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In 1890 Biggs reported a case of ‘endothelioma’ of the pleura. This report may have been the first recognised case of malignant mesothelioma in North America. Since then the incidence of mesothelioma in North America and the world has steadily climbed.
Studies of the incidence of mesothelioma in North America have been hampered by a paucity of data. Before 1988, the United States did not even have a specific code for mesothelioma, so many cases were misclassified on death certificates as lung cancers or abdominal cancers. In the United States, the best estimates of mesothelioma incidence are derived from the Surveillance, Epidemiology and End Results (SEER) Program of the National Cancer Institute. The SEER database includes about 9.5 per cent of the United States population. It covers 10 regional areas, in five states (Connecticut, Iowa, New Mexico, Utah and Hawaii), and five major urban areas – San Francisco–Oakland, New Orleans, Seattle, Atlanta, and Detroit.
There is some modest evidence that immunotherapy for malignant mesothelioma is possible; atlanta mesothelioma side effects: however we need to develop better regimes to deliver the cytokines to the local tumour environment which do not cause significant side effects. It is also impor- tant to perform other studies in conjunction with other therapeutic modalities such as chemotherapy, gene therapy and cytoreductive surgical debulking to see whether com- bination therapy will be more successful. We also need to determine the optimal method to deliver cytokines . There is some evidence to suggest that continuous cytokine delivery via intratumoral or intracavitary catheters is more effective. The animal models suggest that other agents such as IL-12 are likely to be important and may hold promise.

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