Butchart Staging System
Over the years, there have been a few different systems designed to help doctors determine the stage of an asbestos cancer patient’s disease. The one that was developed first and is used most often by physicians in the U.S. who specialize in the treatment of this cancer is the Butchart System. This system was developed in 1976 by Dr. Eric Butchart. Though it is more than 30 years old, it remains, in the opinion of most U.S. oncologists and thoracic surgeons, the most dependable and accurate way to measure how far mesothelioma has progressed in the body. This particular staging system defines where the tumor is located but doesn’t take into consideration other factors such as tumor burden.
Provided below are the four stages that mesothelioma can progress though as defined in the Butchart Staging System:
- Stage 1: Mesothelioma is present within the right or left pleura, and may also involve the lung, pericardium, or diaphragm (the muscle separating the chest from the abdomen) on the same side.
- Stage 2: Mesothelioma invades the chest wall or involves the esophagus (food passage connecting the throat to the stomach), heart, or pleura on both sides. The lymph nodes in the chest may also be involved.
- Stage 3: Mesothelioma has penetrated through the diaphragm into the peritoneum (lining of the abdominal cavity). Lymph nodes beyond those in the chest may also be involved.
- Stage 4: There is evidence of distant metastases (spread through the bloodstream to other organs).
By this time, little can be done to control any further spread of the disease and the patient is usually provided with palliative treatments to keep them as comfortable as possible.
As mentioned above, the original Butchart staging system is still used most often to describe the spread of pleural mesothelioma even though the recently developed TNM Staging System is more detailed and precise. Understanding these staging systems for mesothelioma is important both for estimating and better understanding prognosis, and also for assessing therapeutic options.
National Cancer Institute - Stages of Malignant Mesothelioma
David J. Sugarbaker and JoseJ. Norberto. “Multimodality Management of Malignant Pleural Mesothelioma.” Chest 1998