Stage IV Mesothelioma Treatment

In Stage IV, mesothelioma treatment focus changes to end-of-life care, emotional support and management of physical symptoms. Invasive surgery may offer temporary relief from pain, but is not recommended for this late stage of malignant mesothelioma.

What is Stage IV Mesothelioma?

Stage IV Mesothelioma is terminal. The cancer has spread to vital organs through the lymphatic system and blood stream. Tumors occur beyond the point of origin in the pleura, pericardium or peritoneum. The removal of large or primary tumors may provide comfort, but at this stage, removing all tumors from affected tissues is impossible and does not prevent future metastasizing.
With Stage IV Pleural Mesothelioma, the entire lung (s) may be involved, along with the esophagus and lymph nodes in the neck and under the arms.
With Stage IV Pericardial Mesothelioma, the cancer may have metastasized beyond the heart into the chest cavity. Through the blood stream, mesothelioma may travel to remote parts of the body.
With Stage IV Peritoneal Mesothelioma, not only does the cancer spread throughout the entire abdominal cavity, it may have metastasized to nearby lymph nodes in the groin and to other organs.
At this stage, metastasized cells may have penetrated organs near the original site.

What are the Common Treatments for Stage III Mesothelioma?

Surgery / Radiation / Chemotherapy

Conventional multimodal treatment plans that combine surgery, radiation and chemotherapy are not typically used for Stage IV Mesothelioma patients. They are, however, sometimes used for pain management reasons.
Surgery may remove the primary tumor, but it does not guarantee relief from further metastasizing or reoccurrence.
With pleural mesothelioma, surgery may remove the primary tumor to ease pressure on the lungs and improve breathing. Similarly, surgery for pericardial and peritoneal mesothelioma may reduce pressure on the heart and abdomen and provide pain relief.
Chemotherapy may lessen pain for some patients, but at this advanced stage of mesothelioma, there are considerable risks. In some cases, after removing the primary tumor, chemotherapy may help slow metastasizing.
A Stage IV prognosis is terminal and the treatment plan is palliative rather than curative.

Thoracentesis / Paracentesis / Pericardiocentesis

Draining excess fluid from the affected areas may provide symptomatic relief but is not a curative option for Stage IV Mesothelioma.
Thoracentesis drains excess fluid in the lungs; paracentesis drains excess fluid in the abdomen; and pericardiocentesis drains fluid from the heart.
These procedures, however, may only provide temporary relief because there is a significant risk for fluid buildup to reoccur.

Palliative Care

With advanced stages of mesothelioma, treatment turns to palliative care, ensuring that the patient is pain free and comfortable.
Hospice care provides a dignified option for some Stage IV Mesothelioma patients. Quality of life is a primary goal of hospice care along with providing necessary emotional support not only for the patient but for loved ones as well.
Integrating alternative options with palliative care may provide additional physical, emotional and spiritual support. For those with Stage IV Mesothelioma, meditation or art therapy may provide a necessary emotional outlet and help cope with the terminal nature of the disease. Other alternative mesothelioma treatments may not be appropriate for Stage IV Mesothelioma patients because many of them require movement.