What Are the Signs, Symptoms & Timeline for End-Stage Mesothelioma?

Doctor holding hands with an end-stage mesothelioma patient

If advanced-stage mesothelioma patients progress toward the final stage of cancer, it is important to know what to expect with end-stage mesothelioma. Each prognosis is unique, but some symptoms and changes are more common than others.

As patients near the end, many physical, mental and emotional changes may occur. Some choices, like using palliative care, may help manage these changes. Preparing before death arrives and making decisions in advance may also help patients and their loved ones find some peace.

Stage 3 and stage 4 mesothelioma are both categorized as advanced-stage mesothelioma. Stage 4 is the final mesothelioma stage. But not all patients with advanced or final-stage mesothelioma are nearing death. Doctors can tell patients if their cancer is progressing to this point.

Symptoms of End-Stage Mesothelioma

Mesothelioma symptoms near death are different for each patient. These final stages may last for months, weeks or days. As death approaches, the signs and symptoms may further change or advance.

Common Mesothelioma Final Stage Symptoms

Physical Changes

  • Acute drowsiness, often asleep and difficult to wake up
  • Blurry or dim vision
  • Breath may “rattle” due to excess mucus in throat
  • Cough (dry or bloody)
  • Dark urine
  • Difficulty breathing
  • Exhaustion and weakness
  • Extremities (legs and arms) may be cool
  • Inability to take medicine and pills
  • Irregular and increased heart rate
  • Jerking of hands, arms, legs or face
  • Limited food and fluid intake
  • Low blood pressure
  • Needing help with most things
  • Pain (commonly in chest, neck or stomach)
  • Skin may be cold and unusually damp or dry
  • Slow or irregular breathing
  • Sudden muscle movements
  • Weight loss

Mental & Emotional Changes

  • Anxiety
  • Confusion about people, time or place
  • Delirium
  • Fear
  • Hallucinations
  • Inability to focus
  • Limited or no appetite
  • Loneliness
  • Loss of interest
  • Restlessness
  • Semi-conscious with sudden periods of awareness
  • Short attention span
  • Talking about past events or to people not present
  • Wanting limited visitors

These changes may be difficult for caregivers and loved ones to see. Some symptoms, like mucus buildup, may sound alarming but do not cause patient discomfort. Other symptoms that cause pain or distress may be potentially eased with medication and other measures.

Care for Mesothelioma Patients Nearing Death

In this advanced stage, mesothelioma treatment often focuses on patient comfort and symptom relief. A patient’s oncologist may recommend stopping therapeutic (curative) treatments. This can help reduce therapeutic treatment-related side effects. Instead, palliative care is generally considered beneficial for patients in their final days.

There may be some medications to help ease specific symptoms. Stronger pain relievers, for example, may be available for end-stage mesothelioma patients. Other medications may also help with anxiety, fever, nausea or seizures.

Palliative care is also called hospice care. Patients and their loved ones may choose hospice care at home or in a facility. Their healthcare provider can provide more information about options. Whether at home or in a facility, caregivers can take steps to help their loved one stay comfortable.

Depending on which mesothelioma symptoms near death a patient is experiencing, loved ones can:

  • Administer medications to ease symptoms
  • Avoid forcing a patient to consume food or liquids
  • Avoid sudden noises or movements
  • Bathe the patient, if comfortable for them
  • Leave indirect lights on
  • Pad their bed with layers of disposable, waterproof pads
  • Raise up the patient’s head on pillows
  • Remind them of who is present and when it is
  • Speak with a calming, quiet voice
  • Touch or caress them gently, possibly holding or rocking
  • Turn and change the patient’s position every few hours
  • Use cool, moist washcloths if overheated
  • Warm up a cold patient with blankets

Other actions may be helpful to a patient as they near the end, too. Loved ones can speak with the patient’s doctor for specific insights for health-related advice. Caregivers can also speak with the patient about what they would prefer in their final days.

When To Call Healthcare Providers

Patients with advanced-stage mesothelioma may experience pain and confusion. It can be difficult to know when this pain is expected or especially concerning. Palliative care may also adapt based on a patient’s discomfort levels and life expectancy.

A patient’s healthcare team is there for every step of the process. Caregivers can ask providers about anything they’re worried about or questioning. If they’re in a hospice facility, providers are typically present. If patients are at home, caregivers can call their healthcare team whenever needed.

Preparing and Planning for the Final Mesothelioma Stages

Each mesothelioma patient’s disease progression is unique. Many factors influence if and when a patient will reach the final stages of mesothelioma. While monitoring the patient, their doctor can identify if this time is approaching.

Preparing and planning in advance can be helpful for patients and loved ones. These preparations often involve medical decisions and end-of-life arrangements. Planning these sooner allows the patient to be involved in the decisions, if possible. This helps loved ones know they are honoring the patient’s wishes after they are gone.

It can feel scary to think about these outcomes. But doing so may give loved ones and patients a sense of peace. It may also relieve some stress, knowing difficult decisions have already been made. Healthcare teams often have patient support resources to help guide these conversations.

Some topics to potentially discuss include:

  • Any people the patient would like to see in their final weeks
  • If an intensive care unit (ICU) will be used
  • If antibiotics will be given for infections
  • If a ventilator will be used to continue the patient’s breathing
  • If blood transfusions will be attempted
  • If cardiopulmonary resuscitation (CPR) will be used if the heart and breathing stops
  • If the patient wants a do-not-resuscitate (DNR) order
  • If religious or spiritual practices will be observed
  • Whether to sedate the patient when discomfort becomes too much
  • Which medications their doctor recommends stopping

Lastly, funeral or burial arrangements can also be decided. Healthcare teams often have services available to connect with funeral homes.

Once these decisions are settled, patients and their loved ones can focus on time together. They can also prepare emotionally for what may come. There is no true preparation for grief or loss, but some things can help manage it.

Support for Loved Ones of End-Stage Mesothelioma Patients

Loved ones of advanced-stage mesothelioma patients face many emotional struggles. The prospect of losing a loved one is difficult to process. They may also be caring for the patient in these final days. This devotion and care are worthwhile, but it often comes with added grief or a sense of lost purpose once the patient is gone. Loved ones can access resources to support themselves during this time.

Many cancer centers offer emotional support services, like support groups and therapy. These may be invaluable for loved ones as the patient nears death. Afterwards, funeral arrangements and other obligations may overshadow loved ones’ emotional needs. But therapy and other supportive services can still be deeply important. Grief is not linear, and help is always available.

Common Questions About End-Stage Mesothelioma

How long are the final stages of mesothelioma?

The final stages of mesothelioma vary from patient to patient. Various factors may impact if and when they reach end-stage mesothelioma. Factors include the stage at diagnosis, cancer location and treatment plan. Doctors monitoring disease progression may provide estimates depending on the case.

What happens when someone dies of mesothelioma?

When someone dies of mesothelioma, they may have been exhibiting worsening signs for days or weeks. No longer breathing or having a heartbeat are immediate signs of death. Loved ones can spend time saying goodbye before calling in doctors. Religious or spiritual practices can also be observed. When ready, doctors and other loved ones can be informed.

What are the next steps after someone dies from mesothelioma?

After a patient’s death from mesothelioma, loved ones often begin funerary arrangements. Patients may have already laid out their wishes for these plans. Arrangements may include burial, cremation, memorial service or funeral ceremony. Loved ones may be able to file for mesothelioma compensation, which can help with costs and provide some financial stability during a difficult time.