherapy options such as pemetrexed, cisplatin and bevacizumab are used to prolong life and improve quality of life. Immunotherapy treatments have also become standard options after chemotherapy.

• Radiation therapy: Radiation therapy is less common in advanced stages of cancer, but it can be used as a palliative to reduce tumors and reduce symptoms such as chest pain and breathing difficulties.

Patients with mesothelioma may decide to continue experimental treatments and clinical trials after a stage 4 diagnosis. Patients and their families should discuss all options when working with their doctor to determine the best treatment plan for their condition. them.