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Stage 4 Near Death Symptoms of Malignant Mesothelioma

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Stage 4 near-death mesothelioma involves cancer spreading or metastasizing to distant organs, lymph nodes, and tissues. This is the most serious stage of the disease, and treatments are intended mostly to reduce pain and improve quality of life. Most patients with stage 4, near-death mesothelioma live one year or less. (Cancer.org)

When cancer has spread to such distant areas of the body, treatment options are limited. In most cases, surgery is no longer possible. However, patients with this final stage of mesothelioma can receive palliative care and ease their pain. Clinical trials also may be available for stage 4 mesothelioma patients.

Stage 4 Near Death Mesothelioma Cancer Symptoms

At stage 4, the typical symptoms of mesothelioma have grown more severe and can become unbearable. Because the tumors have spread outside the lungs or abdomen, the symptoms are not just isolated to the chest or abdominal cavities.

Some of the common symptoms of stage 4 mesothelioma include the following:

  • Extreme shortness of breath
  • Abdominal pain
  • Pain and tightness in the chest
  • Night sweats and fever
  • Loss of mobility
  • Hard to swallow – dysphagia
  • Coughing up blood
  • Fatigue
  • Severe loss of weight
  • Feeling of malaise

Some stage 4 patients also suffer from cachexia. This is a syndrome that involves loss of weight, atrophy in the muscles, appetite loss, and weakness. This stage of cancer also could cause blood problems, including a high platelet count and low red blood cell count.

Another common symptom of near-death mesothelioma is pleural effusion. This is a build-up of fluid in the chest cavity around the lungs. The excess fluid makes it more difficult to breathe. If this happens to you, your surgeon may perform a procedure that drains some of the fluid from your chest so you can breathe better.

In patients with peritoneal mesothelioma in the abdomen, the fluid build-up is called peritoneal effusion.

Types of Stage 4 Mesothelioma Cancer

Below is more information about stage four of these specific cancer types.

Pleural Mesothelioma

This is the most common type of the disease, comprising approximately 75% of mesothelioma cases. In stage 4 pleural mesothelioma, the most common characteristic of the disease is distant metastasis. Metastasis involves cancer cells spreading outside of the pleura or lung lining.

Metastasis most often occurs in the:

  • Bones
  • Liver
  • Lung on the other side
  • Lymph nodes
  • The lining of the abdomen

Once pleural mesothelioma is in stage 4, the five-year survival rate is approximately 4%.

Peritoneal Mesothelioma

At stage 4 of peritoneal of mesothelioma, tumors have spread outside the abdomen. Metastasis may occur in the:

  • Chest wall
  • Lymph nodes all over the body
  • Other distant organs and tissues

While peritoneal mesothelioma is very serious, people with this form of the disease tend to live longer than those with pleural mesothelioma. The 5-year survival rate for stage 4 peritoneal mesothelioma is approximately 30%.

Pericardial Mesothelioma

Pericardial mesothelioma is extremely rare and it is seldom detected before the near-death final stages. This type of mesothelioma is often diagnosed after the patient dies. Stage 4 pericardial mesothelioma can spread to the:

  • Abdomen
  • Chest cavity
  • Esophagus
  • Organs and tissues outside the heart lining

Testicular Mesothelioma

Testicular mesothelioma is also very rare and accounts for only 1% of all mesothelioma diagnoses. It is possible for stage 4 testicular mesothelioma to spread to distant lymph nodes, tissues, and organs.

Stage 4 Near Death Mesothelioma Cancer Treatment Options

Once mesothelioma reaches stage 4, treatment options are much more limited. However, standard mesothelioma treatments may be used to make the patient more comfortable and to improve their quality of life.


Palliative care for near-death mesothelioma can include minimally invasive surgical procedures. These treatments are used to drain fluid buildup:

  • Thoracentesis: Removes fluid from the pleural space with a needle so it is easier to breathe.
  • Pleurodesis: Closes the pleural space so fluid cannot build up. This surgery can be done chemically or mechanically.
  • Paracentesis: Removes fluid from the abdomen. A catheter may be inserted to drain fluid over the long term.


Chemotherapy can be used in some patients to improve their quality of life. Common chemotherapy drugs for stage 4 mesothelioma are pemetrexed, cisplatin, and bevacizumab. Chemotherapy can reduce the size of the tumors and make it easier for the patient and to move around without pain.


Radiation is not used as often for advanced-stage mesothelioma. It may be an option for some patients to reduce the size of tumors to ease discomfort. The treatment also can reduce trouble breathing and chest pain.

Recently, radiation treatment has been developed for end-stage pleural mesothelioma patients called SMART, or Surgery for Mesothelioma After Radiation Therapy. The idea is to reduce the size of the tumors dramatically with radiation and follow it with EPP surgery to remove the damaged lung. Radiologists use higher than normal doses of radiation to shrink the tumors. The overall, three-year survival rate for this surgery in one study was an impressive 84%.

Clinical Trials

Near-death mesothelioma patients may be able to participate in clinical trials. Some of the studies that are showing promise include photodynamic therapy. (Annalsthoracicsurgery.org)

Alternative Therapies

Stage 4 mesothelioma patients may turn to alternative therapies to ease pain and improve quality of life. Some options are massage, herbal remedies, acupuncture and yoga.

Get Mesothelioma Help Immediately

A patient with stage 4 mesothelioma has a poor prognosis in most cases. However, there are treatments available to reduce symptoms, improve quality of life, and ease the pain. Talk to your doctor about your treatment options so that your near-death mesothelioma symptoms are more manageable.

With over $30 billion available for victims through the Asbestos Trust Funds, did you know you could be entitled to financial compensations without ever filing a lawsuit? Mesothelioma & Lung Cancer victims qualify immediately. Complete the form or call us toll-free (800) 352-0871


  • Photodynamic Therapy in Thoracic Surgery. (2002). Retrieved from https://www.annalsthoracicsurgery.org/article/S0003-4975(01)03369-0/fulltext
  • Detection and Diagnosis of Malignant Mesothelioma. (n.d.). Retrieved https://www.cancer.org/cancer/malignant-mesothelioma/detection-diagnosis-staging/staging.html
  • Mesothelioma Stage 4. Retrieved from https://www.mesotheliomaveterans.org/mesothelioma/pleural/stage-4/