Kaposi Sarcoma (KS), AIDS/HIV

HIV/AIDS - Infection, Drugs, Epidemic, Africa

Kaposi sarcoma (KS), a very rare form of skin cancer, is one of the most visible signs of AIDS. In fact, it literally became the face of AIDS, back in the early 80s.

Remember Tom Hanks’ character in the film Philadelphia? The Kaposi’s sarcoma on his face was the one thing that alerted his prejudiced colleague to the fact that he had full blown AIDS.

Even today the cancer is the one outward indicator of the illness. It can affect anyone with a weakened immune system but is rarely seen in someone who is not infected with HIV.

Kaposi sarcoma is caused by a herpes virus known as the Human Herpes Virus 8 which is sexually transmitted. Once in the body it sets about creating tiny new blood vessels in a process called angiogenesis. It is these tiny blood vessels which make up the lesions or tumors known as KS.

These lesions can be a range of pinks, purples or reds and are generally flat and painless. To look at they are very similar to a bruise but as they develop they can become raised and several can join together to form large elevated patches. Unlike bruises they don’t turn white when pressed.

They vary from person to person. In some people their growth is very slow but in others, new ones can appear every day. The face, arms and legs are the most common places.

Within HIV circles Kaposi’s sarcoma is far more common among men than women – eight men are affected to every one woman so it’s very much regarded as a man’s disease.

If the Kaposi sarcoma remains on the skin and the cancer cells haven’t invaded the lymph nodes, the illness is not life threatening. It can be cosmetically disfiguring and patches on the soles of the feet or on the legs can make walking painful.

Generally doctors prefer to leave the KS alone if they are restricted to the skin and are not causing any problem. But for appearances sake they can be treated with liquid nitrogen, which will freeze them off, or injected with the anti cancer drug vincristine which can shrink them. Highly active antiretroviral therapy (HAART) can stop their growth and sometimes clear up the lesions.

If KS has spread to the lymph nodes it is likely that it will move on (or “metastasize”) to somewhere else in the body like the stomach or lungs. The most serious place is the lungs where the damage will cause shortness of breath and possibly an increase of fluid which can be fatal. At this stage chemotherapy is the standard treatment. Combinations of chemo drugs such as vincristine, etoposide and doxorubicin have proved highly effective.

Like any treatment for cancer, there are side effects and the cure can sometimes be worse than the original problem. Certainly chemotherapy can cause, nausea, weight and hair loss and radiotherapy can cause burning on the skin.

Another new treatment for advanced Kaposi’s sarcoma involves liposome drugs. These are chemotherapy drugs put inside tiny bubbles of fat called liposomes and injected into the body. Some chemotherapy side effects are reduced using these drugs.

Note: The name Kaposi’s sarcoma is derived from the name of a Hungarian researcher who first identified the condition in 1872, more than a century before the world woke up to HIV and AIDS.



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