Free Mesothelioma Information Packet

Stage 4 Mesothelioma

Cancer, in general, is staged according to a variety of systems. The ones most often used for the staging of mesothelioma include the Butchart, TNM, and Brigham systems. Each indicates something a little different about each stage of the disease but the systems are fairly consistent across the board.

Stage 4 mesothelioma is the most advanced form of the cancer and offers a poor prognosis with little chance for survival beyond a few months. In this case, the disease has traveled from the primary site to distant locations. Hence, Stage 4 cancer is sometimes referred to as Distant Metastatic Cancer. In the case of mesothelioma, it usually spreads throughout the chest cavity, into the abdomen, and may travel to the brain as well. Lymph nodes are extensively involved.

In regards to staging with the various systems, Stage 4 is indicated as follows:

  • Butchart System – In this oldest staging system that is the most common one used for measuring the severity of malignant pleural mesothelioma, Stage 4 indicates that the disease has spread through the bloodstream to distant organs.
  • TNM System – In this “Tumor, Nodes, Metastasis” system of staging, Stage 4 refers to the fact that the tumor has metastasized to the other side of the body. For example, both lungs may now be affected. Often, the organs in the neck are now involved and the lymph nodes – both nearby and distant – are affected as well.
  • Brigham System – In this newest staging system that looks at whether tumors can be removed surgically and whether lymph nodes are affected, Stage 4 indicates that surgery is no longer a possibility because of the spread of the disease and the likelihood for recurrence if tumors were indeed removed.

Treatment of Stage 4 Mesothelioma

As this is considered “end stage” cancer, there are few treatment options left at this point and certainly none that offer the potential for cure. Basically, the patient is in very bad health at this point and too weak to withstand anything but palliative therapies designed to relieve pain and ease breathing. Treatments like chemotherapy should be carefully considered when recommended as the side effects can be debilitating and little success will result from taking advantage of the treatment at this stage.

Families of the victim should begin to consider end-of-life issues at this point if they have not already done so, including wills and funeral plans.


Last modified: April 13, 2010.